Interfacility transport of patients with decompression illness: literature review and consensus statement.

Objective: Decompression illness (DCI) is a potentially lethal complication of diving and may occur far from hyperbaric facilities. The need for prompt transport to a hyperbaric facility often involves air medical transport, but this may exacerbate DCI. The authors reviewed available literature to establish evidence-based transport strategies utilizing safe altitudes for patients, with DCI.

Warfarin-induced gastric bleeding and intestinal obstruction.

Oral anticoagulant therapy with warfarin is commonly used to prevent thromboembolic events in patients at risk. The degree of anticoagulation is variable among individuals and is influenced by many factors; therefore, patients must be monitored frequently to assess potential adverse effects related to treatment. There is a direct relationship between excessive anticoagulation and the risk of bleeding.

Acute graded hypercapnia increases collateral coronary blood flow in a swine model of chronic coronary artery obstruction.

Objective: To evaluate the effect of acute hypercapnia on regional myocardial blood flow in a swine model of chronic, single-vessel coronary artery obstruction. Permissive hypercapnia is being used frequently in critical care settings. One possible detrimental effect of hypercapnia is the initiation of coronary "steal" in patients with coronary artery disease.

Gas exchange and hemodynamics in experimental pleural effusion.

Objective: To investigate the cardiorespiratory effects of graded bilateral pleural effusions in the anesthetized pig.

Design: Prospective, randomized, controlled, laboratory study.

Setting: Animal laboratory.

Epidural bupivacaine-morphine analgesia versus patient-controlled analgesia following abdominal aortic surgery: analgesic, respiratory, and myocardial effects.

Background: The efficacy and effects of epidural analgesia compared with patient-controlled analgesia (PCA) have not been reported in patients undergoing major vascular surgery. We compared the effects of epidural bupivacaine-morphine with those of intravenous PCA morphine after elective infrarenal aortic surgery.

Methods: Forty patients classified as American Society of Anesthesiologists physical status 2 or 3 received general anesthesia plus postoperative PCA using morphine sulfate (group PCA; n = 21) or general anesthesia plus perioperative epidural morphine-bupivacaine (group EPI; n = 19) during a period of 48 h.