Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[The accuracy of 4 different oximeters for continuous monitoring of mixed venous oxygen saturation during abdominal aortic surgery].
Several systems for mixed-venous oximetry are now available. There are one three-wave-length system (Abbott) and three two-wave-length systems with (Spectramed) and without automatic correction for hemoglobin or hematocrit (Edwards). The purpose of this prospective randomized study was to compare the different systems and to examine the accuracy of continuous mixed-venous oximetry during abdominal aortic surgery. ⋯ Data sets were obtained at eight predetermined times. Hemoglobin was kept constant at +/- 1 g.dl-1. Continuous oximetry in comparison to in-vitro measurements yielded a correlation coefficient of r = 0.873 (P less than 0.0001) and a value of bias and precision (b +/- p) of -0.9 +/- 2.6% for the SAT-1, r = 0.815 (P less than or equal to 0.0001) and b +/- p = -2.2 +/- 2.5% for the SAT-2, r = 0.901 (P less than or equal to 0.0001) and b +/- p = 0.35 +/- 2.5% for the Hemopro2, and r = 0.920 (P less than or equal to 0.0001) and b +/- p = 0.1 +/- 1.8% for the Oximetrix 3, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
[Atropine in the premedication of patients at risk. Its effect on hemodynamics and salivation during intubation anesthesia using succinylcholine].
Should atropine be administered for premedication? This question continues to be controversial; in particular, the combined administration of atropine and succinylcholine has been investigated with conflicting results by numerous researchers. The present study was carried out to assess the effect of premedication with atropine on hemodynamic variables and salivation in patients assigned to ASA class II and III. METHODS. ⋯ No increase in heart rate occurred in the control groups during tracheal intubation. Neither i.m. nor i.v. atropine had any significant effect on blood pressure. Arrhythmias occurred in a few cases with both routes of administration; several instances of marked tachycardia were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
[Successful therapy of a cardiac arrest during accidental hypothermia using extracorporeal circulation].
We report the case of a 59-year-old woman suffering from profound accidental hypothermia promoted by intoxication with codeine, sedatives, and a beta-blocking agent ingested in a suicidal attempt. Treatment was further complicated by ventricular fibrillation and asystole that was refractory to therapeutic interventions. The comatose patient (Glasgow score 3) was found outdoors in rainy weather--environmental temperature approximately 10 degrees C (50 degrees F)--by children. ⋯ After 110 min of extracorporeal circulation (ECC, flow 4.5 l/min) normothermia was achieved and the asystole reverted spontaneously to sinus rhythm. The patient's course was subsequently complicated by worsening pulmonary gas exchange with signs of pulmonary edema on X-ray films and cardiac failure, which was treated successfully with epinephrine and dopamine. No neurological deficits were detectable after consciousness had returned.(ABSTRACT TRUNCATED AT 250 WORDS)