Recruitment maneuvers during prone positioning in patients with acute respiratory distress syndrome.

Objective: To evaluate the interaction of recruitment maneuvers and prone positioning on gas exchange and venous admixture in patients with early extrapulmonary acute respiratory distress syndrome ventilated with high levels of positive end-expiratory pressure. We hypothesized that a sustained inflation performed after 6 hrs of prone positioning would induce sustained improvement in oxygenation (Pao2/Fio2) and venous admixture.

Design: Prospective, interventional study.

HLA-DR as a marker for increased risk for systemic inflammation and septic complications after cardiac surgery.

Objective: This study investigated the predictive value of a decrease in monocyte HLA-DR expression as an early marker for postoperative SIRS and septic complications. We hypothesized that decreased HLA-DR levels in the first 24 h after cardiac surgery is not related to postoperative SIRS/sepsis. We also compared HLA-DR levels of patients with postoperative complications to those with an uncomplicated course.

Remifentanil or propofol for sedation during carotid endarterectomy under cervical plexus block.

Background: During carotid endarterectomy under regional anaesthesia, patients often require medication to control haemodynamic instability and to provide sedation and analgesia. Propofol and remifentanil are used for this purpose. However, the benefits, side-effects, and optimal dose of these drugs in such patients are unclear.

Nalbuphine by PCA-pump for analgesia following hysterectomy: bolus application versus continuous infusion with bolus application.

The analgesic properties of the partial agonist-antagonist nalbuphine in the postoperative period are well known. When used for patient-controlled analgesia (PCA) the effectiveness of this substance is comparable to that of morphine or tramadol. However, the optimal programme for administration of nalbuphine in PCA-pumps has not been investigated.

Naloxone-resistant respiratory depression and neurological eye symptoms after intrathecal morphine.

We describe a case of neurological symptoms after the intrathecal use of an opioid. These symptoms were not reversible by the use of an opioid-antagonist.

Complications following the use of the Combitube, tracheal tube and laryngeal mask airway.

In a prospective, randomised trial, 75 patients scheduled for routine surgery were randomly allocated to one of three groups to evaluate trauma and postoperative complications after insertion of the Combitube, tracheal tube or laryngeal mask airway. Insertion of the Combitube was associated with a higher incidence of sore throat (48% vs. 16% vs.