Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Multicenter Study Observational Study
Analgesic, sedative, antipsychotic, and neuromuscular blocker use in Canadian intensive care units: a prospective, multicentre, observational study.
Our aim was to describe analgo-sedation and antipsychotic and neuromuscular blocking drug (NMBD) use in critically ill patients, management strategies, and variables associated with these practice patterns. ⋯ Nearly all MV patients received analgo-sedation. Opioids were used more often than sedatives despite infrequent use of pain scales. Few patients received antipsychotic therapy, but physical restraint was common. Protocol use was poor compared to DSI. Duration of MV predicted the use of either.
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Randomized Controlled Trial
An acceleromyographic train-of-four ratio of 1.0 reliably excludes respiratory muscle weakness after major abdominal surgery: a randomized double-blind study.
This randomized double-blind study was designed to determine if respiratory muscle weakness - measured by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) - persists even if an acceleromyographic train-of-four ratio (TOFR) of 1.0 is reached after major abdominal surgery. ⋯ Acceleromyographic TOFR of 1.0 excludes residual neuromuscular paralysis. However, major respiratory dysfunction is observed after abdominal surgery. This trial was registered at ClinicalTrials.gov: NCT01503840.
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Case Reports
Novel use of a guidewire to facilitate intubation in an obstructing anterior mediastinal mass.
This report describes the management of a life-threatening tracheal obstruction due to a thymoma in the anterior mediastinum and the use of a guidewire to facilitate intubation. ⋯ Confirmed guidewire placement prior to induction enabled intubation in a setting without cardiothoracic backup capabilities.