Articles: patients.
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Journal of anesthesia · Jan 2000
Changes in hemodynamic variables and catecholamine levels after rapid increase in sevoflurane or isoflurane concentration with or without nitrous oxide under endotracheal intubation.
Rapid increases in concentrations of isoflurane and desflurane in oxygen have been shown to increase sympathetic activity. The aim of this study was to determine whether concomitant administration of nitrous oxide would reduce these sympathomimetic effects of volatile anesthetics. ⋯ Even if nitrous oxide was added to isoflurane or sevoflurane, the increase in heart rate could not be avoided. Contrary to previous reports, severe hyperdynamic circulation was not observed after a rapid increase in isoflurane concentration.
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Place of care in advanced cancer: a qualitative systematic literature review of patient preferences.
It is commonly written that more patients wish to die at home than currently achieve this. However, the evidence for preferences for place of terminal care and death has not been systematically reviewed. ⋯ Home care is the most common preference, with inpatient hospice care as second preference in advanced illness. Meeting these preferences could be important outcomes for services. Study designs in this area need to be improved.
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Despite recent advances in technology, the mortality rate for patients suffering from adult respiratory distress syndrome remains in the range of 40-50%. This high mortality rate may be in part related to complications from ventilator management, such as ventilator-induced lung injury. In these patients, adjunct therapies aiming at ameliorating ventilator-induced lung injury are being developed. This article discusses the rationale for use of pharmacologic adjunct therapies, including inhaled nitric oxide, surfactant replacement therapy, antioxidants, prostaglandins, and corticosteroids, in patients with acute lung injury, and reviews the effectiveness of these agents in human clinical trials to date.
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Two older adults presented to the emergency department with rib fractures following minor trauma. Both were discharged on oral analgesics and died within 2 days. Rib fractures more often lead to adverse outcomes in older adults. Emergency physicians should consider admitting any such patient who presents with two or more rib fractures.
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To determine the frequency of use and the success rates of intraosseous (IO) vascular access in the emergency department. ⋯ IO success rates were high despite infrequent use.