Current opinion in anaesthesiology
-
Percutaneous tracheostomy is now established in intensive care practice. However, discussion continues on many aspects of the procedure. ⋯ The introduction of percutaneous tracheostomy into an intensive care unit has training implications, particularly for surgeons. The timing of percutaneous tracheostomy in critically ill patients, and the use of the technique in children remain controversial.
-
Since the introduction of the combined spinal-epidural technique in the early 1980s it has gained increasing popularity for analgesia and anesthesia in labor and delivery. The benefit of the rapid onset of analgesia from the intrathecal injection, coupled with the flexibility of an epidural catheter that can provide a long duration of labor analgesia or conversion to an anesthetic when operative delivery is necessary, has made combined spinal-epidural the labor analgesic of choice in many obstetric anesthesia practices.
-
Curr Opin Anaesthesiol · Jun 1999
New developments in the management of the paediatric airway: cuffed or uncuffed tracheal tubes, laryngeal mask airway, cuffed oropharyngeal airway, tracheostomy and one-lung ventilation devices.
The use of a cuffed endotracheal tube should no longer be limited by the age of the child but by his or her clinical condition (e.g. poor lung compliance). To prevent pharyngeal damage, overinflation of the cuff of the laryngeal mask airway should be avoided by inflating it with the minimum volume required to maintain an effective seal and by monitoring intracuff pressure if nitrous oxide is used. Percutaneous tracheostomy in children is still in the experimental stage. New and older devices to perform one-lung ventilation in children are also described.
-
In this review, we attempted to summarize the effectiveness and the limitation of end-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. End-tidal carbon dioxide can be an indicator of the real return of spontaneous circulation and can also be an indicator of the effectiveness of cardiac massage. We cannot, however, estimate the prognosis of cardiopulmonary resuscitation from the end-tidal carbon dioxide value. We concluded that cardiopulmonary resuscitation should never be abandoned for the sole reason that the end-tidal carbon dioxide value is low.