European journal of anaesthesiology
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Randomized Controlled Trial
Bispectral index guided titration of sevoflurane in on-pump cardiac surgery reduces plasma sevoflurane concentration and vasopressor requirements: A prospective, controlled, sequential two-arm clinical study.
Electroencephalographic-based monitoring systems such as the bispectral index (BIS) may reduce anaesthetic overdose rates. ⋯ BIS-guided titration of sevoflurane reduces the SPC and decreases noradrenaline administration compared with routine care during on-pump cardiac surgery.
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Randomized Controlled Trial
The effect of adjusting tracheal tube cuff pressure during deep hypothermic circulatory arrest: A randomised trial.
Regular endotracheal tube cuff monitoring may prevent silent aspiration. ⋯ We recommend that the cuff of the tracheal tube should be checked regularly during surgery under deep hypothermia, and the cuff pressure adjusted as required.
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Strategies targeting the protection of the vascular barrier, in particular the endothelial glycocalyx, are subjects of current research. Antithrombin III and hydrocortisone have been shown to reduce shedding of the glycocalyx following ischaemia/reperfusion. Platelet adhesion to endothelial cells is one consequence of ischaemia/reperfusion. ⋯ Pretreatment with hydrocortisone or antithrombin III can reduce platelet adhesion during reperfusion after warm ischaemia by protection of the endothelial glycocalyx.
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Lung recruitment manoeuvres in neonates during anaesthesia are not performed routinely due to concerns about causing barotrauma, haemodynamic instability and oxidative stress. ⋯ Recruitment manoeuvres in PCV with a constant driving pressure are a well tolerated open-lung strategy in a healthy-lung neonatal animal model under general anaesthesia. The recruitment manoeuvres improve oxygenation parameters and lung mechanics and do not cause barotrauma, haemodynamic instability or oxidative stress.