British journal of anaesthesia
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Review Randomized Controlled Trial Clinical Trial
NICE guidelines for central venous catheterization in children. Is the evidence base sufficient?
Recent guidelines from the National Institute for Clinical Excellence (NICE) recommend the use of ultrasound guidance for central venous catheterization in children. This study prospectively examined the use of ultrasound guidance for central venous catheterization in children undergoing heart surgery. ⋯ These results are different from the published results on which the NICE guidelines were based; however, the evidence base in children is small. There is currently insufficient evidence to support the use of ultrasound guidance for central venous catheterization in children.
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The intravascular expansion effect of 20% albumin is roughly double its infused volume, although 15% greater again in the healthy versus those with sepsis.
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Case Reports
Retrieval of a retrograde catheter using suction, in patients who cannot open their mouths.
In difficulty, tracheal intubation can be facilitated by passing a retrograde catheter, but the mouth has to be opened for the retrieval of the catheter from the pharynx. Two patients with ankylosis of a temporomandibular joint were unable to open their mouth, and required general anaesthesia for gap arthroplasty. ⋯ Catheter-guided tracheal intubation was done without complication. A suction catheter can assist retrograde retrieval of a catheter to aid intubation in patients who cannot open the mouth.
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Comment Letter Case Reports
Another case of use of the ProSeal laryngeal mask airway in a difficult obstetric airway.