Medical science monitor : international medical journal of experimental and clinical research
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Comparative Study Clinical Trial
The pleth variability index as an indicator of the central extracellular fluid volume in mechanically ventilated patients after anesthesia induction: comparison with initial distribution volume of glucose.
The pleth variability index (PVI) has been demonstrated to be a useful, noninvasive indicator of continuous fluid responsiveness. Whether PVI can be used to assess the changes of intravascular volume status remains to be elucidated. ⋯ Our results show that strong correlations exist among IDVG, PVI, PPV, and SPV in the evaluation of volemia. PVI can serve as a useful, noninvasive indicator of continuous central extracellular fluid volume for those patients not requiring invasive hemodynamic monitoring, but needs attention to changes in intravascular volume status for optimal fluid management.
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Randomized Controlled Trial
Sidestream capnographic monitoring reduces the incidence of arterial oxygen desaturation during propofol ambulatory anesthesia for surgical abortion.
This study investigated whether early intervention based on additional use of sidestream capnography could reduce the incidence of oxygen desaturation and hypoxic events in patients receiving propofol anesthesia during surgical abortion. ⋯ Sidestream capnographic monitoring improves early detection of alterations in ventilation parameters and reduces the incidence of oxygen desaturation and hypoxemia resulting from propofol anesthesia during surgical abortion.
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Comparative Study Clinical Trial
To clarify features of photoplethysmography in monitoring balanced anesthesia, compared with Cerebral State Index.
Although photoplethysmography and cerebral state index (CSI) have been used as indices in monitoring vital signs perioperatively, there are only a few reports comparing the performance of photoplethysmography with CSI in monitoring anaesthesia depth. The aim of the present study was to clarify features of photoplethysmography in monitoring balanced general anesthesia compared with CSI. ⋯ The present study shows that photoplethysmography-derived parameters appear to be more suitable in monitoring the nociceptive component of balanced general anesthesia, while CSI performs well in detecting the sedation or hypnotic component of balanced general anesthesia.
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Advances in intensive care medicine have enormously improved ability to successfully treat seriously ill patients. However, intensive treatment and prolongation of life is not always in the patient's best interest, and many ethical dilemmas arise in end-of-life (EOL) situations. We aimed to assess intensive care unit (ICU) physicians' experiences with EOL decision making and to compare the responses according to ICU type. ⋯ Limitation of LST was regularly used by Slovene ICU physicians. DNR orders and withholding of LST were the most commonly used measures. Hydration was only rarely terminated. In addition, use of advance directives was almost non-existent in practice, and the patients' relatives and nurses only infrequently participated in the decision making.
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Randomized Controlled Trial
Local airway anesthesia attenuates hemodynamic responses to intubation and extubation in hypertensive surgical patients.
The aim of this study was to evaluate the effects of topical ropivacaine anesthesia on hemodynamic responses during intubation and extubation of hypertensive patients. ⋯ Topical lidocaine and ropivacaine anesthesia can effectively reduce hemodynamic responses during intubation, with ropivacaine better at inhibiting hemodynamic changes at emergence in hypertensive patients.