British journal of anaesthesia
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Respiratory rate is an important measurement in patient care but frequently poorly assessed. We set out to develop a simple non-invasive device to reliably measure respiratory movements and estimate respiratory rate, in clinical circumstances. ⋯ The Orient speck provides a reliable measure of respiratory rate at frequent intervals in subjects receiving patient-controlled morphine analgesia after surgery.
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Bibliometrics provide surrogate measures of the quality and quantity of research undertaken by departments and individuals. Previous reports have suggested that academic anaesthesia research in the UK is in decline. We wished to provide a comprehensive description of current and historical published output of UK anaesthesia researchers. ⋯ The general distribution of bibliometric data is similar to that seen in other specialities in Europe and North America. Four departments contribute to more than 50% of published anaesthesia research output in this data set. These data provide useful comparative tools for individuals, departments, and national bodies.
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Dexmedetomidine (DEX) is an alpha 2-adrenoreceptor agonist, which induces sedation and analgesia. This study aimed to determine whether intranasal DEX offered perioperative sedation and better postoperative analgesia. ⋯ Patients receiving intranasal DEX for unilateral third molar surgery with local anaesthesia were more sedated perioperatively with better postoperative pain relief. No delay in psychomotor recovery was seen.
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Comparative Study
Open lung approach vs acute respiratory distress syndrome network ventilation in experimental acute lung injury.
Setting and strategies of mechanical ventilation with positive end-expiratory pressure (PEEP) in acute lung injury (ALI) remains controversial. This study compares the effects between lung-protective mechanical ventilation according to the Acute Respiratory Distress Syndrome Network recommendations (ARDSnet) and the open lung approach (OLA) on pulmonary function and inflammatory response. ⋯ According to the OLA, mechanical ventilation improved oxygenation and redistributed pulmonary perfusion when compared with the ARDSnet protocol, without differences in lung inflammatory response.
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Complications of an inadequate haemodynamic state are a leading cause of morbidity and mortality after cardiac surgery. Unfortunately, commonly used methods to assess haemodynamic status are not well documented with respect to outcome. The aim of this study was to investigate Sv(O2) as a prognostic marker for short- and long-term outcome in a large unselected coronary artery bypass grafting (CABG) cohort and in subgroups with or without treatment for intraoperative heart failure. ⋯ Sv(O2) <60% on admission to ICU was related to worse short- and long-term outcome after CABG, regardless of whether the patients were admitted to ICU with or without treatment for intraoperative heart failure.