Journal of investigative surgery : the official journal of the Academy of Surgical Research
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Randomized Controlled Trial Comparative Study
Comparison of analgesic effects of remifentanil and fentanyl NCA after pediatric cardiac surgery.
The purpose of this study was to compare the analgesic effects of remifentanil with fentanyl following pediatric cardiac surgery. Fifty patients were included in the study and were randomized into two groups. Patients in group R were given remifentanil (50 μg/ml) at an infusion rate of 0.07 μg/kg/min and with bolus doses of 0.25 μg/kg with a 5-min lockout time; group F patients received fentanyl (50 μg/ml) at an infusion rate of 0.1 μg/kg/min and with bolus doses of 1 μg/kg with a 5-min lockout time. ⋯ The total number of boluses and demands were significantly greater for group R than for group F. Itching as a side-effect was more severe in group F (p < .05). NCA remifentanil and fentanyl offer similarly effective pain control after pediatric cardiac surgery, but remifentanil has fewer side effects than fentanyl, indicating the suitability of remifentanil for use in NCA systems.
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Clinical Trial
Central venous access via external jugular vein with CT-venography using a multidetector helical 16-section CT.
To determine the success rate and complications of using the external jugular vein (EJV) for central venous access with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V). ⋯ The EJV route is associated with comparable technical success and lower major procedural complication. The EJV approach with CT-V guidance is an option as the initial method when central venous cannulation must be performed under suboptimal conditions.
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Different volume fluid resuscitations were closely associated with different cytokine responses, which could influence shock-induced lung and intestinal destruction. The aim of the study is to compare the effects of limited and traditional resuscitation on the levels of inflammatory response and lung and intestinal injury of hemorrhagic shock (HS) rats. ⋯ Comparing with conventional fluid resuscitation, limited fluid resuscitation (LFR) could not only decrease the levels of lactic acid and pro-inflammatory factors but also attenuate the intestinal and lung injury.
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Critically ill patients who demonstrate impaired gastric emptying benefit from post-pyloric enteral nutrition. However, correct placement of post-pyloric tube is challenging. ⋯ Electromagnetic technology facilitates safe and effective post-pyloric feeding tube placement at the bedside in critically ill patients with impaired gastric emptying.
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Venovenous (VV) extracorporeal membrane oxygenation (ECMO) applied through a single site with a bicaval dual-lumen (BCDL) catheter is a growing method of treatment of acute respiratory failure, thus animal models for research purposes are needed. We describe a rapid technique for the placement of the BCDL catheter for single-site VV ECMO in swine. ⋯ Using anatomical landmarks for the placement of the BCDL catheter was rapid and effective in a swine model of VV ECMO, resulting in improved time efficiency for research.