Anaesthesia
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Comment Letter Comparative Study
Comparison of the Macintosh and McCoy laryngoscope blades.
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Randomized Controlled Trial Clinical Trial
A non-rebreathing coaxial anaesthesia system: dependence of end-tidal gas concentrations on fresh gas flow and tidal volume.
A non-rebreathing adaptation of the Bain coaxial anaesthesia circuit was developed in Nepal as a simple and economical anaesthetic system for underdeveloped countries. It was made by inserting a coaxial (Bain) tubing between an Ambu-E valve and an Ambu self-inflating bag. The present study examined the dependence of end-tidal gas concentrations on fresh gas flow and tidal volume during halothane/oxygen/air inhalation anaesthesia. ⋯ With increasing fresh gas flow rates, there were proportionate increases in the end-tidal concentrations of oxygen and halothane; with decreasing tidal volume and therefore less air dilution, there were proportionate increases in the end-tidal concentrations of carbon dioxide, oxygen and halothane. Both effects were statistically and clinically significant. Thus, when this system is used as described, the end-tidal concentrations of oxygen and halothane are highly dependent upon both the fresh gas flow and the tidal volume.
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The Short Form 36 was used to compare critically ill patients' premorbid quality of life with normal values and investigate any changes following 6 months convalescence. One hundred and sixty-six survivors completed the Short Form 36 at discharge from intensive care. The answers given by survivors were significantly lower than normal for all dimensions. ⋯ After 6 months, 95 questionnaires were returned. Patients who had suffered acute pathologies reported significant decreases in quality of life whilst other patients with pre-existing ill health reported significant improvement with reduced pain and better mental health, vitality and social function. This study suggests that quality of life of most patients admitted to intensive care is not as good as in the normal population but does not deteriorate except for those patients admitted after acute life-threatening events.