British journal of anaesthesia
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Cardiovascular changes during drainage of pericardial effusion are not well understood, and most studies are of systemic effects and not of right ventricular performance. Thoracoscopy is not widely used to drain pericardial effusions because of haemodynamic changes in relation to the use of single lung ventilation. ⋯ Pericardial effusion reduces right ventricular distensibility, right and left systolic ventricular function, and cardiac output. Anaesthesia with mechanical ventilation and a low-pressure pneumothorax do not affect the circulation greatly. Drainage of the pericardial effusion allows cardiac distensibility to increase and cardiac performance changes to allow increased ejection.
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Randomized Controlled Trial Comparative Study Clinical Trial
The Bispectral Index in children: comparing isoflurane and halothane.
The Bispectral Index (BIS) has been calibrated for several general anaesthetic agents including isoflurane. Halothane is still used in paediatric anaesthesia. Compared with other volatile anaesthetics, halothane has a different receptor affinity and differing effects on the EEG. There are limited data evaluating the BIS with halothane. We set out to compare the BIS using halothane and isoflurane at a clinically relevant equipotent concentration (1 MAC) and at a reproducible measure of anaesthetic effect (awakening). ⋯ At equipotent concentrations of halothane and isoflurane BIS valves were significantly greater with halothane. At awakening the BIS values were equivalent for each agent. This finding is consistent with the BIS being more affected by the agent used at higher concentrations of anaesthetic. The BIS must be interpreted with caution when using halothane.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preoperative saline versus gelatin for hip fracture patients; a randomized trial of 396 patients.
The aim of this study was to determine if the preoperative administration of 500 ml of a gelatin colloid solution intravenously before hip fracture surgery improves outcome, compared with a conventional i.v. fluid regime with a crystalloid solution. ⋯ The inclusion of 500 ml of colloid solution to the i.v. fluid regime before hip fracture surgery does not improve outcome.