Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Although intensive care unit (ICU) acquired sodium disturbances are common in critically ill patients, few studies have examined sodium disturbances in patients following cardiac surgery. The objective of this study was to describe the epidemiology of ICU-acquired hyponatremia and hypernatremia in patients following cardiac surgery. ⋯ ICU-acquired hyponatremia and hypernatremia are common complications in critically ill patients following cardiac surgery. They are associated with patient demographic and clinical characteristics and an increased risk of hospital mortality.
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Randomized Controlled Trial Comparative Study
A comparison of the Supreme laryngeal mask airway with the Proseal laryngeal mask airway in anesthetized paralyzed adult patients: a randomized crossover study.
The Supreme laryngeal mask airway (SLMA) is a new single-use advanced form of the Proseal laryngeal mask airway (PLMA). This study tested the hypothesis that the SLMA is equally as effective as the PLMA as a supraglottic ventilatory device in anesthetized paralyzed adult patients. ⋯ The clinical performance of the SLMA as a ventilatory device is comparable with that of the PLMA, as illustrated by the similar LSPs. The inferior position of the SLMA airway tube compared with that of the PLMA does not affect its ease of ventilation.
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A case of difficult intubation in a patient with cervical spinal cord injury with diffuse idiopathic skeletal hyperostosis (DISH) is described. The trachea could not be intubated with a videolaryngoscope, and successful intubation was achieved with a laryngeal mask airway device (LMAD) and a fibreoptic bronchoscope (FOB). ⋯ Although often considered to be a benign entity, DISH can predispose patients to catastrophic cervical injury and difficult airway management. Careful review of plain radiographs in the spinal cord injury patient may assist with appropriate selection of airway interventions. The videolaryngoscope is useful for difficult airways, but its effectiveness may be compromised with an anteriorly displaced airway in combination with restricted cervical movement and limited oropharyngeal airspace.
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The purpose of this brief narrative review is to summarize the evidence derived from randomized controlled trials pertaining to the nonsurgical treatment of lumbar spinal stenosis (LSS). ⋯ Because of their variable quality, published RCTs can provide only limited evidence to formulate recommendations pertaining to the nonsurgical treatment of LSS. In this narrative review, no study was excluded based on factors such as sample size justification, statistical power, blinding, definition of intervention allocation, or clinical outcomes. This aspect may represent a limitation as it may serve to overemphasize evidence derived from "weaker" trials. Further well-designed RCTs are warranted.