British journal of anaesthesia
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The differential effects of i.v. anaesthesia on the response of the mesenteric microcirculation after haemorrhage in vivo are previously unexplored. ⋯ In summary, i.v. anaesthetic agents differentially alter the response of the mesenteric microcirculation to haemorrhage.
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Randomized Controlled Trial Comparative Study Clinical Trial
Positive pressure ventilation during fibreoptic intubation: comparison of the laryngeal mask airway, intubating laryngeal mask and endoscopy mask techniques.
The efficacy of delivery of mechanical ventilation through different airway devices during fibreoptic intubation is not known. ⋯ PPV is possible with the LMA, ILM or endoscopy mask during fibreoptic intubation. With an airway pressure of 20 cm H2O, ventilation during intubation using a size 3 or 4 LMA was almost insufficient, while ventilation using a size 5 LMA or an ILM was almost acceptable. Ventilation during intubation with the endoscopy mask was greater than that with the LMA or ILM, but gastric insufflation was more frequent.
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Review Comparative Study
Comparison of predictive models for postoperative nausea and vomiting.
In order to identify patients who would benefit from prophylactic amtiemetics, six predictive models have been described for the risk assessment of postoperative nausea and vomiting (PONV). This study compared the validity and practicability of these models in patients undergoing general anaesthesia. ⋯ The simplified risk scores provided better discrimination and calibration properties compared with the more complex risk scores. Therefore, simplified risk scores can be recommended for antiemetic strategies in clinical practice as well as for group comparisons in randomized controlled antiemetic trials.
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Case Reports
Infected mediastinitis secondary to perforation of superior vena cava by a central venous catheter.
We describe the first case of infected mediastinitis associated with central venous catheter insertion. The rare occurrence of this complication may be explained by the fact that it results from central venous catheter-related bloodstream infection and catheter perforation of superior vena cava. The symptoms of this complication (chest pain, dyspnoea) are not specific. ⋯ Appropriate antibiotic therapy, guided by sensitivities of the cultured organisms, should be commenced. Any pleural effusion should be drained by thoracocentesis, and the pleural fluid cultured. In case of fever, bacteraemia or shock, a thoracotomy to drain mediastinal and pleural effusions may be considered.