British journal of anaesthesia
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Desflurane triggers post-conditioning in the diabetic human myocardium. We determined whether protein kinase C (PKC), mitochondrial adenosine triphosphate-sensitive potassium (mitoK(ATP)) channels, Akt, and glycogen synthase kinase-3β (GSK-3β) were involved in the in vitro desflurane-induced post-conditioning of human myocardium from patients with type 2 diabetes. ⋯ Desflurane-induced post-conditioning in human myocardium from patients with type 2 diabetes was mediated by the activation of PKC, the opening of the mitoK(ATP) channels, and the phosphorylation of Akt and GSK-3β.
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Central venous catheter (CVC) placement under ECG guidance in the left thoracocervical area can lead to catheter misplacement. The aim of this study was to identify the cause and quantify the magnitude of this error. ⋯ CVC placement under ECG guidance is a reliable method to site the line tip at the optimal position. However, when using a left-sided thoracocervical access point, the Seldinger wire-conducted ECG delivered a constant error. This could be adjusted for by advancing the CVC 20 mm in addition to the wire-based measurement of the insertion depth at the left IJ vein and 10 mm at the left SC vein.
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Post-dural puncture headache (PDPH) might be related to cerebrospinal fluid hypotension. Studies in brain-injured patients have shown a good relationship between optic nerve sheath diameter (ONSD) measured by ocular sonography and invasively measured intracranial pressure (ICP). The aim of this study was to evaluate changes in ONSD after lumbar epidural blood patch (EBP). ⋯ In this preliminary report, EBP was followed by ONSD enlargement in subjects with successful EBP, but not in the subject with EBP failure. Since ONSD is a surrogate marker of ICP, this suggests that a sustained increase in ICP is associated with successful EBP.