British journal of anaesthesia
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Review Meta Analysis
The Effect of patient warming during Caesarean delivery on maternal and neonatal outcomes: a meta-analysis.
Perioperative warming is recommended for surgery under anaesthesia, however its role during Caesarean delivery remains unclear. This meta-analysis aimed to determine the efficacy of active warming on outcomes after elective Caesarean delivery. ⋯ Active warming for elective Caesarean delivery decreases perioperative temperature reduction and the incidence of hypothermia and shivering. These findings suggest that forced air warming or warmed fluid should be used for elective Caesarean delivery.
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Case Reports
Printed three-dimensional airway model assists planning of single-lung ventilation in a small child.
Single-lung ventilation in infants and small children is challenging because suitable sizes of double-lumen cuffed tracheal tubes are not available. A 6-yr-old child required pulmonary saline washout for primary alveolar proteinosis, and therefore needed sequential single-lung ventilation in order to achieve safe oxygenation. Before undertaking this potentially hazardous procedure, we practised bronchial intubation on an anatomical model of her airway constructed from computed tomography (CT) data. ⋯ Three-dimensional printing of a model of the airway of a small child aided planning of bronchial intubation and single-lung ventilation. Three-dimensional printing of airway structures may have wider application in anaesthesia practice.
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Randomized Controlled Trial
Effect of acute cigarette smoking on gastric contents in regular smoker volunteers. A prospective randomized cross-over study.
The authors sought to assess the effect of acute smoking on gastric contents in regular smoker volunteers. The primary endpoint was the variation in antral area during the 120-min study period after cigarette smoking. ⋯ NCT 02080598.
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Randomized Controlled Trial
Randomized controlled trial of stroke volume optimization during elective major abdominal surgery in patients stratified by aerobic fitness.
The benefits of stroke volume optimization during surgery are unclear, with recent data not replicating the positive effects of earlier studies. ⋯ ISRCTN21597243.
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Review Practice Guideline
European Malignant Hyperthermia Group guidelines for investigation of malignant hyperthermia susceptibility.
It is 30 yr since the British Journal of Anaesthesia published the first consensus protocol for the laboratory diagnosis of malignant hyperthermia susceptibility from the European Malignant Hyperthermia Group. This has subsequently been used in more than 10 000 individuals worldwide to inform use of anaesthetic drugs in these patients with increased risk of developing malignant hyperthermia during general anaesthesia, representing an early and successful example of stratified medicine. ⋯ We now present an updated and complete guideline for the diagnostic pathway for patients potentially at increased risk of developing malignant hyperthermia. We introduce the new guideline with a narrative commentary that describes its development, the changes to previously published protocols and guidelines, and new sections, including recommendations for patient referral criteria and clinical interpretation of laboratory findings.