European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Airway management by first responders when using a bag-valve device and two oxygen-driven resuscitators in 104 patients.
To evaluate the capability of first responders to ensure an airway and ventilate the lungs of a patient employing a bag-valve device and two oxygen-driven resuscitators. ⋯ The use of an oxygen-driven device improves the ability of first responders to secure an airway and reduce gastric insufflation, even when distracted. Oxylators perform significantly better (P < 0.0001) than the bag-valve device.
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Randomized Controlled Trial Clinical Trial
Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients.
To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators. ⋯ The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators improves performance (P < 0.001) vs. the bag-valve device significantly.
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Randomized Controlled Trial Clinical Trial
Bolus application of remifentanil with propofol for dilatation and curettage.
This study was designed to determine which single bolus dose of remifentanil in combination with propofol and nitrous oxide is best to control the haemodynamic, autonomous and somatic responses in patients scheduled for dilatation and curettage of the uterine cervix. We evaluated the adequacy of different bolus doses of remifentanil, associated with propofol and nitrous oxide, for dilatation and curettage in a prospective double-blind study. ⋯ Remifentanil 1.5 microg kg(-1) i.v. with propofol 2 mg kg(-1) i.v. and 60% nitrous oxide in oxygen provided the best anaesthetic control with the fastest recovery times.
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Randomized Controlled Trial Comparative Study Clinical Trial
No difference in electroencephalographic power spectra or sensory-evoked potentials in patients anaesthetized with desflurane or sevoflurane.
Hitherto, neither desflurane nor sevoflurane, with similar physicochemical properties, have been compared with regard to their effects on the central nervous system. We compared the effects of desflurane and sevoflurane on electrical cortical activity and sensory transmission at two anaesthetic concentrations in patients undergoing hysterectomy. ⋯ Both desflurane and sevoflurane possess a similar profile with regard to their hypnotic effects and a similar outline in depressing propagation within the sensory nervous system. Cortical nervous effects are mirrored closely in heart rate and systolic blood pressure.
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Sepsis is an infection-induced syndrome characterized by a generalized inflammatory state. The normal reaction to infection involves a series of complex immunological processes. A potent, complex immunological cascade ensures a prompt protective response to microbial invasion in human beings. ⋯ Infected fluid collections and/or infected necrotic tissues should be drained or debrided without delay. Adequate nutritional support is indicated in the management of the septic patient. A number of adjuvant therapies, aimed at blunting/downregulating the host immune response to bacterial infection are currently under intensive investigation; however, the complexity of immunological defences and the potential for complementary interaction of the different components of the inflammatory cascade make the development of these pharmacological interventions difficult.