British journal of anaesthesia
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Case Reports
Venous air embolism: ultrasonographic diagnosis and treatment with hyperbaric oxygen therapy.
A man with neuromuscular respiratory failure requiring intubation and ventilation suffered a venous air embolism during inadvertent administration of 5 ml of air. Ultrasound (US) imaging confirmed an air embolus in the left subclavian vein, which was only partially treated by US-guided aspiration. ⋯ Venous air embolism is under-recognised, and can cause siginificant neurological morbidity and death if untreated. When available, urgent hyperbaric oxygen therapy appears to be an effective approach.
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Near infrared spectroscopy (NIRS) is widely used to monitor regional cerebral tissue oxygenation (rScO2). We compared rScO2 values during cardiac surgery in patients with or without new cerebral ischaemic lesions on diffusion weighted magnetic resonance imaging (DWI). We hypothesised patients with new cerebral lesions would have impaired tissue oxygenation reflected in their rScO2 values. ⋯ NCT 02185885.
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Anaesthetic medication administration errors are a significant threat to patient safety. In 2002, we began collecting data about the rate and nature of anaesthetic medication errors and implemented a variety of measures to reduce errors. ⋯ Reforms intended to reduce medication errors were associated with substantial improvement.