Anaesthesia
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A 13-year-old girl was admitted to the intensive care unit with status asthmaticus. Conventional bronchodilator therapy failed to relieve her bronchospasm. ⋯ She regained consciousness 30 minutes after the end of the infusion and became well orientated after one hour. Ketamine is a useful drug in the intensive treatment of status asthmaticus and should be tried before a decision is taken to start mechanical ventilation.
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We present here clinical data from 993 patients who were destined to undergo elective Caesarean section under epidural analgesia. In 29 cases the attempt to provide an epidural was abandoned before the operation started. In regard to this, the importance of monitoring the fetal heart rate during initiation of the epidural is emphasised. ⋯ Characteristics of the data did not permit a close analysis of the main factors which could have led to an episode of maternal hypotension. However, it did appear that such an episode could be ascribed to too brief an interval between the first and second, or the second and third top-up doses. The frequency with which blood was transfused during operation was markedly lower than that noted in a concurrent series of elective sections conducted under general anaesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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We applied positive end expiratory pressure to the nondependent, nonventilated lung, or both nondependent and dependent, ventilated lung during one lung anaesthesia, and compared the results to those obtained by other techniques, such as increasing the inspired oxygen concentration in the dependent lung, or insufflating with oxygen using positive end expiratory pressure in the nondependent lung. Our study suggests that arterial oxygenation and intrapulmonary shunt can be lessened during one lung ventilation by continuous oxygen insufflation of the nondependent lung at 0.98 kPa positive end expiratory pressure while the dependent lung is ventilated with 0.49 kPa positive end expiratory pressure.