Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 2001
Randomized Controlled Trial Clinical TrialChange in endotracheal tube cuff pressure during nitrous oxide anaesthesia: a comparison between air and distilled water cuff inflation.
In this prospective, randomized controlled trial, changes in endotracheal tube cuff pressure were studied in 60 patients undergoing elective surgery under general anaesthesia with nitrous oxide and oxygen. The cuffs were inflated with either air or distilled water. ⋯ The pressure and the rate of rise in cuff pressure were significantly lower (P<0.05) in the water-filled cuffs throughout the hour of study. When an endotracheal tube cuff is distended with water, the rise in cuff pressure during nitrous oxide anaesthesia is lower than that of an air-filled cuff.
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Anaesth Intensive Care · Oct 2001
Case ReportsTracheal intubation using suspension laryngoscopy in an infant with Goldenhar's syndrome.
We present a case of a ten-month-old boy with Goldenhar's syndrome and significant retrognathia in whom a tracheostomy was performed to relieve upper airway obstruction. Tracheal intubation was facilitated by direct suspension laryngoscopy using a slotted rigid laryngoscope. We propose this technique as an alternative method for tracheal intubation in infants and young children with a difficult airway. The management of the difficult airway in children with Goldenhar's syndrome is discussed.
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Anaesth Intensive Care · Oct 2001
Comparative StudyHaemodilution-induced enhancement of coagulation is attenuated in vitro by restoring antithrombin III to pre-dilution concentrations.
Moderate haemodilution enhances coagulability in vitro and in vivo as measured by thrombelastography (TEG). The mechanism has never been established. We have conducted an in vitro study to determine whether the effect can be moderated or prevented when the reduction in antithrombin III caused by dilution is prevented by supplementation. ⋯ A predictable drop of AT III (24.2%) occurred with saline dilution, while AT III levels in the AT III/Saline group were similar to the undiluted control. Haemodilution-induced coagulation enhancement is attenuated, but not prevented, if AT III levels are maintained in the normal range. This is in keeping with the established concept of an antithrombin threshold preventing positive coagulation feedback into the intrinsic pathway.