British journal of anaesthesia
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Editorial Comment
Minimally invasive cardiac output monitoring: what evidence do we need?
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Comparative Study
Performance of electroencephalogram-derived parameters in prediction of depth of anaesthesia in a rabbit model.
The index of consciousness (IoC), the permutation entropy (PE), and the approximate entropy are recent EEG-derived indices of anaesthetic depth. In this study, a rabbit model under fentanyl and isoflurane anaesthesia was used to compare the performance of these indices and also the classic median and spectral edge frequency 95%. ⋯ The IoC and PE are promising indices for anaesthetic depth monitoring. The PE might benefit from the application of a burst suppression correction at deeper stages of anaesthesia. The rabbit is useful as a translational research animal model for the validation of clinical indices.
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Dyspnoea is the result of a complex interaction of physiological, psychosocial, social, and environmental factors. Although several sensory receptors located throughout the respiratory system are considered to be responsible for generation of dyspnoea, there is no afferent receptor solely responsible for the sensation of dyspnoea. Afferent information from the sensory receptors is processed at the cortex along with the respiratory motor command from the cortex and brainstem, and a mismatch between the motor command and the incoming afferent information may result in dyspnoea. ⋯ Recent neuroimaging studies suggest that neural structures subserving pain and dyspnoea might be shared, and therefore the neurophysiological and psychophysical approaches used to understand pain can be applied to dyspnoea research. Although effective treatment of dyspnoea remains an elusive goal at the moment, a better understanding of the pathophysiology and neurophysiology of dyspnoea may provide a rationale for effective therapy of dyspnoea. In this context, treatment strategies in dyspnoea should be similar to those used in pain.