British journal of anaesthesia
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Clinicians performing orotracheal intubation need to be competent to perform this technical skill safely. It is recognized that aggressive force applied during direct laryngoscopy may damage the oropharyngeal soft tissue; however, force is seldom considered in assessment of competency. The objective of this study was to explore the force applied during orotracheal intubation as a method of further discriminating between levels of competence. We sought evidence of construct validity in the form of discriminant, criterion, and concurrent validity. We hypothesized that the force generated during simulated intubation could serve to discriminate skill level among clinicians. ⋯ Force exerted during intubation provides meaningful information when attempting to discriminate intubation skill level. Force demonstrated criterion validity and could be used as a measure of competency during training.
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Comparative Study Clinical Trial
Comparison of Bispectral Index and Entropy values with electroencephalogram during surgical anaesthesia with sevoflurane.
Concomitantly recorded Bispectral Index® (BIS) and Entropy™ values sometimes show discordant trends during general anaesthesia. Previously, no attempt had been made to discover which EEG characteristics cause discrepancies between BIS and Entropy. We compared BIS and Entropy values, and analysed the changes in the raw EEG signal during surgical anaesthesia with sevoflurane. ⋯ NCT01077674.
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Randomized Controlled Trial
Perioperative myocardial injury in patients receiving cardiac output-guided haemodynamic therapy: a substudy of the OPTIMISE Trial.
Evidence suggests that cardiac output-guided haemodynamic therapy algorithms improve outcomes after high-risk surgery, but there is some concern that this could promote acute myocardial injury. We evaluated the incidence of myocardial injury in a perioperative goal-directed therapy trial. ⋯ Myocardial injury is common among patients undergoing major gastrointestinal surgery. In this study, the frequency was not affected by cardiac output-guided fluid and low-dose inotropic therapy.
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Clinical Trial
Referred pain and cutaneous responses from deep tissue electrical pain stimulation in the groin.
Persistent postherniotomy pain is located around the scar and external inguinal ring and is often described as deep rather than cutaneous, with frequent complaints of pain in adjacent areas. Whether this pain is due to local pathology or referred/projected pain is unknown, hindering mechanism-based treatment. ⋯ Our results corroborate a systematic relationship between deep pain and changes in cutaneous nociception. The individual referred/projected pain patterns and cutaneous responses are variable, but reproducible, supporting individual differences in anatomy and sensory processing. Future studies investigating the responses to deep tissue electrical stimulation in persistent postherniotomy pain patients may advance our understanding of underlying pathophysiological mechanisms and strategies for treatment and prevention.
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Clinical Trial
Strong ion and weak acid analysis in severe preeclampsia: potential clinical significance†.
The influence of common disturbances seen in preeclampsia, such as changes in strong ions and weak acids (particularly albumin) on acid-base status, has not been fully elucidated. The aims of this study were to provide a comprehensive acid-base analysis in severe preeclampsia and to identify potential new biological predictors of disease severity. ⋯ clinicaltrials.gov: NCT 02164370.