British journal of anaesthesia
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The elderly are perceived as a high-risk group for procedural sedation. Concern exists regarding the safety of sedation of this patient group by emergency physicians, particularly when using propofol. ⋯ We observed safe sedation practice in this high-risk group of patients in this department. A sentinel adverse event rate of 2.6% including a hypoxaemia rate of 0.5%, with no adverse outcomes sets a benchmark for elderly sedation. We recommend quality pre-oxygenation, an initial propofol bolus of no more than 0.5 mg kg-1, and a robust training and governance framework.
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Hypotension is common in anaesthetised children, and its impact on cerebral oxygenation is unknown. The goal of the present study was to investigate the effects of moderate systemic arterial hypotension (mHT) and severe hypotension (sHT) on cerebral perfusion and brain tissue oxygenation in piglets. ⋯ Induction of mHT and sHT by hypovolaemia and nitroprusside infusion caused alterations in brain tissue oxygenation in a piglet model, but without detectable changes in brain tissue perfusion and regional oxygen saturation.
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Letter Randomized Controlled Trial
Prospective randomised trial of the Integrated Pulmonary Index™ in low-acuity inpatients.
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Case Reports
Are high-sensitivity troponins always reliable? Donor-recipient troponin transfusion in liver transplantation.
Blood troponins are used to diagnose perioperative myocardial injury and infarction. During liver transplantation, a passive donor-recipient troponin transfer with the graft may result in an increase of troponins in the transplant recipient questioning the diagnosis of myocardial injury. We present a case of liver transplantation with sudden elevation of recipient's serum troponin levels immediately after graft reperfusion and its subsequent normalization in which myocardial damage and other non-ischaemic potential causes were ruled out. Patient consent for publication was obtained prior to submission of the manuscript.
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As the intensity of nausea, a subjective symptom, is difficult to estimate in children, vomiting is used as the objective clinical endpoint in managing paediatric postoperative nausea and vomiting. The pictorial Baxter Retching Faces (BARF) scale is a validated quantitative measure of paediatric nausea, but versions in languages other than English have not been validated. ⋯ NCT02007109.