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European Journal of Anaesthesiology

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https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#1
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29135535/blood-glucose-concentrations-in-prehospital-trauma-patients-with-traumatic-shock-a-retrospective-analysis
#2
Janett Kreutziger, Wolfgang Lederer, Stefan Schmid, Hanno Ulmer, Volker Wenzel, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen
BACKGROUND: Deranged glucose metabolism after moderate to severe trauma with either high or low concentrations of blood glucose is associated with poorer outcome. Data on prehospital blood glucose concentrations and trauma are scarce. OBJECTIVES: The primary aim was to describe the relationship between traumatic shock and prehospital blood glucose concentrations. The secondary aim was to determine the additional predictive value of prehospital blood glucose concentration for traumatic shock when compared with vital parameters alone...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29120939/clinical-signs-and-electroencephalographic-patterns-of-emergence-from-sevoflurane-anaesthesia-in-children-an-observational-study
#3
Laura Cornelissen, Carolina Donado, Johanna M Lee, Norah E Liang, Ian Mills, Andrea Tou, Aykut Bilge, Charles B Berde
BACKGROUND: Few studies have systematically described relationships between clinical-behavioural signs, electroencephalographic (EEG) patterns and age during emergence from anaesthesia in young children. OBJECTIVE: To identify the relationships between end-tidal sevoflurane (ETsevoflurane) concentration, age and frontal EEG spectral properties in predicting recovery of clinical-behavioural signs during emergence from sevoflurane in children 0 to 3 years of age, with and without exposure to nitrous oxide...
November 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29120938/fibrinogen-on-admission-in-trauma-score-early-prediction-of-low-plasma-fibrinogen-concentrations-in-trauma-patients
#4
Tobias Gauss, Sébastien Campion, Sébastien Kerever, Mathilde Eurin, Mathieu Raux, Anatole Harrois, Catherine Paugam-Burtz, Sophie Hamada
BACKGROUND: Early recognition of low fibrinogen concentrations in trauma patients is crucial for timely haemostatic treatment and laboratory testing is too slow to inform decision-making. OBJECTIVE: To develop a simple clinical tool to predict low fibrinogen concentrations in trauma patients on arrival. DESIGN: Retrospective cohort study. SETTING: Three designated level 1 trauma centres in the Paris Region, from January 2011 to December 2013...
November 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112553/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-executive-summary
#5
Arash Afshari, Walter Ageno, Aamer Ahmed, Jacques Duranteau, David Faraoni, Sibylle Kozek-Langenecker, Juan Llau, Jacky Nizard, Maurizio Solca, Jakob Stensballe, Emmanuel Thienpont, Eleftherios Tsiridis, Linas Venclauskas, Charles Marc Samama
No abstract text is available yet for this article.
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112552/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis
#6
Charles Marc Samama, Arash Afshari
No abstract text is available yet for this article.
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112551/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-inferior-vena-cava-filters
#7
Raquel Ferrandis Comes, Patrick Mismetti, Arash Afshari
: The indications for the use of an inferior vena cava filter (IVCF) in the context of deep venous thrombosis to prevent pulmonary embolism remain controversial. Despite wide use in clinical practice, great variation exists in national and international guidelines in regard to the indications. In addition, clinical practice is based on poor-quality data from trauma and bariatric surgery with a high incidence of complications. It is often difficult to assess their efficacy and lack of filter retrieval appears to be a substantial issue compared with a potential benefit by insertion of these devices...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112550/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-mechanical-prophylaxis
#8
Arash Afshari, Christian Fenger-Eriksen, Manuel Monreal, Peter Verhamme
: Institutional protocols need to address the indications for pharmacological and mechanical thromboprophylaxis. The use of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) strongly differs between institutions. As a consequence, no strong recommendations can be made based on the contemporary high-level evidence. Although different clinical practices can be supported, such approaches should be part of an institutional strategy to reduce the burden of venous thromboembolism (VTE)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112549/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-patients-with-preexisting-coagulation-disorders-and-after-severe-perioperative-bleeding
#9
Aamer Ahmed, Sibylle Kozek-Langenecker, François Mullier, Sue Pavord, Cedric Hermans
: In patients with inherited bleeding disorders undergoing surgery, we recommend assessment of individual risk for venous thromboembolism, taking into account the nature of the surgery and anaesthetic, type and severity of bleeding disorder, age, BMI, history of thrombosis, the presence of malignancy and other high-risk comorbidities. Venous thromboembolism risk should be balanced against the increased bleeding risk associated with anticoagulant use in patients with known bleeding disorders (Grade 1C). In these patients undergoing major surgery, we recommend against routine postoperative use of pharmacological thromboprophylaxis, especially for patients with haemophilia A and B (Grade 1B)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112548/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-aspirin
#10
Jean-Yves Jenny, Ingrid Pabinger, Charles Marc Samama
: There is a good rationale for the use of aspirin in venous thromboembolism prophylaxis in some orthopaedic procedures, as already proposed by the 9th American College of Chest Physicians' guidelines (Grade 1C). We recommend using aspirin, considering that it may be less effective than or as effective as low molecular weight heparin for prevention of deep vein thrombosis and pulmonary embolism after total hip arthroplasty, total knee arthroplasty and hip fracture surgery (Grade 1C). Aspirin may be less effective than or as effective as low molecular weight heparins for prevention of deep vein thrombosis and pulmonary embolism after other orthopaedic procedures (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112547/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-chronic-treatments-with-antiplatelet-agents
#11
Juan V Llau, Pieter Kamphuisen, Pierre Albaladejo
: Antiplatelet agents (APA) are considered first-line therapy in preventing cardiovascular thrombotic events, but they are of limited value in the prophylaxis of venous thromboembolism (VTE) during the perioperative period. Consequently, many patients should receive both an APA and an anticoagulant. This combination can increase the bleeding risk and it is necessary to make some recommendations to minimise that risk. In patients receiving APA chronically, if the risk of VTE outweighs the risk of bleeding, we suggest pharmacological prophylaxis (grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#12
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112545/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-intensive-care
#13
Jacques Duranteau, Fabio Silvio Taccone, Peter Verhamme, Walter Ageno
: Venous thromboembolism is a common and potentially life-threatening complication that occurs in 4 to 15% of patients admitted to ICUs despite the routine use of pharmacological prophylaxis. We therefore recommend an institution-wide protocol for the prevention of venous thromboembolism (Grade 1B). The routine use of ultrasonographic screening for deep vein thrombosis is not recommended when thromboprophylactic measures are in place (Grade 1B), as the detection of asymptomatic deep vein thrombosis may prompt therapeutic anticoagulation that may increase bleeding risk but has no proven reduction of clinically significant thrombotic events...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112544/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-day-surgery-and-fast-track-surgery
#14
Linas Venclauskas, Juan V Llau, Jean-Yves Jenny, Per Kjaersgaard-Andersen, Øivind Jans
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112543/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-during-pregnancy-and-the-immediate-postpartum-period
#15
Anne-Sophie Ducloy-Bouthors, Andrea Baldini, Rezan Abdul-Kadir, Jacky Nizard
: Thromboembolic events in the pregnant and postpartum patient remain rare but potentially fatal complications. The aim of this section was to analyse the few prospective studies addressing the issue of thromboprophylaxis following a surgical procedure during and immediately after pregnancy, as well as national guidelines, and to propose European guidelines on this specific condition. Thromboprophylaxis is broadly recommended due to the combined risks of surgery and pregnancy or the postpartum period, regardless of the mode of delivery...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112542/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-neurosurgery
#16
David Faraoni, Raquel Ferrandis, William Geerts, Matthew D Wiles
: Although there are numerous publications addressing venous thromboembolism and its prevention in neurosurgery, there are relatively few high-quality studies to guide decisions regarding thromboprophylaxis. In patients undergoing craniotomy, we recommend that if intermittent pneumatic compression (IPC) is used, it should be applied before the surgical procedure or on admission (Grade 1C). In craniotomy patients at particularly high risk for venous thromboembolism, we suggest considering the initiation of mechanical thromboprophylaxis with IPC preoperatively with addition of low molecular weight heparin (LMWH) postoperatively when the risk of bleeding is presumed to be decreased (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112541/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-cardiovascular-and-thoracic-surgery
#17
Aamer B Ahmed, Andreas Koster, Marcus Lance, David Faraoni
: None of the predictive models for venous thromboembolism (VTE) prophylaxis have been designed for and validated in patients undergoing cardiothoracic and vascular surgery. The presence of one or more risk factors [age over 70 years old, transfusion of more than 4 U of red blood cells/fresh frozen plasma/cryoprecipitate, mechanical ventilation lasting more than 24 h, postoperative complication (e.g. acute kidney injury, infection/sepsis, neurological complication)] should place the cardiac population at high risk for VTE...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29084009/microvascular-reactivity-assessed-by-near-infrared-spectroscopy-and-a-vascular-occlusion-test-is-associated-with-patient-outcomes-following-cardiac-surgery-a-prospective-observational-study
#18
Ethan Butler, Sajeev Mahendran, John Nguyen, Anders Aneman
BACKGROUND: Microvascular dysfunction in patients admitted to the ICU following cardiac surgery may be related to perioperative complications and increased resource utilisation even in the presence of acceptable systemic haemodynamic variables. OBJECTIVES: To assess the relationship between microvascular impairment using peripheral near-infrared spectroscopy at ICU admission and 6 h postadmission and the duration of mechanical ventilatory support, length of stay in ICU and in hospital...
October 27, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29023246/effect-of-various-durations-of-smoking-cessation-on-postoperative-outcomes-a-retrospective-cohort-analysis
#19
Alparslan Turan, Onur Koyuncu, Cameron Egan, Jing You, Kurt Ruetzler, Daniel I Sessler, Jacek B Cywinski
BACKGROUND: Preoperative smoking cessation is commonly advised in an effort to improve postoperative outcomes. However, it remains unclear for how long smoking cessation is necessary, and even whether a brief preoperative period of abstinence is helpful and well tolerated. OBJECTIVE: We evaluated associations between various periods of preoperative smoking cessation and major morbidity and death. DESIGN: Retrospective cohort analysis. SETTING: Adults who had noncardiac surgery at the Cleveland Clinic Main Campus between May 2007 and December 2013...
October 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28937531/median-effective-dose-of-intranasal-dexmedetomidine-sedation-for-transthoracic-echocardiography-examination-in-postcardiac-surgery-and-normal-children-an-up-and-down-sequential-allocation-trial
#20
Yang Liu, Qing Yu, Mang Sun, Shangyingying Li, Jing Zhang, Yao Lei, Chaofeng Li, Fei Yang, Shengfen Tu
BACKGROUND: Dexmedetomidine (DEX) has been used for sedation in young infants and children undergoing transthoracic echocardiography (TTE). The median effective dose of intranasal DEX has not been described for postcardiac surgery children. Postcardiac surgery children could require more DEX to achieve satisfactory sedation for TTE examination than children suspected of congenital heart disease. OBJECTIVES: To study whether postcardiac surgery children need a larger dose of DEX for TTE than normal children...
September 20, 2017: European Journal of Anaesthesiology
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