British journal of anaesthesia
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Randomized Controlled Trial
Effect of fluid loading with saline or colloids on pulmonary permeability, oedema and lung injury score after cardiac and major vascular surgery.
The optimal type of fluid for treating hypovolaemia without evoking pulmonary oedema is still unclear, particularly in the presence of pulmonary vascular injury, as may occur after cardiac and major vascular surgery. ⋯ Provided that fluid overloading is prevented, the type of fluid used for volume loading does not affect pulmonary permeability and oedema, in patients with acute lung injury after cardiac or major vascular surgery, except for HES that may ameliorate increased permeability. During fluid loading, changes in LIS (and respiratory compliance) do not represent changes in pulmonary permeability or oedema.
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Randomized Controlled Trial Multicenter Study
Org 25969 (sugammadex), a selective relaxant binding agent for antagonism of prolonged rocuronium-induced neuromuscular block.
Org 25969 is a cyclodextrin compound designed to reverse a rocuronium-induced neuromuscular block. The aim of this study was to explore the efficacy, dose-response relation and safety of Org 25969 for reversal of a prolonged rocuronium-induced neuromuscular block. ⋯ Org 25969 effectively reversed a deep and prolonged neuromuscular block induced by rocuronium. The effective reversal dose appears to be 2-4 mg kg(-1).
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Randomized Controlled Trial Comparative Study
Equivalent dose of ephedrine and phenylephrine in the prevention of post-spinal hypotension in Caesarean section.
Comparative studies of ephedrine and phenylephrine in prevention of hypotension after spinal anaesthesia for Caesarean section have lacked a consensus on dose equivalence. The aim of this study was to determine the minimum vasopressor dose for each of these drugs to calculate the dose ratio for clinical equivalence in the prevention of hypotension. ⋯ This study demonstrates a potency ratio of 81.2 (95% CI 73.0-89.7) for equivalence between phenylephrine and ephedrine in prevention of hypotension after spinal anaesthesia for Caesarean section.
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Multicenter Study
Factors influencing emergency intubation in the pre-hospital setting--a multicentre study in the German Helicopter Emergency Medical Service.
Definitive airway control by endotracheal intubation (ETI) is standard of care in pre-hospital airway management. However, there are specific factors that may influence and complicate ETI. ⋯ Despite various factors increasing the difficulties in managing the airway in the field, definitive airway control by ETI seems to be safe practice.
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Pulse transit time (PTT) measurement may provide rapidly available beat-to-beat cardiovascular information when conditions change quickly and routine invasive arterial pressure measurement is not justified, for example during obstetric spinal anaesthesia. Method. We obtained ethics approval for an observational study of PTT during the onset of spinal anaesthesia in patients having elective or urgent Caesarean section. PTT was measured as the difference in time between the peak of the ECG R wave and the upstroke of the toe plethysmograph. Arterial pressure was measured by non-invasive sphygmomanometry. ⋯ PTT measurement gave a beat-to-beat indication of arterial pressure during spinal anaesthesia, and could be developed to allow prediction of the onset of hypotension.