Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2012
Review Meta AnalysisInadvertent epidural injection of drugs for intravenous use. A review.
The frequency of inadvertent injection of drugs in the epidural space is probably underestimated and underreported, but it can cause serious morbidity and possibly mortality. ⋯ Most drugs do not lead to sequelae other than pain during injection or transient neurological complaints. Other drugs may have more deleterious consequences, such as paraplegia. Both the dose of the inadvertent injected drug and the time frame play an important role in the patient's outcome. "Syringe swap", "ampoule error", and epidural/intravenous line confusion due to inaccurate or absent colour coding of epidural catheters were the main sources of error. Preventive strategies, including non Luer-lock epidural injection ports, might increase safety.
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Acta Anaesthesiol Belg · Jan 2003
Meta Analysis Comparative StudyColloids versus crystalloids as priming solutions for cardiopulmonary bypass: a meta-analysis of prospective, randomised clinical trials.
Using Cochrane methodology a review was performed of prospective randomized clinical trials comparing colloidal pump priming solutions for cardiopulmonary bypass. Dextrans were not considered. Database searches from 1966 through December 2002 delivered 265 articles. ⋯ To conclude, using mere crystalloids produced more pronounced positive fluid balances and their avoidance as a single pump-prime component can be suggested. Since albumin is not necessarily associated with better outcomes and is more expensive, it is hard to continue its use. However, there is still insufficient evidence available to allow definitive conclusions.