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Items 1 - 23 of 23 |
One page. |
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A response to 'Difficult Airway Society guidelines for management of the unanticipated difficult intubation', Henderson JJ, Popat MT, Latto IP and Pearce AC, Anaesthesia 2004; 59: 675-94.
Sellers WF.
Stoke Mandeville Hospital Aylesbury HP21 8AL, UK E-mail: wfssellers@hotmail.com.
PMID: 15479351 [PubMed - in process]
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A response to 'The effect of critical care outreach on postoperative serious adverse events', Story DA, Shelton AC, Poustie SJ, Colin-Thome NJ and McNicol PL, Anaesthesia 2004; 59: 762-6.
Sartain JB.
Cairnes Base Hospital Queensland, Australia E-mail: james_sartain@health.qld.gov.au.
PMID: 15479350 [PubMed - in process]
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A response to 'Effect of chronic B-blockade on peri-operative outcome in patients undergoing non-cardiac surgery: an analysis of observational and case control studies', Giles JW, Sear JW and Foex P, Anaesthesia 2004; 59: 574-83.
Pivalizza EG, Warters RD.
University of Texas Health Sciences Center Houston, TX, USA E-mail: Evan.G.Pivalizza@uth.tmc.edu.
PMID: 15479349 [PubMed - in process]
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A response to 'Difficult Airway Society guidelines for management of the unanticipated difficult intubation', Henderson JJ, Popat MT, Latto IP and Pearce AC, Anaesthesia 2004; 59: 675-94.
Segal R.
Royal Melbourne Hospital Melbourne, Australia E-mail: Reny.Segal@mh.org.au.
PMID: 15479346 [PubMed - in process]
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A response to 'Abdominal muscle action during expiration can impair pressure controlled ventilation', Prasad CV and Drummond GB, Anaesthesia 2004; 59: 715-8.
Ireland T.
Royal Alexandra Hospital Paisley, Northern Ireland E-mail: tom.ireland@rah.scot.nhs.uk.
PMID: 15479345 [PubMed - in process]
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A response to 'Decreasing epidural failure', Picton P and Das S, Anaesthesia 2004; 59: 729.
Kadry M.
West Middlesex University Hospital London TW6 7AF, UK E-mail: miramasr@aol.com.
PMID: 15479343 [PubMed - in process]
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A response to 'Cerebral and extracerebral release of protein S100B in cardiac surgical patients', Snyder-Ramos SA, Gruhlke T, Bauer H, Bauer M, Luntz AP, Motsch J, Martin E, Vahl CF, Missler U, Wiesmann M and Bottiger BW, Anaesthesia 2004; 59: 344-9.
Janigro D.
Cleveland Clinic Foundation Cleveland, OH, USA.
PMID: 15479342 [PubMed - in process]
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Effect of xenon anaesthesia on accuracy of cardiac output measurement using partial CO rebreathing.
Bein B, Hanne P, Hanss R, Renner J, Weber B, Steinfath M, Scholz J, Tonner PH.
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105 Kiel, Germany.
Summary Cardiac output (CO) determination based on partial CO(2) rebreathing has recently been introduced into clinical practice. The determination of flow is crucial for exact CO readings and the physical properties of xenon, i.e. high density and viscosity, may influence flow readings. This study compared echocardiography-derived CO measurements with the partial rebreathing method during total intravenous (TIVA) vs. xenon-based anaesthesia. Thirty-nine patients ASA physical status III undergoing aortic reconstruction were randomly assigned to receive either xenon (Xe, n = 20) or TIVA (T, n = 19) based general anaesthetic. Paired measurements were taken before xenon administration, after xenon administration, before and after clamping of the abdominal aorta and after declamping and at corresponding time points in the TIVA group. Data were analysed with a Bland-Altmann plot. Bias and precision were acceptable and comparable before xenon administration (T 0.54 +/- 0.92 l.min(-1) vs. Xe 0.11 +/- 1.1 l.min(-1)), but after xenon administration CO was largely overestimated by partial CO(2) rebreathing (T 0.04 +/- 0.91 l.min(-1) vs. Xe -4.0 +/- 2.1 l.min(-1)). In the TIVA group, bias and precision after declamping increased significantly (P < 0.01) compared to all time points except baseline. In its current application, the NICO cardiac output monitor appears to be inappropriate for determination of CO during xenon based anaesthesia.
PMID: 15479320 [PubMed - in process]
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The effects of cryoanalgesia combined with thoracic epidural analgesia in patients undergoing thoracotomy.
Yang MK, Cho CH, Kim YC.
Department of Anaesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710 Korea.
Summary This study was performed to evaluate the effects of cryoanalgesia combined with thoracic epidural analgesia on pain and respiratory complications in patients undergoing thoracotomy. Ninety patients were prospectively randomised to epidural analgesia alone (n = 45) or epidural analgesia and cryoanalgesia combined (n = 45). We monitored the use of rescue pain medication and changes in forced vital capacity and forced expired volume in 1 s, and recorded pain and opioid-related side-effects during the immediate postoperative period. The incidence of post-thoracotomy pain and numbness were also assessed up to the sixth month after surgery. Cryoanalgesia combined with thoracic epidural analgesia was associated with earlier recovery in pulmonary function, less pain during movement and a lower daily requirement for rescue analgesia one week after surgery. However, the combination of cryoanalgesia and epidural analgesia failed to decrease the incidence of long-term pain and numbness. In view of its associated long-term morbidity, cryoanalgesia combined with thoracic epidural analgesia is not recommended for patients undergoing thoracotomy.
PMID: 15479314 [PubMed - in process]
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A BIS-guided study of sevoflurane requirements for adequate depth of anaesthesia in Caesarean section.
Chin KJ, Yeo SW.
Registrar, Department of Anaesthesia, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Republic of Singapore.
Summary Caesarean section carries a high risk of awareness, especially in the period prior to neonatal delivery. We investigated the concentration of sevoflurane required to maintain bispectral index (BIS) < 60 until delivery occurred. We enrolled 23 parturients into an up-down sequential allocation study. The median effective end-tidal concentration (EC(50)) of sevoflurane was defined as that which maintained BIS < 60 between skin incision and delivery in 50% of patients. This was calculated using Dixon and Massey's method. Receiver operating characteristic curve analysis was used to establish BIS response probability thresholds. The EC(50) for sevoflurane was 1.22% (1.08-1.33, 95% CI). The probability of maintaining BIS < 60 was < 55% at a concentration of < 1.1%; this increased to 80% at concentrations of 1.2-1.3%. We conclude that sevoflurane concentrations of at least 1.2-1.3% should be administered in uncomplicated Caesarean section, so as to minimise the risk of awareness and recall.
PMID: 15479312 [PubMed - in process]
[Implementation of an internal transfer pricing system for anaesthesia services.]
[Article in German]
Raetzell M, Reissmann H, Steinfath M, Schuster M, Schmidt C, Scholz J, Bauer M.
Klinik fur Anasthesiologie und Operative Intensivmedizin, Universitatsklinikum Schleswig-Hostein, Campus Kiel.
Internal transfer pricing system (ITPS) of anaesthesia services is established to guarantee a close connection of delivered service and the budget of the department of anaesthesia. In most cases a time-based system is used with the pricing unit being calculated as the quotient from the enumerator "costs" divided by the denominator "anaesthesia time in minutes". The implementation of a transfer pricing system requires the identification of all relevant costs caused by the department of anaesthesia and a cost centre structure is needed which allocates all costs correctly according to their cause. The regulations regarding cost calculations as defined by the German DRG System should be considered. To generate valid data not only the necessary technical infrastructure is needed, but also detailed training of the staff and plausibility checks are needed to ensure correct and complete data. Subsequent agreements with the hospital administration are necessary in order to adjust the system if extrinsic cost increases occur. This paper gives a step-by-step guidance for the successful implementation of an internal transfer pricing system based on anaesthesia time.
PMID: 15480519 [PubMed - as supplied by publisher]
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Acute obstruction of an endotracheal tube: a case report.
Park C, Kim H, Yum K.
Department of Dental Anesthesiology and Dental Research Institute, Seoul National University, College of Dentistry, Seoul, Korea. chang40@snu.ac.kr
This report describes a case of sudden ventilatory failure, originally diagnosed as bronchospasm, in a child during general anesthesia. A blood clot impaction in the nasotracheal tube was detected using flexible fiberoptic bronchoscopy. The clot was successfully treated as a result of its passage. We hope this report will stress to dental anesthesiologists the intraoperative importance of fiberoptic bronchoscopy not only as an intubation-aiding device but also as a diagnostic and therapeutic tool.
Publication Types:
PMID: 15366320 [PubMed - indexed for MEDLINE]
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The feasibility of bispectral index monitoring for intravenous sedation during dental treatment.
Matsuzaki S, Tanaka H.
Department of Dental Anesthesiology, Nihon University School of Dentistry, Tokyo, Japan. matsuzaki@dent.nihon-u.ac.jp
Intravenous sedation during dental treatment is primarily used in outpatient clinics. Maintenance of a level of sedation sufficient to allow treatment while using the minimum dose possible and to induce faster waking is very important. The benefits of bispectral index monitoring have recently been reported for many applications, and it is expected to prove useful in intravenous sedation during dental treatment. However, because the sensor is attached to the forehead, which may be close to the site of operation, and because no neuromuscular blocking drugs are used, monitoring may be excessively interrupted by artifacts such as electromyographic input. Thus, we investigated the usefulness of bispectral index monitoring for patients under intravenous sedation during dental treatment. The incidence of "good" electroencephalograms, for which the electromyogram was less than 50 dB, signal quality index was more than 25%, and impedance was less than 10 kOhms, was 82.4% +/- 9.2%. These findings suggest that bispectral index monitoring will prove effective for intravenous sedation during dental treatment.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15366318 [PubMed - indexed for MEDLINE]
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The effects of preoperative anxiety on intravenous sedation.
Osborn TM, Sandler NA.
University of Minnesota School of Dentistry, Division of Oral and Maxillofacial Surgery, Minneapolis, Minnesota 55455, USA.
Anxiety is known to cause feelings of uneasiness, tension, and nervousness, and previous studies have noted that anxiety and its effects may have an effect on out-patient sedation for patients undergoing surgical procedures. In this study, we assess the effects of anxiety on 25 outpatients undergoing intravenous sedation for third molar extraction. Before the procedure, subjects completed the State-Trait Anxiety Inventory, and intraoperative patient movement was assessed using a subjective scale. We found that patients with a high level of preoperative anxiety had a greater degree of average intraoperative movement (P = .037) and also required a greater amount of propofol to maintain a clinically acceptable level of sedation (P = .0273) when compared with patients with less preoperative anxiety. Increased state anxiety and trait anxiety serve as predictors for an increased total dose requirement of propofol to maintain an acceptable level of sedation (r2 = 0.285, P = .0060, and r2 = 0.233, P = .0146, respectively). An increased level of trait anxiety was also a predictor of an increased degree of average intraoperative movement (r2 = 0.342, P = .0022). Patients who exhibit a high level of preoperative anxiety require a greater total dose of propofol to achieve and maintain a clinically acceptable level of sedation and are more prone to unwanted movement while under sedation.
PMID: 15366317 [PubMed - indexed for MEDLINE]
Unconscious auditory priming during surgery with propofol and nitrous oxide anaesthesia: a replication.
Deeprose C, Andrade J, Harrison D, Edwards N.
Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, UK.
BACKGROUND: Priming during anaesthesia has been hard to replicate and the conditions under which it occurs remain poorly understood. We replicated and extended a recent study to determine whether intraoperative priming during propofol and nitrous oxide anaesthesia is a reliable phenomenon, whether it occurs due to awareness during word presentation and whether it is suppressed by a dose of fentanyl at induction. METHODS: Words were played through headphones during surgery to 62 patients receiving propofol and nitrous oxide anaesthesia. Thirty-two patients received fentanyl 1.5 microg kg(-1) at induction and 30 received no fentanyl. Neuromuscular blocking drugs were not used. Depth of anaesthesia was measured using the bispectral index (BIS). Anaesthetic variables were recorded at 1 min intervals during word presentation. On recovery, implicit and explicit memory were assessed using an auditory word-stem completion test and a yes-no word-recognition test, respectively. RESULTS: BIS, blood pressure, end-tidal carbon dioxide and heart rate during word presentation did not differ between the study groups. The infusion rate of propofol and the patients' ventilatory frequency were significantly higher in the group not receiving fentanyl. No patient had unprompted explicit recall of surgery, although there was above-zero performance in six patients on the yes-no recognition task (P<0.05). There was no physiological evidence of awareness during anaesthesia (median mean-BIS=38 in the no-fentanyl group and 42 in the fentanyl group). There was evidence for priming (mean priming score=0.09, P<0.05 in the no-fentanyl study group; mean priming score=0.07, P<0.05 in the fentanyl group) even when patients with momentary light anaesthesia (maximum recorded BIS>/=60) and/or positive recognition scores were excluded from the analysis. CONCLUSIONS: Existing knowledge can be primed by information presented during propofol and nitrous oxide anaesthesia. This priming is evidence of unconscious information processing and not the result of moments of awareness.
PMID: 15486010 [PubMed - as supplied by publisher]
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Effect of obesity and thoracic epidural analgesia on perioperative spirometry.
von Ungern-Sternberg BS, Regli A, Reber A, Schneider MC.
Department of Anaesthesia, University of Basel/Kantonsspital, CH-4031 Basel, Switzerland.
BACKGROUND: Lung volumes in obese patients are reduced significantly in the postoperative period. As the effect of different analgesic regimes on perioperative spirometric tests in obese patients has not yet been studied, we investigated the effect of thoracic epidural analgesia and conventional opioid-based analgesia on perioperative lung volumes measured by spirometry. METHODS: Eighty-four patients having midline laparotomy for gynaecological procedures successfully completed the study. Premedication, anaesthesia and analgesia were standardized. The patients were given a free choice between epidural analgesia (EDA) (n=42) or opioids (n=42) for postoperative analgesia. We performed spirometry to measure vital capacity (VC), forced vital capacity, peak expiratory flow, mid-expiratory flow and forced expiratory volume in 1 s at preoperative assessment, 30-60 min after premedication and 20 min, 1 h, 3 h and 6 h after extubation. RESULTS: Baseline values were all within the normal range. All perioperative spirometric values decreased significantly with increasing body mass index (BMI). The greatest reduction in VC occurred directly after extubation, but was less in the EDA group than in the opioid group: mean of -23(SD 8)% versus -30(12)% (P<0.001). In obese patients (BMI>30) the difference in VC was significantly more pronounced than in patients of normal weight (BMI<25): -45(10)% versus -33(4)% (P<0.001). Recovery of spirometric values was significantly quicker in patients receiving EDA, particularly in obese patients. CONCLUSION: We conclude that EDA should be considered in obese patients undergoing midline laparotomy to improve postoperative spirometry.
PMID: 15486001 [PubMed - as supplied by publisher]
Intravenous anaesthetics inhibit nicotinic acetylcholine receptor-mediated currents and Ca2+ transients in rat intracardiac ganglion neurons.
Weber M, Motin L, Gaul S, Beker F, Fink RH, Adams DJ.
The effects of intravenous (i.v.) anaesthetics on nicotinic acetylcholine receptor (nAChR)-induced transients in intracellular free Ca(2+) concentration ([Ca(2+)]i) and membrane currents were investigated in neonatal rat intracardiac neurons. In fura-2-loaded neurons, nAChR activation evoked a transient increase in [Ca(2+)]I, which was inhibited reversibly and selectively by clinically relevant concentrations of thiopental. The half-maximal concentration for thiopental inhibition of nAChR-induced [Ca(2+)]i transients was 28 microM, close to the estimated clinical EC50 (clinically relevant (half-maximal) effective concentration) of thiopental. In fura-2-loaded neurons, voltage clamped at -60 mV to eliminate any contribution of voltage-gated Ca(2+) channels, thiopental (25 microM) simultaneously inhibited nAChR-induced increases in [Ca(2+)]i and peak current amplitudes. Thiopental inhibited nAChR-induced peak current amplitudes in dialysed whole-cell recordings by approximately 40% at -120, -80 and -40 mV holding potential, indicating that the inhibition is voltage independent. The barbiturate, pentobarbital and the dissociative anaesthetic, ketamine, used at clinical EC50 were also shown to inhibit nAChR-induced increases in [Ca(2+)]i by approximately 40%. Thiopental (25 microM) did not inhibit caffeine-, muscarine- or ATP-evoked increases in [Ca(2+)]i, indicating that inhibition of Ca(2+) release from internal stores via either ryanodine receptor or inositol-1,4,5-trisphosphate receptor channels is unlikely. Depolarization-activated Ca(2+) channel currents were unaffected in the presence of thiopental (25 microM), pentobarbital (50 microM) and ketamine (10 microM). In conclusion, i.v. anaesthetics inhibit nAChR-induced currents and [Ca(2+)]i transients in intracardiac neurons by binding to nAChRs and thereby may contribute to changes in heart rate and cardiac output under clinical conditions.
PMID: 15477224 [PubMed - as supplied by publisher]
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The new PA(Xpress) airway device during mechanical ventilation in anaesthetized patients: a prospective, randomized comparison with the laryngeal mask airway.
Casati A, Vinciguerra F, Spreafico E, Putzu M, Mamo D, Marchetti C.
Publication Types:
PMID: 15473625 [PubMed - in process]
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Eye protection during general anaesthesia: comparison of four different methods.
Ganidagli S, Cengi M, Becerik C, Oguz H, Kilic A.
Publication Types:
PMID: 15473624 [PubMed - in process]
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Abnormalities of contrast sensitivity and electroretinogram following sevoflurane anaesthesia.
Iohom G, Gardiner C, Whyte A, O'Connor G, Shorten G.
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland.
BACKGROUND AND OBJECTIVE: We tested the hypothesis that disturbances of the visual pathway following sevoflurane general anaesthesia (a) exist and persist even after clinical discharge criteria have been met and (b) are associated with decreased contrast sensitivity. METHODS: We performed pattern and full-field flash electroretinograms (ERG) in 10 unpremedicated ASA I patients who underwent nitrous oxide/sevoflurane anaesthesia. ERG and contrast sensitivity were recorded preoperatively, immediately after discharge from the recovery room and 2 h after discontinuation of sevoflurane. The time at which the Post Anaesthesia Discharge Score first exceeded 9 was also noted. Data were analysed using paired, one-tailed t-tests and Pearson's correlation coefficient. RESULTS: On the full-field photopic ERG, b-wave latency was greater at each postoperative time point (31.6+/-1.1 and 30.8+/-1.1 ms) compared to preoperatively (30.1+/-1.1 ms, P < 0.001 and P = 0.03, respectively). Oscillatory potential latencies were greater on discharge from the recovery room compared with preanaesthetic values (23.1+/-3.1 vs. 22.4+/-3.3 ms, P = 0.01) and returned to baseline by 2 h after emergence from anaesthesia. Also at 2 h after emergence from anaesthesia: (a) P50 latency on the pattern ERG was greater than at baseline (81.5+/-17.9 vs. 51.15+/-22.6ms, P = 0.004); (b) N95 amplitude was less compared to preanaesthetic values (2.6+/-0.5 vs. 3.3+/-0.4 microV, P = 0.003) and (c) contrast sensitivity was less compared to baseline values (349+/-153 vs. 404+/-140, P = 0.048). A positive correlation was demonstrated between contrast sensitivity and both N95 amplitude and b-wave latency (r = 0.99 and r = -0.55 at significance levels of P < 0.005 and P < 0.05, respectively). CONCLUSIONS: Postoperative ERG abnormalities and associated decreases in contrast sensitivity are consistently present in patients who have undergone nitrous oxide/sevoflurane anaesthesia. These abnormalities persist beyond the time at which standard clinical discharge criteria have been met.
PMID: 15473620 [PubMed - in process]
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Exposure of personnel to sevoflurane during paediatric anaesthesia: influence of professional role and anaesthetic procedure.
Gentili A, Accorsi A, Pigna A, Bachiocco V, Domenichini I, Baroncini S, Violante FS.
S Orsola-Malpighi Hospital, Department of Paediatric Anaesthesia and Intensive Care, Bologna, Italy. andrea_gentili@libero.it
BACKGROUND AND OBJECTIVE: This study was performed to determine the individual exposure of paediatric operating theatre personnel to sevoflurane and to evaluate the impact of inhalation induction and various airway approaches on exposure to airborne sevoflurane. METHODS: Mean individual environmental (workplace air) exposure to sevoflurane and a biomarker of exposure (urinary sevoflurane) were monitored in 36 subjects (10 anaesthetists, 10 surgeons, 12 nurses and 4 auxiliary personnel) working in two paediatric operating rooms. RESULTS: Environmental and urinary values were significantly greater in anaesthetists compared with other groups, with median values of 0.65ppm (interquartile range 1.36; 95th percentile 4.36) for breathing zone sevoflurane and 2.1 microgL(-1) urine (interquartile range 2.6; 95th percentile 7.6) for urinary sevoflurane. Anaesthetists exceeded the 2ppm maximum allowed environmental concentration recommended by the National Institute for Occupational Safety and Health in 4 of 22 cases (18.1%). A positive correlation was found between the number of patients undergoing inhalational induction each day and mean values of breathing zone and urinary sevoflurane. An increase in the number of daily laryngeal mask insertions, or the use of rigid bronchoscopy, are statistically related to higher environmental and urinary values (P < 0.01 and <0.00001 for breathing zone sevoflurane, P < 0.05 and <0.01 for urinary sevoflurane, respectively). CONCLUSIONS: Anaesthesia with sevoflurane can pose a hazard of chronic exposure with anaesthetists having the highest risk. Endotracheal intubation offers considerable protection against exposure. Routine anaesthesia using a standard facemask, a laryngeal mask or rigid bronchoscopy are risk factors for increased anaesthetic exposure.
PMID: 15473619 [PubMed - in process]
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Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients.
Noordergraaf GJ, van Dun PJ, Kramer BP, Schors MP, Hornman HP, de Jong W, Noordergraaf A.
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands. g.noordergraaf@elisabeth.nl
BACKGROUND AND OBJECTIVE: To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators. METHODS: Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300 devices, with 20 cmH2O working pressure, and flows of either 24 or 30 L min(-1). One hundred and four patients were analysed. Induction of anaesthesia followed by ventilation of the lungs with a bag-valve device and an Oxylator in manual and automatic modes performed by a fireman first responder. Each series was repeated for three conditions (anaesthesia; anaesthesia plus muscle relaxation, both with facemask; anaesthesia plus relaxation using an endotracheal tube). RESULTS: Patients age 49 +/- 17 yr; 47% males, 48-132 kg. Normocapnia was achieved and maintained in 66% (bag-valve device), 82% (Oxylator). CONCLUSIONS: The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators improves performance (P < 0.001) vs. the bag-valve device significantly.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15141794 [PubMed - indexed for MEDLINE]
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Airway management by first responders when using a bag-valve device and two oxygen-driven resuscitators in 104 patients.
Noordergraaf GJ, van Dun PJ, Kramer BP, Schors MP, Hornman HP, de Jong W, Noordergraaf A.
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands. g.noordergraaf@elisabeth.nl
BACKGROUND AND OBJECTIVE: To evaluate the capability of first responders to ensure an airway and ventilate the lungs of a patient employing a bag-valve device and two oxygen-driven resuscitators. METHODS: Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300 devices, with 20 cmH2O working pressure, flows of 24 and 30 L min(-1). One-hundred-and-four patients were analysed. Induction of anaesthesia was followed by ventilation of the lungs with a bag-valve device and an Oxylator (CPR Medical Devices Corp., Markham, Ontario, Canada) in manual and automatic modes. Each series was repeated twice by a fireman first responder using a hand-held mask to seal the airway, once under anaesthesia and then again under anaesthesia with muscle relaxation. RESULTS: Patients' mean age 49 +/- 17 yr; 47% male, 48-132 kg. Only 29% had optimal facial and airway physiognomy. Airway management was significantly poorer when the bag-valve device was used than with either Oxylator mode (P < 0.0001); 23% of cases were not manageable with the bag-valve device. Gastric insufflation was markedly less with the Oxylator (P < 0.02). CONCLUSIONS: The use of an oxygen-driven device improves the ability of first responders to secure an airway and reduce gastric insufflation, even when distracted. Oxylators perform significantly better (P < 0.0001) than the bag-valve device.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15141793 [PubMed - indexed for MEDLINE]
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