Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study
Smoking cessation interventions in the pre-admission clinic: assessing two approaches.
Brief intervention (BI) to encourage patients who smoke to quit is effective and should occur at every patient interaction. If smokers receive a motivational interview in addition to BI and are offered pharmacotherapy to treat nicotine withdrawal, cessation rates may be improved. We compared the uptake, implementation, and effectiveness of these two approaches in the delivery of a smoking cessation intervention during assessments in a pre-admission clinic (PAC). ⋯ The PAC is a feasible location to identify smokers and offer a cessation intervention. There are considerable logistical barriers to the development of an II intervention program as described. A program that incorporates elements of BI and II could offer a practical approach to the implementation of a hospital-wide smoking cessation intervention.
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Pulmonary hypertension impacts negatively on right ventricular function; however, understanding pulmonary vasculature can be difficult. Data from invasive monitoring or traditional echocardiography may not represent the full extent of pulmonary arterial disease. An important element missing from invasive monitoring is the ability to take into account the effects of pulsatile flow; therefore, mean pressures and mean flows are employed in the calculation of pulmonary vascular resistance. ⋯ We show these concepts in a case vignette involving a patient in a low cardiac output state after a complex re-do sternotomy. Additionally, we describe four distinct patterns of PA PWD tracings and illustrate the ability of PA PWD analysis to assess the pulmonary vasculature in both a qualitative and semi-quantitative way. In the critical care setting, it is vital to understand alterations in the pulmonary circulation, and analysis of PA PWD can provide additional information to complement data from other sources.
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Comparative Study
Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study.
The objective of this study was to compare the catheter-through-needle (CTN) and catheter-over-needle (CON) catheterization techniques ex vivo by measuring leak pressure around the catheter and the catheter's resistance to pulling force. ⋯ In the porcine leg model, CON catheterization provides greater resistance to leakage under high injection pressure and greater holding force in tissue than traditional CTN catheters.