British journal of anaesthesia
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Editorial Observational Study
Volatile sedation with sevoflurane in intensive care patients with acute stroke or subarachnoid haemorrhage using AnaConDa®: an observational study†.
The anaesthetic conserving device, AnaConDa(®), allows use of inhaled anaesthetics for sedation in the intensive care unit. We prospectively measured cerebral and cardiopulmonary parameters in patients with acute stroke or subarachnoid haemorrhage during a switch from i.v. to inhalative sedation. ⋯ Sevoflurane led to sufficient sedation, but decreased MAP and CPP in a selected cerebrovascular neurocritical care population. In about a third of these patients, severe adverse reactions, including intolerable ICP increases, were observed.
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Randomized Controlled Trial Comparative Study
Randomized trial of anaesthetic interventions in external cephalic version for breech presentation.
Spinal anaesthesia improves the success of external cephalic version for breech presentation during pregnancy.
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Pandemic influenza presents a major threat to global health and socioeconomic well-being. Future demand for critical care may outstrip supply and force clinicians to triage patients for admission. We evaluated the Simple Triage Scoring System (STSS), Ontario Health Plan for an Influenza Epidemic (OHPIP) and PaO2 /FiO2 (P/F) ratio to determine utility in predicting need for mechanical ventilation. ⋯ The P/F ratio was a better predictor of need for mechanical ventilation than STSS. The P/F ratio is a simple and accepted determinant of hypoxaemia and should be used if secondary triaging becomes necessary during future influenza pandemics.
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Clinical Trial Observational Study
High-sensitive cardiac troponin T measurements in prediction of non-cardiac complications after major abdominal surgery.
Postoperative non-cardiac complication rates are as high as 11-28% after high-risk abdominal procedures. Emerging evidence indicates that postoperative cardiac troponin T elevations are associated with adverse outcome in non-cardiac surgery. The aim of this study was to determine the relationship between postoperative high-sensitive cardiac troponin T elevations and non-cardiac complications in patients after major abdominal surgery. ⋯ NCT02150486.
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Clinical Trial Observational Study
The Effect of beta-blockade on objectively measured physical fitness in patients with abdominal aortic aneurysms - A blinded interventional study.
Perioperative beta-blockade is widely used, especially before vascular surgery; however, its impact on exercise performance assessed using cardiopulmonary exercise testing (CPET) in this group is unknown. We hypothesized that beta-blocker therapy would significantly improve CPET-derived physical fitness in this group. ⋯ NCT 02106286.