Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2022
Randomized Controlled TrialEvaluation of the conventional and modified aerosol boxes during tracheal intubation in normal and difficult airways: a randomized, crossover, manikin simulation study.
The aim of this study was to evaluate conventional and modified aerosol boxes in terms of intubation time, first-pass intubation success, and mouth-to-mouth distance between the laryngoscopist and patient during tracheal intubation in simulated patients with normal and difficult airways. Sixteen anesthesiologists performed tracheal intubations with direct laryngoscope or three different videolaryngoscopes (McGRATH MAC videolaryngoscope, C-MAC videolaryngoscope, and Pentax-AWS) without an aerosol box or with a conventional or a modified aerosol boxes in simulated manikins with normal and difficult airways. Intubation time, first-pass intubation success, and mouth-to-mouth distance during tracheal intubation were recorded. ⋯ However, no significant differences were found in intubation time between no aerosol box and the modified aerosol box for normal and difficult airways (Pcorrected = 0.336 and Pcorrected = 0.112, respectively). The use of conventional or modified aerosol boxes significantly extended the mouth-to-mouth distances compared to not using an aerosol box during tracheal intubation with each laryngoscope (all Pcorrected < 0.05), and the distances were not different between the conventional and modified boxes in normal and difficult airways. The use of modified aerosol box did not increase intubation time and could help maintain a distance from the simulated patients with normal and difficult airways.
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J Clin Monit Comput · Dec 2022
Randomized Controlled TrialEffects of changes in position, positive end-expiratory pressure and mean arterial pressure on renal, portal and hepatic Doppler ultrasound perfusion indices: a randomized crossover study in cardiac surgery patients.
Point-of-care ultrasound perfusion indices can be used for detection of AKI and venous congestion. Patients in the postoperative- and intensive care units are frequently exposed to alternating treatment and loading conditions. We aimed to study the effects of changes in preload (patient positioning), positive end-expiratory pressure (PEEP) and afterload (phenylephrine) on renal, portal and hepatic ultrasound indices. ⋯ Although the changes in the Doppler ultrasound indices were significant, they were small in absolute numbers. Therefore, from a clinical perspective, the ultrasound indices were robust. Trial registration Registered at clinicaltrials.com, first posted online June 5th 2020, identifier: NCT04419662.
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J Clin Monit Comput · Oct 2022
Randomized Controlled TrialBlind vs. video-laryngoscope-guided laryngeal mask insertion: A prospective randomized comparison of oropharyngeal leak pressure and fiberoptic grading.
Laryngeal Mask Airway (LMA) insertion may not always be smooth without complications. Controversial results of several studies evaluating ideal insertion conditions have been published. This study compared the oropharyngeal leak pressure values and fiberoptic grading scores between blind and video-laryngoscope-guided LMA insertion. ⋯ The findings of our study suggest that the video-laryngoscope-guided LMA-Classic insertion with a standard blade technique may be a helpful alternative to blind insertion.
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J Clin Monit Comput · Oct 2022
Randomized Controlled Trial Observational StudyThe outcomes of using high oxygen concentration in pediatric patients.
Oxygen reserve index, available as part of Masimo Rainbow SET pulse oximetry, is a noninvasive and continuous variable intended to provide insight into a patient's oxygen status in the moderate hyperoxic range (PaO2 > 100 and ≤ 200 mm Hg), defined as a patient's oxygen "reserve". When used in conjunction with pulse oximetry, ORi extends the knowledge on a patient's oxygen status providing clinically important information helping to prevent hyperoxemia and hypoxemia. There are limited data on patients undergoing craniosynostosis surgery. ⋯ In Group 1, ORi values were significantly higher when compared to group 2 at baseline (0.86 ± 0.21 vs 0.45 ± 0.32, p = 0.001), one minute (0.61 ± 0.24 vs 0.27 ± 0.21, p = 0.001), and 5 min (0.34 ± 0.31 vs 0.10 ± 0.13, p = 0.033). High inspired oxygen concentration during induction of anesthesia in pediatric patients is associated with higher levels of ORi. Therefore, ORi may provide the means to safely reduce the inspired oxygen fraction during inhalational induction in paediatric patients.
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J Clin Monit Comput · Oct 2022
Randomized Controlled TrialThe effect of different flow levels and concentrations of sevoflurane during the wash-in phase on volatile agent consumption: a randomized controlled trial.
The standard procedure for low-flow anesthesia usually incorporates a high fresh gas flow (FGF) of 4-6 L/minute during the wash-in phase. However, the administration of a high FGF (4-6 L/min) increases the inhaled anesthetic agent consumption. This study was designed to compare the sevoflurane consumption at 2 rates of flow and vaporizer concentration during the wash-in period. ⋯ The anesthetic agent consumption during the wash-in phase was approximately 3 times lower with the administration of sevoflurane at 1 L/minute FGF than the use of 4 L/minute FGF.