British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Effects of high inspired oxygen fraction during elective caesarean section under spinal anaesthesia on maternal and fetal oxygenation and lipid peroxidation.
Oxygen supplementation is given routinely to parturients undergoing Caesarean section under regional anaesthesia. While the aim is to improve fetal oxygenation, inspiring a high oxygen fraction (FIO2) can also increase free radical activity and lipid peroxidation in both the mother and baby. In this prospective, randomized, double-blind study, we investigated the effect of high inspired oxygen fraction (FIO2) on maternal and fetal oxygenation and oxygen free radical activity in parturients having Caesarean section under spinal anaesthesia. ⋯ We conclude that breathing high FIO2 modestly increased fetal oxygenation but caused a concomitant increase in oxygen free radical activity in both mother and fetus.
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We measured lung mechanics and gas exchange during one-lung ventilation (OLV) of patients with chronic obstructive pulmonary disease, using three respiratory rates (RR) and unchanged minute volume. ⋯ A reduction in RR reduces PEEPi and hypercapnia during OLV in anaesthetized patients with chronic obstructive lung disease.
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Randomized Controlled Trial Clinical Trial
Reliability of epigastric auscultation to detect gastric insufflation.
We studied the reliability of epigastric auscultation to detect gastric insufflation in 30 anaesthetized, paralysed intubated patients. ⋯ We conclude that epigastric auscultation can detect gastric insufflation of 0.25 ml air after 11 breaths and > or = 4 ml air after one breath with 95% confidence. Inter- and intraobserver reliability is moderate to excellent. Epigastric auscultation should be repeated to reduce the risk of false positives.
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We quantified the predictive performance of our computer model of the administration of inhalation anaesthesia from a Datex-Ohmeda Modulus CD circle-absorber system. ⋯ Administration of inhalation anaesthesia can be based on version 2 of this model, but must be guided by active monitoring.