Journal of anesthesia
-
Journal of anesthesia · Feb 2011
Prompt prediction of successful defibrillation from 1-s ventricular fibrillation waveform in patients with out-of-hospital sudden cardiac arrest.
Ventricular fibrillation (VF) is a common cardiac arrest rhythm that can be terminated by electrical defibrillation. During cardiopulmonary resuscitation, there is a strong need for a prompt and reliable predictor of successful defibrillation because myocardial damage can result from repeated futile defibrillation attempts. Continuous wavelet transform (CWT) provides excellent time and frequency resolution of signals. The purpose of this study was to evaluate whether features based on CWT could predict successful defibrillation. ⋯ Energy spectrum analysis based on CWT as short as a 1.0-s VF ECG waveform enables prompt and reliable prediction of successful defibrillation.
-
Journal of anesthesia · Feb 2011
Randomized Controlled Trial Comparative StudyEfficacy of the Airtraq(®) laryngoscope with a fiberoptic bronchoscope compared with that of Airtraq(®) alone for tracheal intubation: a manikin study.
Successful intubation using the Airtraq(®) requires optimal positioning of the glottis in the middle of the viewfinder. If the glottic view cannot be optimized, some glottic manipulation is essential for the Airtraq-assisted successful intubation. We evaluated the efficacy of the combined use of the Airtraq and a fiberoptic bronchoscope (FOB) compared with that of the Airtraq alone for tracheal intubation in simulated airway scenarios. ⋯ The combined use of Airtraq(®) and a FOB enables rapid intubation in simulated difficult airway scenarios compared with intubation using Airtraq alone, and the speed of intubation performed by anesthetists and residents is similar in all airway scenarios.
-
Journal of anesthesia · Feb 2011
Validation of inflationary non-invasive blood pressure monitoring in adult surgical patients.
Oscillometric determination of blood pressure may be advantageous, as cuff inflation requires lower cuff pressure and shorter duration than deflation. In this observational study, we compared the blood pressure value, cuff pressure, and duration of cuff inflation between a prototype of inflationary non-invasive blood pressure (NIBP) and conventional deflationary NIBP in adult patients during anesthesia. Three hundred and twenty-three pairs of measurements were obtained from 64 subjects. ⋯ Inflationary NIBP could better determine NIBP with lower cuff pressure than deflationary NIBP (124 ± 22 vs. 160 ± 33 mmHg, p < 0.05). Inflationary NIBP could also determine NIBP more quickly (13.0 ± 2.3 vs. 32.7 ± 13.6 s, p < 0.05). These data suggest that inflationary NIBP may reduce cuff-related discomfort and complications, and has reasonable accuracy compared to deflationary NIBP in adult surgical patients.
-
Journal of anesthesia · Feb 2011
Protocol-based noninvasive positive pressure ventilation for acute respiratory failure.
Noninvasive positive pressure ventilation (NPPV) has been suggested to be associated with adverse outcomes in emergency patients with acute respiratory failure (ARF), possibly because of a delay in tracheal intubation (TI). We hypothesized that protocol-based NPPV (pNPPV) might improve the outcomes, compared with individual physician-directed NPPV (iNPPV). ⋯ The present study suggests that pNPPV is effective and likely to improve the mortality rate of emergency patients with ARF.