British journal of anaesthesia
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The ultrasound cardiac output monitor (USCOM) is a continuous wave Doppler system designed to measure cardiac output (CO) non-invasively and intermittently either from the pulmonary or from the aortic valve. USCOM scan quality is critical to obtaining reliable data and during anaesthesia it is said to deteriorate with increasing age. The aim of this study was to investigate the effect of age on supra-sternal USCOM scan repeatability during anaesthesia. ⋯ Increasing age has a significant effect on USCOM scan quality and data reliability.
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Blood flow patterns are important modifiers of platelet interactions with plasma coagulation factors. However, it is not feasible to evaluate rheological effects of haemodilution on coagulation using conventional coagulation testing. ⋯ Blood flow affects thrombus formation after haemodilution and subsequent haemostatic component interventions, with differential effects at low and high flow.
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Randomized Controlled Trial
Open-label, phase II study of routine high-flow nasal oxygen therapy in cardiac surgical patients.
Respiratory complications after cardiac surgery increase morbidity, mortality, and length of stay. Studies suggest that routine delivery of positive airway pressure after extubation may be beneficial. We sought to determine whether the routine administration of nasal high-flow oxygen therapy (NHF) improves pulmonary function after cardiac surgery. ⋯ Routine use of NHF did not increase / ratio on Day 3 but did reduce the requirement for escalation of respiratory support.
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Randomized Controlled Trial Comparative Study
Double-lumen tube tracheal intubation using a rigid video-stylet: a randomized controlled comparison with the Macintosh laryngoscope.
Despite an increasing need, there is limited experience of double-lumen endobronchial tube (DLT) placement using video laryngoscope. We evaluated DLT intubation using an OptiScope, a rigid video-stylet with a malleable tip derived from the Clarus Video System, in comparison with a Macintosh laryngoscope. ⋯ The OptiScope® provides faster tracheal intubation and a higher success rate for the first intubation with less trauma and a better vocal cord view than the Macintosh laryngoscope.
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Multicenter Study
Sevoflurane therapy for life-threatening asthma in children.
Asthma is a common disease in children and often develops early in life. This multicentre retrospective case series describe the use and effectiveness of sevoflurane inhalation therapy in a series of children with severe asthma in the paediatric intensive care unit (PICU). ⋯ Sevoflurane inhalation corrects high levels of Pco2 and provides clinical improvement in mechanically ventilated children with life-threatening asthma who fail to respond to conventional treatment.