Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2015
Randomized Controlled TrialEpinephrine adjuvant reduced epidural blood vessel penetration incidence in a randomized, double-blinded trial.
Accidental intravascular injection is a significant and potentially devastating risk of epidural block, particularly in parturients whose epidural veins are engorged and hence more easily pierced. This prospective randomized, double-blinded study determined whether the addition of epinephrine to epidural ropivacaine administered by gravity before catheter insertion was associated with fewer epidural catheter blood vessel penetrations. ⋯ The addition of epinephrine to ropivacaine improves the safety and quality of epidural anesthesia when administered by gravity flow via the Hustead needle for cesarean sections.
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Acta Anaesthesiol Scand · Nov 2015
Measuring resting energy expenditure during extracorporeal membrane oxygenation: preliminary clinical experience with a proposed theoretical model.
Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients with severe respiratory failure. Indirect calorimetry (IC) is a safe and non-invasive method for measuring resting energy expenditure (REE). No data exist on the use of IC in ECMO-treated patients as oxygen uptake and carbon dioxide elimination are divided between mechanical ventilation and the artificial lung. We report our preliminary clinical experience with a theoretical model that derives REE from IC measurements obtained separately on the ventilator and on the artificial lung. ⋯ We present IC-acquired gas analysis in ECMO patients. We propose to insert individually obtained IC measurements at the native and the artificial lung in the Weir equation for retrieving a measured REEcomposite .