British journal of anaesthesia
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Comparative Study
Comparison of the accuracy of the lithium dilution technique with the thermodilution technique for measurement of cardiac output.
A new indicator dilution technique for measurement of cardiac output is described. Lithium chloride is injected via a central venous catheter and its dilution curve measured in arterial blood using a lithium-selective electrode. We assessed the lithium dilution cardiac output measurement (LiDCO) and a conventional thermodilution cardiac output measurement (ThDCO) by comparing the results of both with cardiac output determined by electromagnetic flowmetry (EMCO) under controlled laboratory conditions in 10 swine. ⋯ The correlation coefficient between LiDCO and EMCO (0.95) was higher than that between ThDCO and EMCO (0.87). The precision value of LiDCO (0.04) was significantly less (i.e. better) than that of ThDCO (0.09). The results of this study indicated that LiDCO was more reliable compared with conventional ThDCO.
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A new prototype of the laryngeal mask airway (LMA), the intubating laryngeal mask airway (ILMA), was used to facilitate tracheal intubation in 100 fasted patients presenting for elective surgery. Alignment of the ILMA with the larynx was assessed fibreoptically before intubation without the investigator performing the intubation being aware of the view score. ⋯ Of the seven intubation failures, five occurred in the first 20 patients. Conventional connection to the breathing system and ventilation of the lungs of the patients were possible throughout the intubation procedure.
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The standard laryngeal mask airway (LMA) functions both as a ventilatory device and as an aid to blind/fibrescopic-guided tracheal intubation. We describe the radiological and laboratory work used to bioengineer a new laryngeal mask prototype, the intubating laryngeal mask airway (ILMA). ⋯ Development was aided by analysis of magnetic resonance images of the human pharynx and laboratory testing with a variety of tracheal tubes. The principal features of this new system are an anatomically curved, rigid airway tube with an integral guiding handle, an epiglottic elevating bar replacing the mask bars, a guiding ramp built into the floor of the mask aperture and a modified silicone tracheal tube developed for use with the device.
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Randomized Controlled Trial Clinical Trial
Prevention of hypothermia by cutaneous warming with new electric blankets during abdominal surgery.
We have evaluated the efficacy of new electric warming blankets, which meet the requirements of the international standard for perioperative electrical and thermal safety, in preventing intraoperative hypothermia. We studied 18 patients undergoing abdominal surgery, allocated to one of two groups: in the control group, there was no prevention of intraoperative hypothermia (n = 8) and in the electric blanket group, two electric blankets covered the legs and upper body (n = 10). ⋯ Five patients shivered in the control group compared with one in the electric blanket group (P < 0.05). We conclude that cutaneous warming with electric blankets was an effective means of preventing intraoperative hypothermia during prolonged abdominal surgery.