HSR proceedings in intensive care & cardiovascular anesthesia
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2012
A quantitative evaluation of fluid leakage around a polyvinyl chloride tapered endotracheal tube cuff using an in-vitro model.
This study was designed to quantitatively evaluate the sealing effect of a polyvinyl chloride tapered endotracheal tube cuff and to compare the tapered cuff with cylindrical endotracheal tube cuffs using an in vitro viscous fluid model. ⋯ An endotracheal tube with a tapered polyvinyl chloride cuff had significantly less fluid leakage compared to four tubes with cylindrical cuffs.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2012
Selective decontamination of the digestive tract: an update of the evidence.
Selective decontamination of the digestive tract has been proven to prevent severe infections and to reduce mortality in critically ill patients. Historical arguments against its use, like the development of bacterial resistance and the absence of influence on mortality, have not been confirmed. Recent clinical trials designed to evaluate these variables and meta-analyses showed remarkable reductions in the incidence of resistant bacteria and a significant beneficial effect on survival. This review will update the evidence on the efficacy of selective decontamination of the digestive tract, and the issue of emergence of resistance, using data from randomized controlled trials and meta-analyses.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2012
Case ReportsSudden cardiac arrest in a marathon runner. A case report.
Sudden cardiac death is a rare condition resulting from undetected cardiac abnormalities in athletes and non-athletes. Participant screening, immediate and advanced medical management can probably reduce mortality and ameliorate outcomes. In recent years, extracorporeal membrane oxygenation has emerged as a valuable therapeutic option in patients experiencing refractory cardiac arrest as a bridge to different types of outcome, including recovery, heart transplantation or ventricular assist device and organ donations. In this report we describe a case of a sudden cardiac arrest in a marathon runner treated with extracorporeal membrane oxygenation.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2012
Major themes for 2011 in cardiovascular anesthesia and intensive care.
The past year has witnessed major advances in of cardiovascular anesthesia and intensive care. Perioperative interventions such as anesthetic design, inotrope choice, glycemic therapy, blood management, and noninvasive ventilation have significant potential to enhance perioperative outcomes even further. The major theme for 2011 is the international consensus conference that focused on ancillary interventions likely to reduce mortality in cardiac anesthesia and intensive care. ⋯ This review then highlights the remaining two major themes for 2011, namely the expanding role of noninvasive ventilation in our specialty and the formation of the Roland Hetzer International Cardiothoracic and Vascular Surgery Society. In conclusion, it is time for large adequately powered multicenter trials to test whether prioritized perioperative interventions truly reduce mortality and morbidity in cardiac surgical patients. This essential paradigm shift represents a major clinical opportunity for the global cardiovascular anesthesia and critical care community.