Journal of clinical anesthesia
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To investigate prospectively whether blood gas samples drawn from extracorporeal membrane oxygenation (ECMO) cannulae help to exclude at least clinically significant recirculation volumes in patients with acute respiratory failure. ⋯ The median arterial oxygen tension (PaO(2)) obtained from the arterial cannula was 537 mmHg (range, 366 to 625 mmHg), the median mixed venous oxygen tension (PvO(2)) drawn from the venous cannula was 42 mmHg (range, 25 to 54 mmHg), which was less than 10% of that observed in the arterial cannula, and also within the physiologic range of PvO(2). The ECMO flow necessary to maintain patients' oxygen saturation above 90% (4.1 L/min; range, 1.95 to 5.8 L/min) was significantly lower than the patients' cardiac output (CO; 6.2 L/min; range, 4.1 to 7.9 L/min; p < 0.001). CONSLUSIONS; We recommend obtaining blood gas samples-immediately after initiation of ECMO-from both cannulae. A PvO(2) within physiologic range and below 10% of PaO(2) rules out any clinically relevant recirculation volume.
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Case Reports
A two-person technique for fiberscope-aided tracheal extubation/reintubation in intensive care unit (ICU) patients.
The technique of fiberoptic-aided intubation for management of a difficult airway is often limited in the presence of blood or secretions and conditions in which the passage of a fiberoptic bronchoscope ("fiberscope") beneath the epiglottis and into the glottic opening may prove difficult. Direct laryngoscopy can be utilized in combination with the fiberscope as a two-person technique to overcome these challenges. We report the usefulness of a two-person technique using the flexible fiberscope in combination with direct laryngoscopy for extubation/reintubation in two intensive care unit patients with known difficult airways.
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Randomized Controlled Trial Comparative Study Clinical Trial
Reduction of emetic symptoms during cesarean delivery with antiemetics: propofol at subhypnotic dose versus traditional antiemetics.
To evaluate the efficacy and safety of propofol (at a subhypnotic dose), droperidol, and metoclopramide in reducing emetic symptoms during cesarean delivery. ⋯ Prophylactic antiemetic efficacy of propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg, and metoclopramide 10 mg is comparable in parturients undergoing cesarean delivery. Moreover, propofol at a subhypnotic dose is effective in the prevention of severe nausea.
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Randomized Controlled Trial Comparative Study Clinical Trial
Standard Laryngeal Mask Airway and LMA-ProSeal during laparoscopic surgery.
To compare the frequency of airway seal and sore throat with the LMA-ProSeal (PLMA) and the standard Laryngeal Mask Airway (LMA) during laparoscopic surgery. ⋯ The PLMA and the LMA show similar airtight efficiency during laparoscopy. The patency of the PLMA drainage tube should always be confirmed. The sore throat evaluation performed in recovery room appears as reliable as later evaluations.