Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2011
Washout of sevoflurane from the GE Avance and Amingo Carestation anesthetic machines.
Inhalational anesthetics must be removed from anesthetic machines to prevent malignant hyperthermia (MH) in susceptible patients or to treat MH occurring during inhalational general anesthesia. This study examines the sevoflurane washout from the GE Avance and Amingo Carestations™. ⋯ In case of sudden onset of MH, the Avance or Amingo Carestation™ can stay in place, if the fresh gas flow is increased to 10 l/min or more. To prepare these machines for MH-susceptible patients, the ABS™ should be substituted by a laundered component.
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Acta Anaesthesiol Scand · Oct 2011
Randomized Controlled Trial Comparative StudyGlideScope videolaryngoscope vs. Macintosh direct laryngoscope for intubation of morbidly obese patients: a randomized trial.
Morbidly obese patients are at increased risk of hypoxemia during tracheal intubation because of increased frequency of difficult and impossible intubation and a decreased apnea tolerance. In this study, intubation with the GlideScope videolaryngoscope (GS) was compared with the Macintosh direct laryngoscope (DL) in a group of morbidly obese patients. ⋯ Intubation of morbidly obese patients with GS was slightly slower than with DL. The increased intubation time was of no clinical consequence as no patients became hypoxemic. Both devices generally performed well in the studied population, but the GS provided better laryngoscopic views and decreased IDS scores.
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Acta Anaesthesiol Scand · Oct 2011
ReviewDetermining authorship in multicenter trials: a systematic review.
The practical and ethical issues in determining authorship in multicenter trials raise significant and unique challenges. This systematic review examines methods of assigning authorship in multicenter clinical trials. A literature search (October 2009) was conducted to identify articles with the terms 'authorship' and 'clinical trial,' 'multicenter' or 'multicentre.' Abstracts were reviewed for potential relevance and the complete manuscript was obtained where indicated. ⋯ The authors propose a guide for determining authorship based on the methods identified and the number of collaborators and anticipated publications. For smaller collaborative groups (e.g. <10 persons), byline inclusion of all authors based on relative contributions is recommended. For larger collaborations (e.g. ≥ 10 persons), authorship guidelines should be explicit from the outset of the trial with consideration of relevant scoring systems.
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Acta Anaesthesiol Scand · Oct 2011
High-resolution solid-state manometry of the effect of rocuronium on barrierpressure.
The pressure in the lower esophageal sphincter (LES) is partly dependent on striated muscles derived from the crural portion of the diaphragm. The effect of neuromuscular blockade on the integrity of the esophagogastric junction is not well studied. We conducted a prospective interventional study to determine the effect of rocuronium on the barrier pressure (LES pressure - intragastric pressure) of the esophagogastric junction. We also studied the effect of positive pressure ventilation on the barrier pressure after neuromuscular blockade with rocuronium. ⋯ Neuromuscular blockade with rocuronium and conversion from spontaneous breathing to positive pressure ventilation does not decrease the barrier pressure during anesthesia induction.
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Acta Anaesthesiol Scand · Oct 2011
Influence of prone positioning on the measurement of transpulmonary thermodilution-derived variables in critically ill patients.
Patients with respiratory failure undergoing prone positioning (PP) are often monitored by the transpulmonary thermodilution (TPTD) technique. However, it remains unclear whether the measurement of TPTD-derived variables is influenced by PP. We investigated the effects of 135° PP on the accuracy of TPTD-derived variables and their changes over an 8-10 h period of time. ⋯ EVLWI and GEDVI measurements are possibly influenced by prone positioning. In spite of statistical significance, the differences in EVLWI and GEDVI are low and presumably of no clinical relevance.