Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparison of autologous transfusion procedures in hip surgery].
The risks associated with transfusion can be minimized with autologous blood. The efficiency of preoperative deposit, preoperative hemodilution and intra- and postoperative autotransfusion in reducing homologous transfusions has been demonstrated. There seem to be few studies, however, that compared the different methods of autologous transfusion. ⋯ CONCLUSION. Under the conditions studied, preoperative autologous deposit was the most efficient method of autologous transfusion for hip arthroplasty. It should be employed primarily.
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Randomized Controlled Trial Comparative Study Clinical Trial
[The use of ketamine and midazolam for analgesia and sedation in ventilated patients subject to obligatory treatment with catecholamines].
This study was undertaken to compare two regimens for analgesic sedation in intensive care patients with exogenous catecholamine therapy, giving special regard to catecholamine demand and hemodynamic parameters. A total of 20 ventilated patients in a surgical intensive care unit were investigated in a prospectively randomized design. Exogenous catecholamine therapy with epinephrine and/or norepinephrine was started at systolic pressure (SAP) less than 85 mmHg or mean arterial pressure (MAP) less than 65 mmHg to maintain cardiovascular function. ⋯ In time course, PAP increased by about 5 mmHg in the ketamine group but not in the fentanyl group (P = 0.009). The average central venous pressure (CVP) was 12 mmHg in both groups. At the end of the investigation, CVP decreased in the fentanyl group and increased in the ketamine group (P = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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In 1985 Brain et al. published their first experience with the laryngeal mask, developed by themselves. With this mask it is possible to seal the larynx and ventilate a patient during anesthesia without endotracheal intubation. Meanwhile, further reports of successful use have been published, especially in Great Britain. ⋯ Our investigation confirmed the previously described advantages of the laryngeal mask. We consider its use to be especially indicated in general anesthesia for short surgical or diagnostic procedures or if specific complications of endotracheal intubation should be avoided. A critical aspect in the use of the laryngeal mask is the fact that there is no complete isolation of the trachea and, therefore, an insufflation of the stomach or aspiration could occur, especially during critical situations (e.g. bronchospasms).(ABSTRACT TRUNCATED AT 250 WORDS)
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Review Comparative Study
[The meaningfulness of central venous blood samples. Central venous versus mixed venous O2 status].
Both mixed-venous and "central-venous" oxygen status (O2 partial pressure [pO2], O2 saturation [sO2], O2 concentration [cO2], hemoglobin concentration [cHb]) are often considered to adequately represent total-body oxygen supply. Since modern technology has made continuously in vivo measurement possible, mixed-venous O2 saturation (svO2) and partial O2 saturation (psO2) have become extensively used for that purpose. Both venous sites of measurement are used as diagnostic adjuncts regarding hemodynamic status. ⋯ The best parameters for interpreting the cardiovascular situation seem to be arteriovenous O2 difference (avDO2) and C. O. In particular, the avDO2 can be accepted as an integrating parameter for AO2 and QO2, and may therefore serve as a diagnostic indication of cardiovascular imbalance.