Current opinion in anaesthesiology
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Hypercapnia is a central component of diverse respiratory disorders, while 'permissive hypercapnia' is frequently used in ventilatory strategies for patients with severe respiratory failure. This review will present data from recent studies relating to hypercapnia, focusing on issues that are of importance to anesthesiologists caring for the surgical and/or critically ill patient. ⋯ The mechanisms of action of hypercapnia and acidosis continue to be elucidated, and this knowledge is central to determining the safety and therapeutic utility of hypercapnia in protective lung ventilatory strategies.
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Describe the importance of monitoring dead space during thoracic surgery, specifically during one-lung ventilation. ⋯ Monitoring dead space helps anesthesiologists monitor the status of the lung and find appropriate ventilatory settings during thoracic surgeries.
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Curr Opin Anaesthesiol · Feb 2015
ReviewProtection strategies during cardiopulmonary bypass: ventilation, anesthetics and oxygen.
To provide an update of research findings regarding the protection strategies utilized for patients undergoing cardiopulmonary bypass (CPB), including perioperative ventilatory strategies, different anesthetic regimens, and inspiratory oxygen fraction. The article will review and comment on some of the most important findings in this field to provide a global view of strategies that may improve patient outcomes by reducing inflammation. ⋯ Lung-protective mechanical ventilation, inhalation anesthesia, and high FiO(2) have the potential to reduce postoperative complications in patients undergoing CPB; however, larger, well powered, randomized control trials are still needed.
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Curr Opin Anaesthesiol · Dec 2014
ReviewValue of expert systems, quick reference guides and other cognitive aids.
Cognitive aids and other methods of decision support are receiving increased interest by the anesthesia community. These tools have significant safety implications because of the possibility to decrease variability in human performance. ⋯ The early work in this field of decision support is encouraging but there are many questions regarding the optimal design, presentation and use.