Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2009
Randomized Controlled TrialThe impact of fluid restriction policy in reducing the use of red blood cells in cardiac surgery.
Hemodilution contributes significantly to transfusion requirements in patients undergoing CABG under CPB. We hypothesised that restriction of parenteral fluids in comparison to a liberal fluid administration policy leads to less use of packed red cells in CABG operations supported by cell salvage. After consent and approval, 130 patients operated under equal conditions were assigned prospectively and randomly either for a restrictive protocol for intravenous fluid administration (group A, 65 pts) or not (group B, 65 pts). ⋯ Hours of mechanical ventilation in ICU were ranging from 5 to 29 (mean = 10.0, median = 9) for A and from 5 to 42 (mean = 14.8, median = 10) for B. Length of stay in ICU in nights for group A was ranging from 1 to 10 (mean = 2.7, median = 2) and for group B was ranging from 1 to 6 (mean = 3.5, median = 2). In conclusion, reduction of transfusions in CABG operations is feasible when a restrictive protocol for intravenous fluids is applied.
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Acta Anaesthesiol Belg · Jan 2009
Randomized Controlled Trial Comparative StudyHydroxyethyl starch 130/0.4 versus modified fluid gelatin for cardiopulmonary bypass priming: the effects on postoperative bleeding and volume expansion needs after elective CABG.
Concerned about high dose starches and potential coagulopathy, we performed a double blinded randomised prospective study on the influence of gelatine or 6% HES 130/04 pump prime on postoperative blood loss and transfusion requirements after CABG surgery. ⋯ 6% HES 130/0.4 is a safe alternative to gelatine pump prime with a volume effect persisting longer in the postoperative phase, mandating less volume expansion with artificial colloid during the first 24 postoperative hours and not causing additional allogeneic blood component exposure.
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Acta Anaesthesiol Belg · Jan 2009
Randomized Controlled TrialEffects of oral preoperative carbohydrate on early postoperative outcome after thyroidectomy.
Preoperative carbohydrate (CHO) reduces perioperative insulin resistance and improves preoperative patient comfort. We tested the hypotheses that preoperative CHO reduces the risk of postoperative nausea and vomiting (PONV) and improves early postoperative patient comfort. ⋯ Oral carbohydrate before thyroidectomy improves pre- and postoperative patient comfort, as well as postoperative analgesia, but has no effect on the PONV.
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Acta Anaesthesiol Belg · Jan 2009
Randomized Controlled TrialLocal anaesthetic use for the iliac crest-donor site: pharmacokinetic and pharmacodynamic evaluations.
During orthopaedic surgery of the limb, we performed a prospective, double blind controlled study on three parallel groups in 30 patients to evaluate the pharmacokinetic and pharmacodynamic effect of infiltration of the iliac crest bone graft harvest site with 20 ml of bupivacaine (100 mg), ropivacaine (150 mg) or saline as control group (n = 10 in each group). Then, in a sheep model of iliac crest infiltration, we compared the pharmacokinetics of single administration of plain bupivacaine (100 mg) and bupivacaine (500 mg)-loaded microspheres. In the clinical control group, pain from the iliac crest was worse than pain from the primary surgical site. ⋯ However, this effect lasts only 12 hours without reducing the morphine consumption due to an increase of pain from the primary surgical site. The local anaesthetic infiltration produced a significant peak of plasma level, which could be dangerous if another infiltration or regional anaesthetic technique was associated with it. Experimentally, as a drug delivery system, the use of local anaesthetic-loaded microspheres could be an interesting alternative.
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Acta Anaesthesiol Belg · Jan 2009
Randomized Controlled TrialThe effect of self-assessment in reciprocal learning with task cards on the quality of CPR.
This study investigated the effect of self-assessment with and without motor activity on the quality of CPR in reciprocal learning with task cards. Gender differences in learning outcomes were analysed as well. Eighty-six university students (39 women and 47 men) were randomised in pairs into three groups: cognitive self-assessment, cognitive-motor self-assessment, and a control. ⋯ Self-assessment with motor activity did not differ significantly from merely cognitive self-assessment. At retention, males ventilated significantly less volume than females. Within the limitations of this study, it can be concluded that implementing self-assessment in reciprocal learning with task cards does not lead to better CPR performance in the present target group.