The second Austrian benchmark study for blood use in elective surgery: results and practice change.

Background: Five years after the first Austrian benchmark study demonstrated relatively high transfusion rate and an abundance of nonindicated transfusions in elective surgeries, this study was conducted to investigate the effects of the first benchmark study.

Study Design And Methods: Data from 3164 patients undergoing primary unilateral total hip replacement (THR), primary unilateral noncemented total knee replacement (TKR), or coronary artery bypass graft (CABG) surgery at 15 orthopedic and six cardiac centers were collected and compared with the first study.

Results: Transfusion rates decreased in THR (41% to 30%) and TKR (41% to 25%), but remained unchanged in CABG surgery (57% vs.

Indirect versus direct laryngoscopy for routine nasotracheal intubation.

Study Objective: To compare the effectiveness of the indirect laryngoscopes, Airtraq (A) and GlideScope (G), with the Macintosh (M) laryngoscope in routine nasotracheal intubation.

Design: Randomized, single-blinded study.

Setting: University-affiliated, tertiary-care hospital.

The utility of using the bispectral index-Vista for detecting cross-clamping decline in cerebral blood flow velocity.

Background: Patients undergoing carotid endarterectomy for extracranial internal carotid artery stenosis are at risk of cerebral ischemia/hypoperfusion. Criterion recommended by European and American committees to determine whether to place a shunt consisted of a decline in transcranial Doppler ultrasonography-measured middle cerebral artery blood flow velocity (MCBFV) to < 30% to 40% of intraoperative preclamp value.

Objective: To assess the discriminative power of the bispectral index (BIS)-Vista monitor for detecting a 40% decline in MCBFV with cross-clamping.

BIS-vista occipital montage in patients undergoing neurosurgical procedures during propofol-remifentanil anesthesia.

Background: Neurosurgical procedures that require a frontal approach could be an impediment for a successful Bispectral Index (BIS) frontal sensor placement. The aim of this study was to explore the utility of using the new BIS-Vista monitor (Aspect Medical Systems, Newton, MA) for occipital sensor placement in the patients undergoing brain neurosurgical procedures during propofol-remifentanil anesthesia.

Methods: Two BIS Quatro sensors (Aspect Medical Systems, Newton, MA) mounted on the occipital and frontal regions were connected to two BIS-Vista monitors at three anesthesia states: before induction, during anesthesia maintenance, and recovery.

Psychological and systemic stress reactions of patients during hyperthermia treatments.

Purpose: This study evaluated psychological stress reactions during hyperthermia (HT) treatments and compared them to systemic stress reactions.

Materials And Methods: 27 patients with malignant disease were treated with superficial or regional hyperthermia. Cortisol and the catecholamines adrenaline and noradrenaline in venous blood were used as markers of psychological stress.

No midterm benefit from low intensity pulsed ultrasound after chevron osteotomy for hallux valgus.

Chevron osteotomy is a widely accepted method for correction of symptomatic hallux valgus deformity. Full weight bearing in regular shoes is not recommended before 6 weeks after surgery. Low intensity pulsed ultrasound is known to stimulate bone formation leading to more stable callus and faster bony fusion.

Effect of flumazenil on bispectral index monitoring in unpremedicated patients.

Background: Flumazenil is an imidazobenzodiazepine that promptly reverses via competitive inhibition the hypnotic/sedative effects of benzodiazepines on gamma-aminobutyric acid receptors. Endogenous benzodiazepine ligands (endozepines) were isolated in urine, cerebrospinal fluid, and breast milk of women who had not received benzodiazepines. The bispectral index (BIS), an electroencephalographically derived parameter widely used for monitoring the effects of anesthetic/hypnotic drugs, was shown to correlate to various conditions that could influence electroencephalography.

Measurement of cardiac output and pulmonary transit time for assessment of pulmonary vascular resistance in domestic piglets.

The degree of elevated pulmonary vascular resistance (PVR) is a crucial clinical parameter. Cardiac output (CO) and pulmonary transit time (PTT) can be ascertained by a number of radiological methods. A close functional relationship between CO, PTT and PVR would facilitate non-invasive PVR measurements.

Effect of somatostatin analogue octreotide on pain relief after major abdominal surgery.

Background: Octreotide acetate is an 8-amino-acids synthetic octapeptide analogue of somatostatin with much-enhanced duration of action and lower incidence of side effects. We assessed the utility of using intravenous octreotide as an adjuvant to opioid analgesia that might exert a post-operative opioid-sparing effect.

Methods: Forty-four patients were randomly allocated, to receive either a placebo or intraoperative octreotide 0.

Blood use in elective surgery: the Austrian benchmark study.

Background: Benchmarking transfusion activity may help to eliminate inappropriate use of blood products. The goal of this study was to measure and to compare the current transfusion practice and to identify predictors of transfusion in public hospitals to develop strategies to optimize transfusion practices.

Study Design And Methods: This was a prospective observational study in 18 randomly selected public hospitals from April 2004 to February 2005.

Bispectral-index-guided versus clinically guided remifentanil/propofol analgesia/sedation for interventional radiological procedures: an observer-blinded randomized study.

Patients undergoing potentially painful interventional radiological procedures generally require a combination of analgesia and sedation. This sedation/analgesia should allow the patient to communicate while also remaining calm. Bispectral index (BIS) monitoring could be useful in achieving this.

Geographic regional differences in rocuronium bromide dose-response relation and time course of action: an overlooked factor in determining recommended dosage.

Background: Geographic location is not acknowledged as a stratifying factor that can directly affect drug potency, because drugs are still licensed with the same recommended dose for different geographic regions. The aim of the current study was to compare the potency and duration of action of rocuronium bromide in 54 patients in three countries with different life habits, diet, and ambient conditions, namely white Austrians, white North Americans, and Han Chinese in China.

Methods: Neuromuscular block of six consecutive 50-microg/kg rocuronium incremental doses followed by 300 microg/kg was evaluated using the Relaxometer mechanomyograph (Groningen University, Groningen, Holland).

[The effect of a homeopathic drug on the blood pressure of hypertensive patients--a randomised double-blind controlled parallel group comparative trial].

Pumpan in a dosage of 3 x 10 drops daily over 6 weeks does not differ in its effect on systolic and diastolic blood pressure significantly from placebo. The tolerance was excellent: not one single patient had to be withdrawn from the study due to side effects. Blood lipids (cholesterol, HDL-, LDL-cholesterol and triglyzerides) did not change, neither in the placebo nor in the verum group.

The effect of different stages of neuromuscular block on the bispectral index and the bispectral index-XP under remifentanil/propofol anesthesia.

Facial electromyographic activity and neuromuscular block could influence bispectral index (BIS) depth of anesthesia monitoring. In this study we examined, in 30 patients undergoing general surgical procedures, the effect of different stages of neuromuscular block on BIS monitoring and compared the conventional A-2000 BIS trade mark (BIS(3.4)) with the new BIS-XP trade mark (BIS(XP)).

Remifentanil versus morphine analgesia and sedation for mechanically ventilated critically ill patients: a randomized double blind study.

Background: The rapid onset and offset of action of remifentanil could make it quickly adjustable to the required level of sedation in critically ill patients. The authors hypothesized that the efficacy of a remifentanil-based regimen was greater than that of a morphine-based regimen.

Methods: Forty intent-to-treat patients were randomly allocated to receive a blinded infusion of either remifentanil 0.

Procalcitonin and C-reactive protein plasma concentrations in nonseptic uremic patients undergoing hemodialysis.

Objective: To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions.

Design And Setting: Prospective observational consecutive clinical study at a university hospital.

Patients: The study recruited 55 end-stage renal failure patients without evidence of systemic infection undergoing the creation of an arteriovenous fistula to start hemodialysis for the first time.

The neuromuscular transmission module versus the relaxometer mechanomyograph for neuromuscular block monitoring.

Unlabelled: The neuromuscular transmission module (M-NMT) is an integrated piezoelectric motion sensor module incorporated in the AS/3(TM) anesthesia monitor. We compared the neuromuscular block of 0.6 mg/kg rocuronium (twice the 95% effective dose) monitored by the M-NMT with that monitored by the Relaxometer mechanomyograph (MMG).