BMC anesthesiology
-
Randomized Controlled Trial
Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy--a pilot study.
Ischemic or volatile anesthetic preconditioning is defined as tissue protection from impending ischemic cell damage by repetitive short periods of tissue exposure to ischemia or volatile anesthetics. Objective of this study was to elucidate, if ischemic preconditioning and pharmacological preconditioning with sevoflurane have effects on muscle tissue oxygen saturation in patients undergoing surgical revascularization of the lower limb. ⋯ Ischemic preconditioning of lower limb muscle tissue and pharmacological preconditioning with sevoflurane have an effect on tissue oxygenation in patients with lower limb occlusive arterial disease.
-
Observational Study
The influence of statin exposure on inflammatory markers in patients with early bacterial infection: pilot prospective cohort study.
In the context of infection, progressive illness resulting in acute organ dysfunction is thought to be secondary to inflammatory response. Our aims were to determine risk factors for progressive illness following infection in a low-risk hospitalised cohort, including the impact of prior stain therapy. ⋯ This cohort of ward patients treated for infection had a low risk of clinical deterioration, inflammatory markers improved over time, and statin exposure was not associated with any outcome. Future larger studies may identify risk factors for progression of illness in this population and plausible surrogate endpoints for evaluation in clinical trials.
-
Comparative Study
Extubation force depends upon angle of force application and fixation technique: a study of 7 methods.
Endotracheal tubes are frequently used to establish alternate airways. Precise placement of the tubes must be maintained to prevent serious complications. Several methods for fixation of endotracheal tubes are available. Available methods vary widely in form and functionality. Due to the unpredictable and dynamic nature of circumstances surrounding intubation, thorough evaluation of tube restraints may help reduce airway accidents such as tube dislodgement and unplanned extubation. ⋯ Clinically, forces can be applied to endotracheal tubes from various directions. Efficacies of different fixation techniques are sensitive to the angle of force application. Standard deviations, which could be used as a measure of fixator reliability, also vary with angle of force application and method of tube restraint. Findings presented in this study may be used to advance clinical implementation of current methods as well as fixator device design in an effort to reduce the incidence of unplanned extubation.
-
Observational Study
The accuracy of locating the cricothyroid membrane by palpation - an intergender study.
The cricothyroid membrane (CTM) is the recommended site of access to the airway during cricothyrotomy to provide emergency oxygenation. We sought to compare the ability of physicians to correctly identify the CTM in male and female patients. ⋯ CTM localisation is more difficult in female subjects irrespective of body habitus. It may be prudent to localize this structure by additional means (e.g. ultrasound) in advance of any airway manoeuvres or to modify the cricothyrotomy technique in the event that it is necessary in an emergency.
-
Patients ≥80 years of age are increasingly being admitted to the intensive care unit (ICU). The impact of relevant variables, such comorbidities and performance status, on short-term outcomes in the very elderly is largely unknown. Few studies address the calibration of illness severity scores (SAPS3 score) within this population. We investigated the risk factors for hospital mortality in critically ill patients ≥80 years old, emphasizing performance status and comorbidities, and assessed the calibration of SAPS3 scores in this population. ⋯ Performance status and comorbidities are important determinants of short-term outcome in critically ill elderly patients ≥80 years old. The addition of simple background information may increase the calibration of the SAPS3 score in this population.