RESUMO
Patients with acute coronary syndrome (ACS), failed percutaneous coronary intervention (PCI) and with an indication for emergent coronary artery bypass graft surgery (CABG) are at an increased risk of perioperative bleeding. Integration of the CytoSorb® (CS) adsorber into the cardiopulmonary bypass appears to bind prasugrel and minimize the risk of perioperative bleeding.
RESUMO
Rhabdomyolysis (RM) is a potentially life-threatening entity that can lead to acute kidney injury (AKI). Continuous renal replacement therapy (CRRT) alone is known as effective therapy, but the additional use of a hemoadsorber (like CytoSorb®) might increase its efficacy.
RESUMO
BACKGROUND: Supraglottic airway devices perform more poorly and have lower oropharyngeal leak pressure in edentulous patients than in patients with teeth. The Ambu Aura Gain is a newer second generation supraglottic airway device. OBJECTIVE: This randomized clinical trial assessed the oropharyngeal leak pressure in edentulous patients using the Ambu Aura Gain with a gastric tube for insertion guidance and without insertion guidance. MATERIAL AND METHODS: Patients with ASA (American Society of Anesthesiology) physical status I-III were recruited. Primary outcome was oropharyngeal leak pressure after insertion. Secondary outcome parameters were oropharyngeal leak pressure 15â¯min and 30â¯min after insertion, insertion time, insertion attempts and glottis view through flexible fiberscope. RESULTS: In this study 72 patients aged between 51 and 90 years (mean 73 years) were randomly allocated to the "with guidance" (nâ¯= 36) or the "without guidance" group (nâ¯= 36). Mean (SD) oropharyngeal leak pressure in "with guidance" and "without guidance" group was 24â¯cm H2O and 24â¯cm H2O (ns), respectively. A difference was found in mean insertion time with guidance versus without guidance group 52â¯s (45â¯s) vs. 26â¯s (15â¯s) (pâ¯<â¯0.001). No difference was found in any of the other secondary outcome parameters. CONCLUSION: A guided insertion technique does not improve oropharyngeal leak pressure of the Ambu AuraGain™ in edentulous patients. As the only difference is an increase in insertion time this technique is of no benefit for this population.