British journal of anaesthesia
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Transcranial Doppler measurements of the middle cerebral artery flow velocity are widely used as an indicator of vasospasm after aneurysmal subarachnoid haemorrhage (SAH). We investigated inter- and intraoperator agreement in SAH patients and healthy volunteers using colour-coded transcranial Doppler (TCCD), with the secondary aim of describing prediction of angiographic vasospasm and mortality. ⋯ TCCD measurement variability is wider in patient measurements than in controls. This discrepancy can largely be explained by a higher degree of error in patients with angiographic vasospasm. Despite the considerable measurement variability in TCCD, values are predictive of outcome in SAH.
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Automated control of end-tidal inhalation anaesthetic concentration using the GE Aisys Carestation™.
Automated control of end-tidal inhalation anaesthetic concentration is now possible. The EtControl™ module of an Aisys Carestation Anaesthetic machine digitally adjusts fresh gas flow and plenum vaporizer output to achieve a target end-tidal concentration. ⋯ Automatic implementation of low-flow anaesthesia using EtControl allows the user to set and maintain a desired end-tidal volatile concentration while using less volatile agent.
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Review Meta Analysis
Goal-directed therapy in cardiac surgery: a systematic review and meta-analysis.
Perioperative mortality after cardiac surgery has decreased in recent years although postoperative morbidity is still significant. Although there is evidence that perioperative goal-directed haemodynamic therapy (GDT) may reduce surgical mortality and morbidity in non-cardiac surgical patients, the data are less clear after cardiac surgery. The objective of this review is to perform a meta-analysis on the effects of perioperative GDT on mortality, morbidity, and length of hospital stay in cardiac surgical patients. ⋯ The use of pre-emptive GDT in cardiac surgery reduces morbidity and hospital length of stay.