Archive for March, 2009|Monthly archive page

Bleedin’ starch

Rapidly Degradable Hydroxyethyl Starch Solutions Impair Blood Coagulation After Cardiac Surgery:A Prospective Randomized Trial. Schramko, A. A et al. Anesth Analg 2009;108:30-6

Thanks to Lynsey Davies & the QMC journal club for reviewing this recent paper. Although the numbers are small, and their end points may not be clinically significant, the potential implications for routine use of starches are important. Especially since the publication of the VISEP trial. You can find Dr. Davies’s presentation in the blue box, named starch and coagulation.

Physiology at the extremes

Bubble Trouble : A review of diving physiology. Levitt, D & Millar, I. Post Graduate Med J. 2008; 84 :571-78.

Arterial Blood Gas and oxygen content in climbers on Mount Everest. Grocott, M et al. NEJM. 2009. 360:2;140-49

Something a bit different from the usual critical appraisal. Two recent papers highlighting the potential of studying normal physiology under extreme conditions for increasing our understanding of the physiology of critical illness, and a good read as well! The Caudwell Everest expedition documented paO2 s of 2.7 kPa on the summit, quite incredible. The first paper is a well written summary of diving physiology & pathology which is of interest, especially if you occasionally connect yourself to a ventilation circuit!