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Anesthesia and Analgesia

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https://www.readbyqxmd.com/read/28719432/perioperative-fluid-management
#1
Brenton Alexander, Alexandre Joosten
No abstract text is available yet for this article.
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719431/bispectral-index-measurements-are-not-degraded-during-aeromedical-evacuations
#2
Nicolas Donat, Audrey Cirodde, Clément Hoffmann, Jean-Vivien Schaal, Yannick Masson, Antoine Nau, Paul Vincent Martin, Samuel Madec, Thomas Leclerc
For a decade, depth of anesthesia monitoring has become a reality in the operating room. It provides valuable help for managing anesthesia, especially for unstable patients. This might be particularly relevant during aeromedical evacuation. In this study, we aimed to assess the validity of the bispectral index (BIS) during long-range patient transportation aboard fixed-wing aircraft. BIS was recorded in 30 patients, 25 under anesthesia and 5 awake, during aeromedical evacuations performed by the French Air Force...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#3
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#4
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719428/blood-product-utilization-among-trauma-and-nontrauma-massive-transfusion-protocols-at-an-urban-academic-medical-center
#5
Eshan U Patel, Paul M Ness, Christi E Marshall, Thomas Gniadek, David T Efron, Peter M Miller, Joseph A Zeitouni, Karen E King, Evan M Bloch, Aaron A R Tobian
BACKGROUND: Hospital-wide massive transfusion protocols (MTPs) primarily designed for trauma patients may lead to excess blood products being prepared for nontrauma patients. This study characterized blood product utilization among distinct trauma and nontrauma MTPs at a large, urban academic medical center. METHODS: A retrospective study of blood product utilization was conducted in patients who required an MTP activation between January 2011 and December 2015 at an urban academic medical center...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719427/opioid-reduction-following-interventional-procedures-for-chronic-pain-a-synthesis-of-the-evidence
#6
Dermot P Maher, Steven P Cohen
The past decade has witnessed the tremendous growth of procedures to treat chronic pain, which has resulted in increased third-party scrutiny. Although most of these procedures appear to be associated with significant pain relief, at least in the short and intermediate term, their ability to improve secondary outcome measures, including function and work status is less clear-cut. One of these secondary outcome measures that has garnered substantial interest in the pain and general medical communities is whether interventions can reduce opioid intake, which is associated with significant risks that in most cases outweigh the benefits in the long term...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719426/blunt-traumatic-injury-to-the-aortic-root-and-aortic-valve
#7
Michael Mazzeffi, Erik Strauss, Joseph Rabin, Bartley Griffith
No abstract text is available yet for this article.
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719425/organizational-contributors-to-the-variation-in-red-blood-cell-transfusion-practices-in-cardiac-surgery-survey-results-from-the-state-of-michigan
#8
Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, Donald S Likosky
BACKGROUND: While large volumes of red blood cell transfusions are given to preserve life for cardiac surgical patients, indications for lower volume transfusions (1-2 units) are less well understood. We evaluated the relationship between center-level organizational blood management practices and center-level variability in low volume transfusion rates. METHODS: All 33 nonfederal, Michigan cardiac surgical programs were surveyed about their blood management practices for isolated, nonemergent coronary bypass procedures, including: (1) presence and structure of a patient blood management program, (2) policies and procedures, and (3) audit and feedback practices...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708668/improving-the-success-rate-of-chest-compression-only-cpr-by-untrained-bystanders-in-adult-out-of-hospital-cardiac-arrest-maintaining-airway-patency-may-be-the-way-forward
#9
Anthony M-H Ho, Glenio B Mizubuti, Song Wan
No abstract text is available yet for this article.
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708667/replication-of-data-makes-statistical-analysis-difficult
#10
Gordon B Drummond
No abstract text is available yet for this article.
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708666/socioeconomic-deprivation-and-utilization-of-anesthetic-care-during-pregnancy-and-delivery-a-french-retrospective-multicenter-cohort-study
#11
Elie Kantor, Jean Guglielminotti, Elie Azria, Dominique Luton, Mandelbrot Laurent, Oury Jean-François, Dominique Mahieu-Caputo, Philippe Ravaud, Candice Estellat
BACKGROUND: Socioeconomic deprivation is associated with reduced use of antenatal resources and poor maternal outcomes with pregnancy. Research examining the association between socioeconomic deprivation and use of obstetric anesthesia care in a country providing universal health coverage is scarce. We hypothesized that in a country providing universal health coverage, France, socioeconomic deprivation is not associated with reduced use of anesthetic care during pregnancy and delivery...
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708665/hyperbaric-versus-isobaric-bupivacaine-for-spinal-anesthesia-systematic-review-and-meta-analysis-for-adult-patients-undergoing-noncesarean-delivery-surgery
#12
Vishal Uppal, Susanne Retter, Harsha Shanthanna, Christopher Prabhakar, Dolores M McKeen
BACKGROUND: It is widely believed that the choice between isobaric bupivacaine and hyperbaric bupivacaine formulations alters the block characteristics for the conduct of surgery under spinal anesthesia. The aim of this study was to systematically review the comparative evidence regarding the effectiveness and safety of the 2 formulations when used for spinal anesthesia for adult noncesarean delivery surgery. METHODS: Key electronic databases were searched for randomized controlled trials, excluding cesarean delivery surgeries under spinal anesthesia, without any language or date restrictions...
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708664/esmolol-administration-to-control-tachycardia-in-an-ovine-model-of-peritonitis
#13
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Adriano José Pereira, Antoine Herpain, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Excessive adrenergic signaling may be harmful in sepsis. Using β-blockers to reduce sympathetic overactivity may modulate sepsis-induced cardiovascular, metabolic, immunologic, and coagulation alterations. Using a randomized ovine fecal peritonitis model, we investigated whether administration of a short-acting β-blocker, esmolol, could control tachycardia without deleterious effects on hemodynamics, renal perfusion, cerebral perfusion, cerebral metabolism, or outcome. METHODS: After induction of fecal peritonitis, 14 anesthetized, mechanically ventilated, and hemodynamically monitored adult female sheep were randomly assigned to receive a continuous intravenous infusion of esmolol to control heart rate between 80 and 100 bpm (n = 7) or a saline infusion (control group, n = 7)...
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708663/in-response
#14
Sergio D Bergese, Michael L Mestek, Scott D Kelley, Robert McIntyre, Alberto A Uribe, Rakesh Sethi, James N Watson, Paul S Addison
No abstract text is available yet for this article.
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708662/imaging-modalities-for-correct-positioning-of-percutaneous-right-ventricular-assist-device-after-left-ventricular-assist-device-implantation
#15
Mariya A Geube, Andrej Alfirevic, Michael Tong
No abstract text is available yet for this article.
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708661/fixing-medical-prices
#16
Katherine A Meese, Nancy M Borkowski
No abstract text is available yet for this article.
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704251/crisis-management-in-acute-care-settings-human-factors-and-team-psychology-in-a-high-stakes-environment-3rd-ed
#17
Craig S Webster
No abstract text is available yet for this article.
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#18
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704249/patient-survey-of-referral-from-one-surgeon-to-another-to-reduce-maximum-waiting-time-for-elective-surgery-and-hours-of-overutilized-operating-room-time
#19
Ilana I Logvinov, Franklin Dexter, Elisabeth U Dexter, Sorin J Brull
BACKGROUND: Studies of shared (patient-provider) decision making for elective surgical care have examined both the decision whether to have surgery and patients' understanding of treatment options. We consider shared decision making applied to case scheduling, since implementation would reduce labor costs. METHODS: Study questions were presented in sequence of waiting times, starting with 4 workdays. "Assume the consultant surgeon (ie, the surgeon in charge) you met in clinic did not have time available to do your surgery within the next 4 workdays, but his/her colleague would have had time to do your surgery within the next 4 workdays...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#20
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
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