Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 1997
Randomized Controlled Trial Clinical TrialImpact of autotransfusion after coronary artery bypass grafting on oxygen transport.
Autotransfusion of shed mediastinal blood after coronary artery bypass grafting (CABG) has been shown to reduce the requirement for allogeneic blood. We have previously demonstrated in non-randomized studies that the oxygen capacity of shed mediastinal blood is similar to the patient's circulating blood and better than stored allogeneic blood. Therefore, we wanted to examine the influence of autotransfusion of shed mediastinal blood on oxygen transport capacity in patients undergoing CABG. ⋯ Autotransfusion of shed mediastinal blood conserves the 2,3-DPG level of the red blood cells, while transfusion of stored blood leads to a decrease in 2,3-DPG levels. Autotransfusion had no effect on hemodynamic parameters, oxygen delivery or oxygen extraction.
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Acta Anaesthesiol Scand · Sep 1997
Case ReportsManagement of the difficult airway. A case of failed fiberoptic intubation.
Fiberoptic intubation is the current gold standard for the management of difficult intubation. Nevertheless, in rare circumstances even fiberoptic intubation fails. ⋯ This case illustrates that even awake fiberoptic intubation has its failure rate, due to inability to visualize the larynx, inability to advance the tube over the fiberscope (as in the present case), or inability to direct the tube towards the larynx. Due to the extreme deviation of the larynx other established techniques for difficult intubation were not deemed appropriate in this case. Therefore, weighing the risks and benefits, a decision was made to perform a tracheotomy under local anaesthesia.