Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialComparison of oxygen cost of breathing between pressure-support ventilation and airway pressure release ventilation.
We compared the oxygen cost of breathing between pressure-support ventilation (PSV) and airway pressure release ventilation (APRV). This prospective, randomized, crossover study was conducted in a mixed ICU of a university hospital. Twenty clinically stable and spontaneously breathing patients after long-term mechanical ventilation were included. ⋯ There were no statistically significant differences with regard to respiratory rate, minute volume, and blood gas analysis. All patients tolerated both ventilatory modes without signs of discomfort. PSV and APRV produced similar results in terms of oxygen cost of breathing and other metabolic variables.
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Anaesth Intensive Care · Apr 2005
Letter Case ReportsLaryngospasm induced by topical application of lignocaine.
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Anaesth Intensive Care · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialRandomized double-blind comparison of ketamine-propofol, fentanyl-propofol and propofol-saline on haemodynamics and laryngeal mask airway insertion conditions.
The aim of this prospective, double-blind, randomized, placebo-controlled clinical trial was to investigate whether the administration of ketamine before induction with propofol improves its associated haemodynamic profile and laryngeal mask airway (LMA) insertion conditions. Ninety adult patients were randomly allocated to receive either ketamine 0.5 mg x kg(-1) (n = 30), fentanyl 1 microg x kg(-1) (n = 30) or normal saline (n = 30), before induction of anaesthesia with propofol 2.5 mg x kg(-1). Insertion of the LMA was performed 60s after injection of propofol. ⋯ Both appeared significantly better than the saline group [median 8.0, interquartile range (6.75-9.25); P = 0.024]. The incidence of prolonged apnoea (> 120s) was higher in the fentanyl group [23.1% (7/30)] compared with the ketamine [6.3% (2/30)] and saline groups [3.3% (1/30)]. We conclude that the addition of ketamine 0.5 mg x kg(-1) improves haemodynamics when compared to fentanyl 1 microg x kg(-1), with less prolonged apnoea, and is associated with better LMA insertion conditions than placebo (saline).
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Anaesth Intensive Care · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of the GlideScope with the Macintosh laryngoscope for tracheal intubation in patients with simulated difficult airway.
We compared the use of the GlideScope and the conventional Macintosh laryngoscope in a simulated difficult airway. The primary hypothesis was that time to intubation would be shorter using the GlideScope than using the Macintosh laryngoscope. After obtaining approval from the ethics committee and written informed consent, we recruited 60 ASA 1 and 2 patients to our randomized controlled trial. ⋯ Group G had a significantly shorter intubation time than group M (mean 41.8s +/- SD 20.2 vs mean 56.2s +/- 26.6, P < 0.05). The GlideScope improved the laryngeal view and decreased time for tracheal intubation time when compared with the Macintosh laryngoscope in patients with simulated difficult airway. The GlideScope may be a good alternative for managing the difficult airway but clinical trials evaluating its use on patients with an actual difficult airway are needed.
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Anaesth Intensive Care · Apr 2005
Case ReportsHigh-frequency jet ventilation through a fibreoptic bronchoscope channel during lung lavage.
Simple manual ventilation facilitates removal of intra-alveolar accumulations. High-frequency jet ventilation can be performed through a narrow lumen like that of a fibreoptic bronchoscope. Accordingly, we expected that high frequency jet ventilation through a fibreoptic bronchoscope channel would facilitate lung lavage, and we developed a new bronchoalveolar lavage system, in which high-frequency jet ventilation through the channel of a fibreoptic bronchoscope was combined with conventional bronchoalveolar lavage. We describe a case in which this new lavage system, unlike conventional bronchoalveolar lavage, successfully removed the lipid material in the alveoli associated with pulmonary alveolar proteinosis.