Articles: outcome.
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Even the best cancer surgery is usually associated with minimal residual disease. Whether these remaining malignant cells develop into clinical recurrence is at least partially determined by adequacy of host defense, especially natural killer cell function. Anesthetics impair immune defenses to varying degrees, but nitrous oxide appears to be especially problematic. We therefore tested the hypothesis that colorectal-cancer recurrence risk is augmented by nitrous oxide administration during colorectal surgery. ⋯ The risk of colorectal cancer recurrence was similar in patients who were randomly assigned to 65% nitrous oxide or nitrogen during colorectal surgery.
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Does the instillation of normal saline before suctioning reduce the incidence of ventilator-associated pneumonia in intubated and ventilated adults? ⋯ Instillation of normal saline before tracheal suctioning decreases the incidence of VAP in mechanically ventilated adults.
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To evaluate the outcomes of early comprehensive rehabilitation protocols for traumatic brain injury (TBI) using the functional independence measure (FIM), and to study the relationship between FIM and Glasgow coma scale (GCS) variables to determine which patients will be best served by rehabilitation therapies. ⋯ Early rehabilitation interventions significantly improved the FIM scores in moderate and severe TBI patients. ERRATUM NOTICE PUBLISHED IN NEUROSCIENCES 2009; 14: 306.
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Indian J Crit Care Med · Jan 2009
Alveolar recruitment maneuvers in acute lung injury/acute respiratory distress syndrome.
Mechanical ventilation can worsen lung damage in acute lung injury and acute respiratory distress syndrome. The use of low tidal volumes is one of the strategies that has been shown to reduce lung injury and improve outcomes in this situation. However, low tidal volumes may lead to alveolar derecruitment and worsening of hypoxia. ⋯ Although recruitment maneuvers have been shown to improve oxygenation, improved clinical outcomes have not been demonstrated. The optimal recruitment strategy and the type of patients who might benefit are also unclear. This review summarizes the impact of recruitment maneuvers on lung mechanics and physiology, techniques of application, and the clinical situations in which they may be useful.
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Objective. This study aims to assess peripheral nerve field stimulation as a treatment option for chronic pain and test for indicators of outcome. Materials and Methods. We reviewed all patients permanently implanted with peripheral nerve field stimulators over the past 24 months. A questionnaire was used to assess outcomes. ⋯ Most patients reported decreases in analgesic use after treatment. Pain relief was significantly and highly correlated with reduced analgesic intake and patient satisfaction. Conclusion. Peripheral nerve field stimulation is a safe, reversible, and effective treatment option for patients with chronic pain, particularly those under 60 years.