British journal of anaesthesia
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Patients undergoing carotid endarterectomy require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. In this study we tested whether non-invasive beat-to-beat Nexfin finger BP (BPfin) can replace invasive beat-to-beat radial artery BP (BPrad) in this setting. ⋯ NCT01451294.
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Automated titration of propofol and remifentanil guided by the bispectral index (BIS) has been used for numerous surgical procedures. Orthotopic liver transplantation (OLT) uniquely combines major changes in circulating volume, an anhepatic phase, and ischaemia-reperfusion syndrome. We assessed the behaviour of this automated controller during OLT. ⋯ This pilot study indicates that automated titration of propofol and remifentanil guided by the BIS is feasible during OLT.
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Randomized Controlled Trial Comparative Study
A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks.
Posterior variants of abdominal wall block include the quadratus lumborum type I, quadratus lumborum type II and quadratus lumborum transmuscular blocks. Our objectives were to compare the spread of injectate and nerve involvement, after conducting blocks using ultrasound guidance in soft embalmed cadavers. ⋯ Consistent spread to lumbar nerve roots was achieved using the transmuscular approach through the quadratus lumborum.
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Tracheal intubation in critically ill patients is a high-risk procedure. The risk of complications increases with repeated or prolonged attempts, making expedient first attempt success the goal for airway management in these patients. ⋯ Operator-related factors such as experience, device selection, and pharmacologic choices affect the odds of a successful intubation on the first attempt. This review will discuss the 'difficult airway' in critically ill patients and highlight recent advances in airway management that have been shown to improve first attempt success and decrease adverse events associated with the intubation of critically ill patients.