Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2013
Review Meta AnalysisPeripherally inserted central catheters in infants and children - indications, techniques, complications and clinical recommendations.
Venous access required both for blood sampling and for the delivery of medicines and nutrition is an integral element in the care of sick infants and children. Peripherally inserted central catheters (PICCs) have been shown to be a valuable alternative to traditional central venous devices in adults and neonates. However, the evidence may not extrapolate directly to older paediatric patients. ⋯ Assisted visualisation, preferably with ultrasound, yields high rates of insertion success. With good catheter care, rates of mechanical, infectious and thrombotic complications are low and compare favourably with those of traditional central venous catheters. Even in the case of occlusion or infection, fibrinolytics and antibiotic locks often allow the catheter to be retained.
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Acta Anaesthesiol Scand · Mar 2013
PaO2 oscillations caused by cyclic alveolar recruitment can be monitored in pig buccal mucosa microcirculation.
Cyclic alveolar recruitment and derecruitment play a role in the pathomechanism of acute lung injury and may lead to arterial partial pressure of oxygen (PaO(2) ) oscillations within the respiratory cycle. It remains unknown, however, if these PaO(2) oscillations are transmitted to the microcirculation. The present study investigates if PaO(2) oscillations can be detected in the pig buccal mucosa microcirculation. ⋯ The present study suggests that PaO(2) oscillations caused by cyclic recruitment and derecruitment were transmitted to the buccal mucosa microcirculation. This non-invasive approach of measuring oxygen waves as a surrogate parameter of cyclic recruitment and derecruitment could be used to monitor PaO(2) oscillations at the bedside.
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Acta Anaesthesiol Scand · Mar 2013
Patient perspectives on informed consent for anaesthesia and surgery: American attitudes.
Principles of informed consent are ethically, morally, and legally grounded in physicians' responsibility to patients. This study examined patient expectations regarding the informed consent during the perioperative process, specifically risk information exchange, preferred method and timing of delivery, and the roles that patient anxiety and understanding might play. ⋯ Greater awareness of patient preferences and expectations may result in better information exchange between anaesthesia providers and their patients.