Preoperative cardiac events in elderly patients with hip fracture randomized to epidural or conventional analgesia.

Background: Perioperative myocardial ischemia occurs in 35% of unselected elderly patients undergoing hip fracture surgery. Perioperative epidural analgesia may reduce the incidence of adverse cardiac events.

Methods: The effect of early administration of epidural analgesia during the stressful period, on cardiac events was evaluated in a prospective randomized study in 68 patients with hip fractures who either had known coronary artery disease or were at high risk for coronary artery disease.

A novel thermoregulatory system maintains perioperative normothermia in children undergoing elective surgery.

Background: Body heat loss during anaesthesia may result in increased morbidity, particularly in high-risk populations such as children. To avoid hypothermia, a novel thermoregulatory system (Allon) was devised. We tested the safety and efficacy of this system in maintaining normothermia in children undergoing routine surgical procedures.

The effect of helium on ventilator performance: study of five ventilators and a bedside Pitot tube spirometer.

Objective: To assess in vitro the performance of five mechanical ventilators-Siemens 300 and 900C (Siemens-Elma; Solna, Sweden), Puritan Bennett 7200 (Nellcor Puritan Bennett; Pleasanton, CA), Evita 4 (Dragerwerk; Lubeck, Germany), and Bear 1000 (Bear Medical Systems; Riverside CA)-and a bedside sidestream spirometer (Datex CS3 Respiratory Module; Datex-Ohmeda; Helsinki, Finland) during ventilation with helium-oxygen mixtures.

Design: In vitro study.

Setting: ICUs of two university-affiliated hospitals.

High oxygen concentration exacerbates cardiopulmonary bypass-induced lung injury.

Objective: To investigate the effect of ventilation with 100% oxygen on lung injury associated with surgery involving cardiopulmonary bypass (CPB).

Design: A prospective randomized study.

Setting: University hospital.

Postcardiopulmonary bypass hypoxemia: a prospective study on incidence, risk factors, and clinical significance.

Objective: To evaluate the clinical significance of low arterial oxygen tension-inspired oxygen concentration (PaO2-FIO2) ratio, as a measure of hypoxemia, in the early period after cardiac surgery with cardiopulmonary bypass (CPB); and to evaluate the preoperative, intraoperative, and postoperative factors contributing to the development of hypoxemia within the first 24 hours after cardiac surgery with CPB.

Design: Prospective observational study.

Setting: University hospital.