Anaesthesia
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The use of the intubating laryngeal mask in three patients is described. In two patients for whom tracheal intubation using traditional techniques had failed, the intubating laryngeal mask was used to achieve successful tracheal intubation. The trachea of one of these patients was subsequently re-intubated for a second procedure using the same technique. A third patient with a cervical spine fracture whose trachea was electively intubated using the intubating laryngeal mask is also presented.
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Serial thermodilution and impedance cardiac output measurements in two critically ill patients are presented. Impedance cardiography failed to detect changes in cardiac output and provided values lower than those derived from thermodilution. ⋯ This failure of impedance cardiography is attributed to aberrant electrical conduction though the lungs as a result of increased lung fluid that alters the impedance waveform. Although reliable when used in normal subjects, impedance cardiography appears not to provide accurate measurements in critically ill patients.