Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Does directed bronchoscopic bronchial cleansing have an advantage over conventional suctioning? A prospective study of hemodynamics, gas exchange and suction-induced mucosal lesions in long-term ventilated patients].
Hypoxic complications and epithelial damage to the trachea and bronchi during conventional blind suctioning have been described in the literature. Fiberoptic suctioning and examination of the trachea of each long-term ventilator patient as a routine method has been recommended in recent studies. We investigated the effect of a conventional tracheal suction technique compared to precise fiberbronchoscopic suction on cardiocirculatory function and gas exchange in mechanically ventilated patients. ⋯ There was no effect on cardiocirculatory function in either group (Figs. 1 and 2), but we found a decrease in arterial PO2 after suctioning in all patients (group I from 99 +/- 25 to 81 +/- 19 mmHg, group II from 104 +/- 23 to 80 +/- 17 mmHg [Fig. 3]). The time needed to re-establish the initial PaO2 after suctioning was significantly different in both groups. Whereas the PaO2 returned to the initial value within 2 min after conventional suctioning, we found a decrease in PaO2 in the bronchoscopic group even after 15 min.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[Effect of different pre-oxygenation procedures on arterial oxygen status].
There are different opinions regarding efficiency, duration, and techniques of preoxygenation. It was the aim of our study to systematically investigate the effectiveness of different preoxygenation methods by means of arterial blood gas parameters (paO2, SaO2, and CaO2). METHODS. ⋯ Most important was the manner of holding the face mask. With a tightly fitting mask, preoxygenation was more effective than with the face mask one digit away from mouth and nose, independent of preoxygenation time and oxygen flow (Table 3). The SaO2 (Fig. 2) increased in the same manner with the different preoxygenation techniques from 94.0% to 97.5% (Table 3); CaO2 (Fig. 3) was influenced in a similar way (16.7 ml/dl to 17.4 ml/dl).(ABSTRACT TRUNCATED AT 250 WORDS)