SOPHIA
Sophia
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The need for preoxygenation in critically ill patients undergoing rapid sequence tracheal intubation is well established. Adequate preoxygenation with as close to 100% oxygen increases the safe apnoea time in these patients. The standard recommendation is spontaneous breathing with oxygen using a non-rebreather mask for a period of between 3 and 5 minutes. A study from a large US hospital set out to evaluate whether longer periods of preoxygentaion improved the Pa02. Arterial blood gases taken at 4, 6 and 8 minutes of preoxygenation revealed no significant improvement in oxygen tension after 4 minutes. This is reassuring in the already time critical scenario of a patient requiring tracheal intubation and mechanical ventilation (Crit Care Med 2009;37:68–71).
A recent Archives of Internal Medicine paper reports on a single centre double-blind trial of vasopressin-epinephrine and corticosteroids during and after cardiac arrest. One hundred patients were enrolled, receiving either vasopressin
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