Revista do Colégio Brasileiro de Cirurgiões
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to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. ⋯ the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg.
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to evaluate the efficacy of the treatment with hyperbaric oxygen therapy or with topical and intralesional heparin in an animal model of degloving lesions. ⋯ tanto a oxigenoterapia hiperbárica quanto a terapia com heparina mostraram-se eficazes na redução do percentual de necrose no modelo estudado, embora neste trabalho apenas a oxigenação hiperbárica tenha demonstrado significância estatística.
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Being a fast and safe method in the hands of well trained professionals in both prehospital and intrahospital care, Cricothyrotomy has been broadly recommended as the initial surgical airway in the scenario "can't intubate, can't ventilate", and is particularly useful when the obstruction level is above or at the glottis. Its prolonged permanence, however, is an endless source of controversy. In this review we evaluate the complications of cricothyrotomy and the need of its routine conversion to tracheotomy through a search on PubMed, LILACS and SciELO electronic databases with no restriction to the year or language of the publication. ⋯ Subglotic stenosis was the main long-term reported complication, even though it was quite infrequent, occurring only in 2.9 to 5%. The frequency of conversion to tracheostomy varied from zero to 100%. Although a small frequency of long-term complications was found for emergency cricothyrotomy, the studies' low level of evidence does not allow the recommendation of routine use of cricothyrotomy as a secure definitive airway.
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Randomized Controlled Trial
Enhanced muscle strength with carbohydrate supplement two hours before open cholecystectomy: a randomized, double-blind study.
to investigate the effects of preoperative fasting abbreviation with oral supplementation with carbohydrate in the evolution of grip strength in patients undergoing cholecystectomy by laparotomy. ⋯ the abbreviation of preoperative fasting to two hours with drink containing carbohydrate improves muscle function in the perioperative period.
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Trauma is one of the world's leading causes of death within the first 40 years of life and thus a significant health problem. Trauma accounts for nearly a third of the lost years of productive life before 65 years of age and is associated with infection, hemorrhagic shock, reperfusion syndrome, and inflammation. ⋯ When one considers the known immunomodulatory effects of traumatic injury, allogeneic blood transfusion, and the overlap between patient populations, it is surprising that so few studies have assessed their combined effects on immune function. We also discuss the relative benefits of curbing inflammation rather than attempting to prevent it.