Articles: prospective-studies.
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Randomized Controlled Trial
Utilization of a gum elastic bougie to facilitate single lung intubation.
Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotracheal tube to maximum depth does not ensure that the proper (nonhemorrhagic) lung is ventilated. Therefore, single lung intubation may be significantly delayed in these patients. The purpose of this study was to assess the accuracy of using a gum elastic bougie ("bougie") to facilitate single lung intubation. ⋯ In our cadaveric model of mainstem intubation, bougie-guided single lung intubation was highly accurate for both left and right mainstem intubations. Future studies should assess the accuracy of this technique among different providers and bodies, as well as live patients.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2016
Randomized Controlled TrialEarly blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies.
Antithrombotic agents increase risks of intracerebral haemorrhage (ICH) and associated adverse outcomes. We determined differential effects of early blood pressure (BP) lowering in patients with/without antithrombotic-associated ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trials (INTERACT1 and 2). ⋯ In patients with ICH, prior antithrombotic therapy is associated with greater haematoma growth, which may be reduced by early intensive BP-lowering treatment.
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Randomized Controlled Trial Comparative Study
Comparison of the effect of continuous intravenous infusion and two bolus injections of remifentanil on haemodynamic responses during anaesthesia induction: a prospective randomised single-centre study.
Remifentanil is an effective drug for protecting against adverse haemodynamic responses to tracheal intubation. We compared the haemodynamic responses during anaesthesia induction between continuous intravenous (IV) infusion and two bolus injections of remifentanil. ⋯ Haemodynamic responses during anaesthesia induction were similar between continuous infusion and two bolus injections of remifentanil within both normotensive and hypertensive patients with or without medication.
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Reg Anesth Pain Med · Nov 2016
Randomized Controlled Trial Comparative StudyA Randomized Controlled Trial of Ultrasound Versus Nerve Stimulator Guidance for Axillary Brachial Plexus Block.
Ultrasound-guided techniques improve outcomes in regional anesthesia when compared with traditional techniques; however, this assertion has not been studied with novices. The primary objective of this study was to compare sensory and motor block after axillary brachial plexus block when performed by novice trainees allocated to an ultrasound- or nerve-stimulator-guided group. A secondary objective was to compare the rates of skill acquisition between the 2 groups. ⋯ We were unable to demonstrate a difference in the efficacy of axillary brachial plexus block performed by novices when ultrasound guidance was compared with a nerve stimulator technique. There was evidence of similarly improved clinical performance of novices in both groups.