British journal of anaesthesia
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Pre-hospital endotracheal intubation for the purpose of controlled ventilation may prevent secondary brain injury in patients with severe head injury. In view of the limited monitoring devices utilized in the pre-hospital setting, little is known about the 'quality' of controlled ventilation initiated in the pre-hospital setting. ⋯ Endotracheal intubation and controlled ventilation of the lungs initiated in the pre-hospital setting do not guarantee optimal oxygenaton and ventilation in patients with severe head injury.
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To determine the effects of sevoflurane on cerebrovascular carbon dioxide reactivity (CCO2R), middle cerebral artery blood flow velocity (CBFV) was measured at different levels of PE'CO2 by transcranial Doppler sonography in 16 ASA I or II children, aged 18 months to 7 yr undergoing elective urological surgery. ⋯ CCO2R is preserved in healthy children anaesthetized with 1.0 MAC sevoflurane.
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Neurological deterioration from intraspinal haematoma following insertion of a spinal needle is extremely rare. We present the case of a 28-yr-old female, who presented with complete paraplegia following attempted spinal anaesthesia for delivery of her third child. Space-occupying iatrogenic spinal haemorrhage from a previously undiagnosed lumbar ependymoma was found to be the precipitating cause. Following laminotomy with blood clot and tumour removal her neurological function improved.
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Diaphragmatic fatigue is implicated as a cause of respiratory failure. This study was undertaken to evaluate the effects of inhaled olprinone, a newly developed phosphodiesterase III inhibitor, on the contractility of fatigued diaphragm in dogs. ⋯ Inhaled olprinone produces a dose-dependent improvement in contractility of fatigued canine diaphragm.