Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2012
Improving the C-MAC video laryngoscopic view when applying cricoid pressure by allowing access of assistant to the video screen.
Videolaryngoscopic view using the C-MAC is improved when the anesthesia assistant applying cricoid pressure also has access to see the C-MAC screen.
pearl -
Anaesth Intensive Care · Jan 2012
Review Meta Analysis Comparative StudyBenefits and risks of using gelatin solution as a plasma expander for perioperative and critically ill patients: a meta-analysis.
This meta-analysis aimed to evaluate the benefits and risks of gelatin solutions compared to other intravenous fluids for patients in perioperative and critical care settings. Of the 66 studies identified from MEDLINE and EMBASE databases, 30 randomised controlled trials involving 2709 patients met the inclusion criteria and were subject to meta-analysis. The risk of mortality (odds ratio 1.03, 95% confidence interval 0.80 to 1.32) and amount of blood loss (weighted-mean-difference 7.56 ml, 95% confidence interval 18.75 to 33.87) were not significantly different between patients who were treated with gelatin solutions and other types of intravenous fluids. ⋯ These findings suggest that using gelatin solutions is associated with a lower risk of acute renal failure compared to older starches. Using gelatin as a plasma expander appears to have no significant advantages over crystalloids or isotonic albumin on mortality and may have a slightly higher risk of requiring allogeneic blood transfusion in perioperative and critically ill patients. An adequately powered randomised controlled trial with economic analysis is needed before gelatin solution can be recommended as a routine plasma expander for patients undergoing major surgery or who are critically ill.
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Anaesth Intensive Care · Jan 2012
End-of-life practices in a tertiary intensive care unit in Saudi Arabia.
Our aim was to evaluate end-of-life practices in a tertiary intensive care unit in Saudi Arabia. A prospective observational study was conducted in the medical-surgical intensive care unit of a teaching hospital in Riyadh, Saudi Arabia. Over the course of the one-year study period, 176 patients died and 77% of these deaths were preceded by end-of-life decisions. ⋯ The patients' families or surrogates were informed for 88% of the decisions and all decisions were documented in the patients' medical records. Despite religious and cultural values, more than three-quarters of the patients whose deaths were preceded by end-of-life decisions gave do-not-resuscitate decisions before death. These decisions should be made early in the patients' stay in the intensive care unit.
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Anaesth Intensive Care · Jan 2012
Letter Case ReportsTarget controlled infusion pump failure due to worn drive nut.