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Anesthesiology

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https://www.readbyqxmd.com/read/27906706/effects-of-cardiopulmonary-bypass-on-renal-perfusion-filtration-and-oxygenation-in-patients-undergoing-cardiac-surgery
#1
Lukas Lannemyr, Gudrun Bragadottir, Vitus Krumbholz, Bengt Redfors, Johan Sellgren, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic cardiopulmonary bypass on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen supply/demand relationship, i.e., renal oxygenation (primary outcome) in patients undergoing cardiac surgery. METHODS: Eighteen patients with a normal preoperative serum creatinine undergoing cardiac surgery procedures with normothermic cardiopulmonary bypass (2...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#2
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27906704/renal-oxygen-flux-during-cardiopulmonary-bypass-tubular-damage-to-preserve-glomerular-filtration-what-s-a-kidney-to-do
#3
Frederic T Billings, Yandong Jiang, Andrew D Shaw
No abstract text is available yet for this article.
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27902493/intravenous-amisulpride-for-the-prevention-of-postoperative-nausea-and-vomiting-two-concurrent-randomized-double-blind-placebo-controlled-trials
#4
Tong J Gan, Peter Kranke, Harold S Minkowitz, Sergio D Bergese, Johann Motsch, Leopold Eberhart, David G Leiman, Timothy I Melson, Dominique Chassard, Anthony L Kovac, Keith A Candiotti, Gabriel Fox, Pierre Diemunsch
BACKGROUND: Two essentially identical, randomized, double-blind, placebo-controlled, parallel-group phase III studies evaluated the efficacy of intravenous amisulpride, a dopamine D2/D3 antagonist, in the prevention of postoperative nausea and vomiting in adult surgical patients. METHODS: Adult inpatients undergoing elective surgery during general anesthesia and having at least two of the four Apfel risk factors for postoperative nausea and vomiting were enrolled at 9 U...
November 30, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27861175/transient-receptor-potential-vanilloid-4-and-serum-glucocorticoid-regulated-kinase-1-are-critical-mediators-of-lung-injury-in-overventilated-mice-in-vivo
#5
Laura Michalick, Lasti Erfinanda, Ulrike Weichelt, Markus van der Giet, Wolfgang Liedtke, Wolfgang M Kuebler
BACKGROUND: Mechanical ventilation can cause lung endothelial barrier failure and inflammation cumulating in ventilator-induced lung injury. Yet, underlying mechanotransduction mechanisms remain unclear. Here, the authors tested the hypothesis that activation of the mechanosensitive Ca channel transient receptor potential vanilloid (TRPV4) by serum glucocorticoid-regulated kinase (SGK) 1 may drive the development of ventilator-induced lung injury. METHODS: Mice (total n = 54) were ventilated for 2 h with low (7 ml/kg) or high (20 ml/kg) tidal volumes and assessed for signs of ventilator-induced lung injury...
November 18, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27861174/ultrasound-images-of-the-epidural-space-through-the-acoustic-window-of-the-infant
#6
Tricia M Vecchione, Karen R Boretsky
No abstract text is available yet for this article.
November 18, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27861171/snakes-and-hypertension
#7
Edward D Miller
Constriction of the renal artery and controlled reduction of renal perfusion pressure is followed by a prompt increase in systemic renin activity and a concomitant rise in blood pressure in trained, unanesthetized dogs. The elevated blood pressure induced by the renal artery stenosis can be prevented by prior treatment with the nonapeptide Pyr-Trp-Pro-Arg-Pro-Gln-Ile-Pro-Pro, which blocks conversion of angiotensin I to angiotensin II. Further, the nonapeptide can restore systemic pressure to normal in the early phase of renovascular hypertension...
November 17, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27841822/vasopressin-versus-norepinephrine-in-patients-with-vasoplegic-shock-after-cardiac-surgery-the-vancs-randomized-controlled-trial
#8
Ludhmila Abrahao Hajjar, Jean Louis Vincent, Filomena Regina Barbosa Gomes Galas, Andrew Rhodes, Giovanni Landoni, Eduardo Atsushi Osawa, Renato Rosa Melo, Marcia Rodrigues Sundin, Solimar Miranda Grande, Fabio A Gaiotto, Pablo Maria Pomerantzeff, Luis Oliveira Dallan, Rafael Alves Franco, Rosana Ely Nakamura, Luiz Augusto Lisboa, Juliano Pinheiro de Almeida, Aline Muller Gerent, Dayenne Hianae Souza, Maria Alice Gaiane, Julia Tizue Fukushima, Clarice Lee Park, Cristiane Zambolim, Graziela Santos Rocha Ferreira, Tânia Mara Strabelli, Felipe Lourenco Fernandes, Ligia Camara, Suely Zeferino, Valter Garcia Santos, Marilde Albuquerque Piccioni, Fabio Biscegli Jatene, Jose Otavio Costa Auler, Roberto Kalil Filho
BACKGROUND: Vasoplegic syndrome is a common complication after cardiac surgery and impacts negatively on patient outcomes. The objective of this study was to evaluate whether vasopressin is superior to norepinephrine in reducing postoperative complications in patients with vasoplegic syndrome. METHODS: This prospective, randomized, double-blind trial was conducted at the Heart Institute, University of Sao Paulo, Sao Paulo, Brazil, between January 2012 and March 2014...
November 11, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27841821/activated-protein-c-drives-the-hyperfibrinolysis-of-acute-traumatic-coagulopathy
#9
Ross A Davenport, Maria Guerreiro, Daniel Frith, Claire Rourke, Sean Platton, Mitchell Cohen, Rupert Pearse, Chris Thiemermann, Karim Brohi
BACKGROUND: Major trauma is a leading cause of morbidity and mortality worldwide with hemorrhage accounting for 40% of deaths. Acute traumatic coagulopathy exacerbates bleeding, but controversy remains over the degree to which inhibition of procoagulant pathways (anticoagulation), fibrinogen loss, and fibrinolysis drive the pathologic process. Through a combination of experimental study in a murine model of trauma hemorrhage and human observation, the authors' objective was to determine the predominant pathophysiology of acute traumatic coagulopathy...
November 11, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27841820/vasopressin-norepinephrine-and-vasodilatory-shock-after-cardiac-surgery-another-vasst-difference
#10
James A Russell
No abstract text is available yet for this article.
November 11, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27820710/innovative-disruption-in-the-world-of-neuromuscular-blockade-what-is-the-state-of-the-art
#11
Mohamed Naguib, Ken B Johnson
No abstract text is available yet for this article.
November 7, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27820709/current-status-of-neuromuscular-reversal-and-monitoring-challenges-and-opportunities
#12
Sorin J Brull, Aaron F Kopman
Postoperative residual neuromuscular block has been recognized as a potential problem for decades, and it remains so today. Traditional pharmacologic antagonists (anticholinesterases) are ineffective in reversing profound and deep levels of neuromuscular block; at the opposite end of the recovery curve close to full recovery, anticholinesterases may induce paradoxical muscle weakness. The new selective relaxant-binding agent sugammadex can reverse any depth of block from aminosteroid (but not benzylisoquinolinium) relaxants; however, the effective dose to be administered should be chosen based on objective monitoring of the depth of neuromuscular block...
November 7, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27811486/double-aortic-arch-causing-severe-tracheal-compression
#13
David W Barbara, Stephen M Broski, Richard K Patch, Alberto Pochettino
No abstract text is available yet for this article.
November 2, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27811485/mask-ventilation-during-induction-of-general-anesthesia-influences-of-obstructive-sleep-apnea
#14
Shin Sato, Makoto Hasegawa, Megumi Okuyama, Junko Okazaki, Yuji Kitamura, Yumi Sato, Teruhiko Ishikawa, Yasunori Sato, Shiroh Isono
BACKGROUND: Depending on upper airway patency during anesthesia induction, tidal volume achieved by mask ventilation may vary. In 80 adult patients undergoing general anesthesia, the authors tested a hypothesis that tidal volume during mask ventilation is smaller in patients with sleep-disordered breathing priorly defined as apnea hypopnea index greater than 5 per hour. METHODS: One-hand mask ventilation with a constant ventilator setting (pressure-controlled ventilation) was started 20 s after injection of rocuronium and maintained for 1 min during anesthesia induction...
November 2, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27811484/it-s-about-time
#15
Sachin Kheterpal
No abstract text is available yet for this article.
November 2, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27801738/texting-under-anesthesia
#16
David Guardiola, Michael Guardiola, Scott D Cook-Sather
No abstract text is available yet for this article.
November 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27792047/does-dexmedetomidine-have-a-perineural-mechanism-of-action-when-used-as-an-adjuvant-to-ropivacaine-a-paired-blinded-randomized-trial-in-healthy-volunteers
#17
Jakob H Andersen, Ulrik Grevstad, Hanna Siegel, Jørgen B Dahl, Ole Mathiesen, Pia Jæger
BACKGROUND: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. METHODS: The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27792046/ivabradine-attenuates-the-microcirculatory-derangements-evoked-by-experimental-sepsis
#18
Marcos L Miranda, Michelle M Balarini, Daniela S Balthazar, Lorena S Paes, Maria-Carolina S Santos, Eliete Bouskela
BACKGROUND: Experimental data suggest that ivabradine, an inhibitor of the pacemaker current in sinoatrial node, exerts beneficial effects on endothelial cell function, but it is unclear if this drug could prevent microcirculatory dysfunction in septic subjects, improving tissue perfusion and reducing organ failure. Therefore, this study was designed to characterize the microcirculatory effects of ivabradine on a murine model of abdominal sepsis using intravital videomicroscopy. METHODS: Twenty-eight golden Syrian hamsters were allocated in four groups: sham-operated animals, nontreated septic animals, septic animals treated with saline, and septic animals treated with ivabradine (2...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27792045/transient-receptor-potential-melastatin-2-regulates-phagosome-maturation-and-is-required-for-bacterial-clearance-in-escherichia-coli-sepsis
#19
ZhanQin Zhang, Ping Cui, Kai Zhang, QiXing Chen, XiangMing Fang
BACKGROUND: Transient receptor potential melastatin 2 is a Ca-permeable cation channel abundantly expressed in macrophages. Trpm2 mice showed exacerbated infection and mortality during polymicrobial sepsis, which is associated with inefficient bacterial killing in macrophages. However, the mechanism of transient receptor potential melastatin 2 regulating bacterial killing remains unknown. METHODS: Trpm2 mice were intraperitoneally injected with Escherichia coli...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27792044/relationship-between-intraoperative-hypotension-defined-by-either-reduction-from-baseline-or-absolute-thresholds-and-acute-kidney-and-myocardial-injury-after-noncardiac-surgery-a-retrospective-cohort-analysis
#20
Vafi Salmasi, Kamal Maheshwari, Dongsheng Yang, Edward J Mascha, Asha Singh, Daniel I Sessler, Andrea Kurz
BACKGROUND: How best to characterize intraoperative hypotension remains unclear. Thus, the authors assessed the relationship between myocardial and kidney injury and intraoperative absolute (intraoperative mean arterial pressure [MAP]) and relative (reduction from preoperative pressure) MAP thresholds. METHODS: The authors characterized hypotension by the lowest MAP below various absolute and relative thresholds for cumulative 1, 3, 5, or 10 min and also time-weighted average below various absolute or relative MAP thresholds...
October 28, 2016: Anesthesiology
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