Journal of clinical anesthesia
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Traditional hemodynamic monitors such as pulmonary artery and central venous catheters provide continuous data and secure intravenous access, but their diagnostic efficacy has been criticized. Dynamic arterial waveform monitoring is promising, but studies suggest it is reliable only within narrow ventilation and rhythm parameters. ⋯ Recent efficacy data, along with other important clinical findings, are reviewed with regard to invasive monitors. We caution against over-generalizing from existing studies, and provide guidance for clinicians wishing to target monitoring techniques for appropriate patients.
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To investigate changes in stroke volume variation (SVV) by both induced hypertension (pressor test) and hypotension (depressor test), and also by induced hypotensive anesthesia in patients with good cardiac function. ⋯ SVV does not misinterpret preload dependency assessment of patients receiving medications to increase or to lower blood pressure.
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Case Reports
An adult patient with Klippel-Feil syndrome presenting for repeat operation: a cautionary tale of the GlideScope.
The introduction of video laryngoscopes has increased the success of intubating the difficult airway. However, failures have been reported in the literature that are associated with certain patient characteristics. Klippel-Feil Syndrome is a condition that typically presents with decreased cervical spine motion, a characteristic that has been associated with GlideScope failure. After an uneventful first anesthetic, a case of a near impossible-to-intubate occurred in a patient with Klippel-Feil Syndrome.