British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Randomized cross-over comparison of cervical-spine motion with the AirWay Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study.
The AirWay Scope (AWS) is a fibreoptic device that allows for intubation without alignment of the oral, pharyngeal, and tracheal axes. It may be useful for patients with an unstable cervical-spine (C-spine) or when C-spine movement is undesirable. This study was conducted to fluoroscopically evaluate upper C-spine movement during tracheal intubation with the AWS and or the Macintosh laryngoscope with in-line stabilization (ILS). ⋯ In comparison with the use of the Macintosh laryngoscope, the AWS decreased median upper C-spine movement during intubation under ILS in patients with normal C-spine.
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It is increasingly believed that acute microvascular alterations may be involved in the development of organ dysfunction in critically ill patients. Propofol significantly decreases vascular tone and venous return, which can induce arterial hypotension. However, little is known about the microcirculatory effects of propofol in healthy humans. ⋯ Propofol infusion for anaesthesia in man reduces capillary blood flow.
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Despite it being generally regarded as futile, patients are regularly brought to the emergency department with ongoing cardiopulmonary resuscitation (CPR). ⋯ Post-resuscitation care in patients who receive CPR during transport is not futile. Once restoration of spontaneous circulation is established, one out of five patients will have good long-term outcome.
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Randomized Controlled Trial
Video-assisted instruction improves the success rate for tracheal intubation by novices.
Tracheal intubation via laryngoscopy is a fundamental skill, particularly for anaesthesiologists. However, teaching this skill is difficult since direct laryngoscopy allows only one individual to view the larynx during the procedure. The purpose of this study was to determine if video-assisted laryngoscopy improves the effectiveness of tracheal intubation training. ⋯ The improved rate of successful intubation and the decreased rate of oesophageal intubation support the use of video laryngoscopy for tracheal intubation training.
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Multicenter Study
Multicentre, parallel-group, comparative trial evaluating the efficacy and safety of sugammadex in patients with end-stage renal failure or normal renal function.
Sugammadex, a modified gamma-cyclodextrin, is the first selective relaxant binding agent that specifically encapsulates the steroidal neuromuscular blocking agent, rocuronium. The action of rocuronium is prolonged in patients with renal failure. As sugammadex is primarily cleared renally, this phase III trial investigated the efficacy and safety of sugammadex for reversal of rocuronium-induced neuromuscular block (NMB) in patients with end-stage renal failure. ⋯ Sugammadex administered at reappearance of T(2) rapidly and effectively reverses NMB induced by rocuronium in renal failure and healthy patients. Sugammadex was well tolerated by all patients. Further safety studies on sugammadex in patients with severe renal impairment are warranted.