Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Constant positive airway pressure reduces hypoventilation induced by inhalation anesthesia.
To discover if reducing respiratory system impedance would increase tidal volume and improve ventilation during inhalation anesthesia. ⋯ We conclude that constant positive airway pressure titrated to optimal respiratory system compliance will increase efficiency of inspiratory muscles and improve ventilation. Constant positive airway pressure facilitates a pattern of breathing that minimizes some of the adverse pulmonary effects of inhalation anesthesia.
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The purpose of this study is to determine whether routine preoperative testing has a usefulness not previously recognized in a small preliminary study to decide if such a hypothesis might be worthy of testing in a larger study. ⋯ Although the incidence of unindicated preoperative screening tests is still more than 50%, no previously unidentified benefit was found to support this persistence of unwarranted testing. The limited number of patients in this study necessitates a larger study to ensure greater certainty before such a recommendation is made to the public. If similar results in another but larger study involving similar design, simple changes in the system of preoperative care may save the health care system the considerable expense of unwarranted testing.
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To measure resistance of the Combitube, a supraglottic ventilatory device used in the management of the patients with difficult airways, and its influence on delivered ventilatory pressures. ⋯ The Combitube has significant airflow resistance that should be considered when patients are mechanically ventilated because the delivered oropharyngeal pressure is significantly lower than the pressure measured at the anesthesia breathing system.
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To compare the effect of inspiratory time and lung compliance on tidal volume (Vt) delivery in anesthesia and intensive care unit (ICU) ventilators operating in pressure control mode. ⋯ Differences in inspiratory flow delivery between ICU and anesthesia ventilators can cause differences in Vt delivery when the pressure control mode is used at high RRs. These differences can significantly impact the perioperative care of critically ill patients requiring ventilatory support.
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A 35-year-old, 39-week pregnant woman underwent an uneventful emergent cesarean delivery for suspected placental abruption or uterine dehiscence. Given the urgency of the situation and the unremarkable airway anatomy, general anesthesia was the chosen technique. ⋯ Hematology tests performed before the cesarean delivery revealed severe thrombocytopenia. This was later diagnosed as idiopathic thrombocytopenia, which was treated successfully with steroid therapy.