Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2013
The LMA-Supreme™ as an intubation conduit in patients with known difficult airways: a prospective evaluation study.
Many extraglottic airway devices allow the direct passage of an adult-sized tracheal tube, but this is not possible with the LMA-Supreme(TM) . We evaluated the feasibility of using the LMA-Supreme(TM) as a conduit for intubation in patients with known difficult airways. ⋯ We conclude that the LMA-Supreme(TM) is a successful conduit for bronchoscopic/Aintree Intubation Catheter-guided intubation in patients with known difficult airway.
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Acta Anaesthesiol Scand · Jan 2013
Multicenter StudyHypersensitivity reactions to Patent Blue V in breast cancer surgery: a prospective multicentre study.
An increasing number of immediate hypersensitivity reactions (HSR) have been reported after the use of Patent Blue V (PBV) for breast cancer surgery. This is the first study to publish prospective data with systematic allergological assessment. ⋯ An incidence rate of one in 300 HSR to PBV was observed for patients exposed to PBV during sentinel lymph node detection. This rate is higher than rates reported after the use of neuromuscular blocking agents, latex or antibiotics.
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Acta Anaesthesiol Scand · Jan 2013
ReviewFluid therapy in uncontrolled hemorrhage--what experimental models have taught us.
Intravenous fluid is life-saving in hypovolemic shock, but fluid sometimes aggravates the bleeding. During the past 25 years, animal models have helped our understanding of the mechanisms involved in this unexpected effect. A key issue is that vasoconstriction is insufficient to arrest the bleeding when damage is made to a major blood vessel. 'Uncontrolled hemorrhage' is rather stopped by a blood clot formed at the outside surface of the vessel, and the immature clot is sensitive to mechanical and chemical interactions. ⋯ Uncontrolled hemorrhage models in rats, except for the 'cut-tail' model, confirm the results from swine. To avoid rebleeding, fluid programs should not aim to fully restore the arterial pressure, blood flow rates, or blood volume. For a hemorrhage of 1000 ml, computer simulations show that deliberate hypovolemia (-300 ml) would be achieved by infusing 600-750 ml crystalloid fluid over 20-30 min or 100 ml of HSD over 10-20 min in an adult male.
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Acta Anaesthesiol Scand · Jan 2013
Intensive care and traumatic brain injury after the introduction of a treatment protocol: a prospective study.
Traumatic brain injury (TBI) treatment protocols have been introduced in the intensive care unit (ICU) to avoid secondary brain injury. In this study, we aimed to evaluate the deviations from such a treatment protocol and the frequency of extracranial complications, and relate these findings to outcome. ⋯ Deviations from the TBI treatment protocol were frequent. Pneumonia was the most frequent extracranial complication. Age, GCS score, pupil dilation, ISS, high ICP, hyperglycaemia and pneumonia predicted a worse outcome.
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Acta Anaesthesiol Scand · Jan 2013
Prevalence of saphenous nerve injury after adductor-canal-blockade in patients receiving total knee arthroplasty.
Adductor-canal-blockade is a new technique for pain relief after knee surgery. This block could cause nerve injury and the aim of this follow-up study was to determine the prevalence of saphenous nerve injury in patients receiving adductor-canal-blockade for pain treatment after total knee arthroplasty. ⋯ We found no indications of saphenous nerve injury caused by the adductor-canal-blockade at the mid-thigh level. However, 84% of the patients had signs of injury to the infrapatellar branch of the saphenous nerve in the operated leg. Such findings are well-known complications to the surgical procedure.