Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Heparin and protamine titration do not improve haemostasis in cardiac surgical patients.
Weight-based heparin and protamine dosing strategies for cardiopulmonary bypass (CPB) do not take into account interpatient variability in drug sensitivity and may result in bleeding complications. We compared the Hemochron RxDx heparin and protamine titration system with standard weight based management with regard to heparin dose, protamine dose, and perioperative bleeding. ⋯ In cardiac surgical patients, heparin and protamine titration did predict a lower protamine dose but did not result in a measurable improvement in haemostasis during the perioperative period.
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We report a case of ischaemic optic neuropathy which occurred after prolonged spine surgery in the prone position in an obese, diabetic patient. ⋯ This patient developed ischaemic optic neuropathy from a prolonged interval in the prone position of the Relton-Hall frame, which may be related to venous engorgement.
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The introduction of the laryngeal mask airway (LMA) has had a major impact on anaesthetic practice in the last ten years. Previous authors have demonstrated pressures equivalent to mean arterial blood pressure within the cuff of the LMA. This study examined the effects of cuff inflation on the cross sectional area, flow and velocity of blood flow at the level of the carotid sinus. ⋯ This study demonstrates that inflation of the cuff on the LMA results in a decrease in carotid bulb cross sectional area which results in a decrease in blood flow.