Laryngoscope plastic blades in scheduled general anesthesia patients: a comparative randomized study.

Study Objective: To compare two brands of disposable plastic laryngoscope blades, Vital View plastic blades and Heine XP plastic blades, with the reusable Heine Classic+ Macintosh metal blades.

Design: Prospective randomized, controlled, single-blinded study.

Setting: Operating room of a university-affiliated hospital.

Clonidine premedication improves metabolic control in type 2 diabetic patients during ophthalmic surgery.

Background: In stressful conditions, increasing blood glucose concentrations are closely related to an increase in catecholamines and cortisol release. Clonidine, a centrally acting alpha(2)-adrenoceptor agonist, has neuroendocrine effects, including inhibition of sympathoadrenal activity. We therefore evaluated the effect of clonidine on blood glucose control and insulin requirements during ophthalmic surgery when given as premedication in type 2 diabetic patients.

Low exogenous lactate clearance as an early predictor of mortality in normolactatemic critically ill septic patients.

Objective: To evaluate the prognostic value of lactate clearance and lactate production in severely ill septic patients with normal or mildly elevated blood lactate concentration. DESIGN Prospective, observational study.

Setting: Nineteen-bed mixed medicosurgical intensive care unit.

Initial effect of sodium bicarbonate on intracellular pH depends on the extracellular nonbicarbonate buffering capacity.

Objective: The effect of sodium bicarbonate on intracellular pH under conditions close to those in vivo, with both bicarbonate and nonbicarbonate buffering systems, is unknown. We postulated that this effect depends on the nonbicarbonate buffering capacity because the alkali-induced back-titration of these buffers results in a concentration-dependent release of CO2 in the extracellular space, leading to a decrease in intracellular pH.

Design: The study was conducted in two stages.

The increase in CO2 production induced by NaHCO3 depends on blood albumin and hemoglobin concentrations.

Objective: To evaluate the origin of H+ ions participating in the generation of CO2 coming from sodium bicarbonate infusion during metabolic acidosis. We hypothesized that these H+ ions come from a back-titration of the main non-bicarbonate buffers present in the blood, i. e.

Mild hyperlactatemia in stable septic patients is due to impaired lactate clearance rather than overproduction.

A prospective study was conducted on 34 stable septic patients to determine whether mild hyperlactatemia is a marker of lactate overproduction or an indicator of lactate underutilization during sepsis. Plasma lactate clearance and lactate production were evaluated by modeling the lactate kinetic induced by an infusion of 1 mmol/kg L-lactate over 15 min. The patients were divided in two groups depending on their blood lactate: < or = 1.

Effect of continuous venovenous hemofiltration with dialysis on lactate clearance in critically ill patients.

Objective: To evaluate the effect of continuous venovenous hemofiltration with dialysis on lactate elimination by critically ill patients.

Design: Prospective, clinical study.

Setting: Surgical intensive care unit of a university hospital.