British journal of anaesthesia
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Regional cerebral oxygen saturation (S(ct)O(2)) has recently been shown to decrease significantly during thoracic surgery. The present study investigates whether these desaturations are related to postoperative complications. ⋯ Thoracic surgery with SLV seemed to be associated with a significant decrease in S(ct)O(2), and minimal S(ct)O(2) values correlated positively with postoperative complications.
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The aim of this prospective study was to determine whether a level of positive airway pressure was generated in participants receiving nasal high flow (NHF) delivered by the Optiflow system (Fisher and Paykel Healthcare Ltd, Auckland, New Zealand) in a cardiothoracic and vascular intensive care unit (ICU). ⋯ This study demonstrated that a low level of positive pressure was generated with NHF at 35 litre min(-1) of gas flow. This is consistent with results obtained in healthy volunteers. Australian Clinical Trials Registry www.actr.org.au ACTRN012606000139572.
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Randomized Controlled Trial
Effects of maintaining a remifentanil infusion on the recovery profiles during emergence from anaesthesia and tracheal extubation.
Emergence from anaesthesia and tracheal extubation can be associated with hyperdynamic circulatory responses. We examined the effects of maintaining a remifentanil infusion on recovery profiles such as coughing and cardiovascular responses after general anaesthesia. ⋯ Maintaining a remifentanil infusion reduced haemodynamic changes and coughing associated with tracheal extubation almost without significantly delaying recovery from anaesthesia.
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Pentraxin-3 (PTX3) may be a useful biomarker in sepsis, but its regulatory mechanisms are still unclear. Oxidative stress is well defined in patients with sepsis and has a role in regulation of inflammatory pathways which may include PTX3. We undertook an in vitro study of the effect of antioxidants on regulation of PTX3 in endothelial cells combined with a prospective observational pilot study of PTX3 in relation to markers of antioxidant capacity and oxidative stress in patients with sepsis. ⋯ PTX3 expression is down-regulated in vitro by antioxidants. Plasma levels of PTX3 are elevated in sepsis but seem to be unrelated to markers of oxidant stress or antioxidant capacity.
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Comparative Study
Comparison of a supra-sternal cardiac output monitor (USCOM) with the pulmonary artery catheter.
Cardiac output (CO) cannot reliably be estimated by clinical examination. We aimed to measure the agreement between CO measurements using a supra-sternal Doppler monitor (USCOM, Coffs Harbour, Australia) and the pulmonary artery catheter (PAC). ⋯ In our subjects, there was poor agreement between CO measurements done with the supra-sternal Doppler monitor and PAC.