Anaesthesia and intensive care
-
Anaesth Intensive Care · Sep 2008
Randomized Controlled TrialView of the larynx obtained using the Miller blade and paraglossal approach, compared to that with the Macintosh blade.
The purpose of this study was to determine if laryngoscopy using a Miller blade with a paraglossal approach would yield an improved view of the larynx compared to that obtained with a Macintosh blade using the standard approach. One-hundred and sixty-one patients, scheduled for elective surgery requiring tracheal intubation, voluntarily participated in this study. Patients were randomly assigned to one of the two groups (Miller vs. ⋯ A grade 1 Cormack and Lehane view of the larynx was obtained in 96.5% of cases in the Miller group compared with 85% in the Macintosh group (P = 0.02). Direct laryngoscopy using the Miller blade and paraglossal approach, afforded a much-improved view of the larynx in the majority of cases. For this reason trainees should learn laryngoscopy using both blades.
-
Anaesth Intensive Care · Sep 2008
Evaluation of an Oxford Miniature Vaporizer placed in-circuit during the maintenance phase of low-flow anaesthesia.
The aim of the study was to assess Oxford Miniature Vaporizer output when mounted in-circuit during the maintenance phase of anaesthesia, using isoflurane, controlled ventilation and a fresh gas flow rate less than 1 l/min. Twenty patients of ASA Physical Status I and II were recruited from routine general surgical lists. All patients were paralysed and ventilated. ⋯ At a dial setting of 0.5, the Oxford Miniature Vaporizer produced a steady end-tidal isoflurane of 0.63% (95% confidence interval 0.60 to 0.66). However, when the dial was turned to 1.0 the output was almost always excessive and had to be reduced. These findings indicate that a stable, predictable and clinically useful output can be achieved when the Oxford Miniature Vaporizer is positioned in-circuit using low-flow and controlled ventilation.
-
Anaesth Intensive Care · Sep 2008
Antimicrobial effects of two anaesthetic agents: dexmedetomidine and midazolam.
Some anaesthetic agents are known to inhibit microbial growth. The aim of this in vitro study was to investigate possible antimicrobial effects of two frequently used agents in intensive care units, dexmedetomidine and midazolam. Antimicrobial effect was tested on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Pseudomonas aeruginosa by broth microdilution method. ⋯ Midazolam had inhibitor and bactericidal effects on S. aureus and E. faecalis. Dexmedetomidine had only inhibitor effects on S. aureus, E. coli and P aeruginosa. Further studies are needed to determine the antimicrobial mechanisms and clinical applications.
-
Anaesth Intensive Care · Sep 2008
Glomerular hyperfiltration and albuminuria in critically ill patients.
Glomerular hyperfiltration and albuminuria are two pathological conditions that could alter renal drug elimination, but they have been rarely studied in a critical care setting. The aims of this descriptive, prospective study performed on 89 critically ill patients are to determine rates of glomerular hyperfiltration (main objective) and albuminuria (secondary objective). ⋯ Seventy-five percent showed albuminuria on admission, with rates remaining high throughout the week of the study. Since glomerular hyperfiltration as well as albuminuria are frequent pathophysiological conditions in critical care patients, the implications that these phenomena may have regarding drug elimination need further evaluation.