Anaesthesia, critical care & pain medicine
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Anaesth Crit Care Pain Med · Oct 2021
Observational StudyMaternal heart rate responses in the supine position and their relationship with hypotension and phenylephrine requirements during elective caesarean delivery using spinal anaesthesia: An observational study.
Hypotension is the main side effect of spinal anaesthesia (SA) for elective caesarean delivery (CD). An increased in heart rate in response to inferior vena cava (IVC) compression has been reported to be predictive of hypotension and vasopressor requirements in this setting. The objective of the study was to evaluate the prevalence of an increase in heart rate in response to IVC compression and its potential effect on hypotension and phenylephrine requirements. ⋯ A positive SST to IVC compression was found in a quarter of term women scheduled for elective CD under SA. This condition has no significant impact on hypotension and phenylephrine requirements when using a crystalloid coload and a phenylephrine infusion targeted at maintaining SAP close to baseline.
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Anaesth Crit Care Pain Med · Aug 2021
Practice GuidelineGuidelines for the acute care of severe limb trauma patients.
To provide healthcare professionals with comprehensive multidisciplinary expert recommendations for the acute care of severe limb trauma patients, both during the prehospital phase and after admission to a Trauma Centre. ⋯ There was significant agreement among experts on strong recommendations to improve practices for severe limb trauma patients.
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Anaesth Crit Care Pain Med · Aug 2021
Practice GuidelinePrevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021): From the French working group on perioperative haemostasis (GIHP) and the French study group on thrombosis and haemostasis (GFHT), in collaboration with the French society of anaesthesia and intensive care (SFAR).
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Anaesth Crit Care Pain Med · Jun 2021
Randomized Controlled TrialAlveolar recruitment manoeuvre results in improved pulmonary function in obese patients undergoing bariatric surgery: a randomised trial.
Perioperative ventilation is an important challenge of anaesthesia, especially in obese patients: body mass index is correlated with reduction of the pulmonary volume and they develop significantly more perioperative atelectasis and pulmonary complications. The alveolar recruitment manoeuvre is the most effective technique to reverse atelectasis. However, the clinical benefit on lung function in the perioperative period is not clear. ⋯ No significant differences were found for secondary outcomes. No patient was excluded from the recruitment manoeuvre group for intolerance to the manoeuvre. Recruitment manoeuvre is safe and effective in reducing early pulmonary dysfunction in obese patients undergoing bariatric surgery.