Anesthesiology
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Randomized Controlled Trial
Cognitive Changes after Saline or Plasmalyte Infusion in Healthy Volunteers: A Multiple Blinded, Randomized, Cross-over Trial.
In an incidental finding, during a study of plasma chemistry after crystalloid infusion, participants reported subjective cognitive changes, particularly slower thinking, after saline but not Hartmann's (Ringer's lactate) solution. The authors tested the hypothesis that saline infusion would produce greater adverse cognitive changes than Plasmalyte infusion. ⋯ Despite expected differences in plasma chemistry, the authors found that measures of cognition did not differ after infusions of Plasmalyte or saline.
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Randomized Controlled Trial Comparative Study
Changes in blood pressure and cardiac output during Cesarean delivery: the effects of oxytocin and carbetocin compared with placebo.
Little is known about maternal hemodynamics after Cesarean delivery. Uterine contractions may increase cardiac output. Oxytocin is the first-line treatment for uterine atony, although the effects of the long-acting oxytocin analogue carbetocin are comparable with that of oxytocin. The authors analyzed the effects of i.v. oxytocin 5 U, carbetocin 100 μg, and placebo on hemodynamics, uterine tone, adverse events, and blood loss after Cesarean delivery. ⋯ The hemodynamic side effects of oxytocin 5 U and carbetocin 100 μg were comparable. The lack of an increase in stroke volume in the placebo group challenges the theory that uterine contraction causes autotransfusion of uterine blood, leading to an increase in preload.
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Randomized Controlled Trial
Prospective randomized crossover study of a new closed-loop control system versus pressure support during weaning from mechanical ventilation.
Intellivent is a new full closed-loop controlled ventilation that automatically adjusts both ventilation and oxygenation parameters. The authors compared gas exchange and breathing pattern variability of Intellivent and pressure support ventilation (PSV). ⋯ Compared with PSV, Intellivent during a 24-h period improved the Pao2/Fio2 ratio in parallel with more variability in the ventilatory support and more changes in ventilation settings.
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Randomized Controlled Trial
Different Propofol-Remifentanil or Sevoflurane-Remifentanil Bispectral Index Levels for Electrocorticographic Spike Identification during Epilepsy Surgery.
Medical therapy, the cornerstone of managing epilepsy, still fails a substantial portion of patients. Little information is available regarding the potential impact of different bispectral index (BIS) levels on electrocorticographic spike identification for surgical epileptic foci resection. ⋯ Decreasing BIS levels in the propofol and sevoflurane groups enhanced epileptogenic spike frequency and amplitude with the same location and number of spiking leads.