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Anaesthesia, Critical Care & Pain Medicine

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https://www.readbyqxmd.com/read/30513357/blood-pressure-variability-in-surgical-and-intensive-care-patients-is-there-a-potential-for-closed-loop-vasopressor-administration
#1
Joseph Rinehart, Michael Ma, Michael David Calderon, Aurelie Bardaji, Reda Hafiane, Philippe Van der Linden, Alexandre Joosten
Blood pressure management in the operating rooms (OR) and intensive care units (ICU) frequently involves manually titrated vasopressor therapy to an optimal range of mean arterial pressure (MAP). Ideally, changes in vasopressor infusion rates have to quickly follow variations in blood pressure measurements. However, such a tightly controlled feedback loop is difficult to achieve. Few studies have examined blood pressure control when vasopressor therapy is administered manually in OR and ICU patients. We extracted MAP data from 3,623 patients (2,530 from the ORs and 1,093 from the ICU) on vasopressors from our electronic medical records...
December 1, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30394347/haemodynamic-changes-and-incisional-bleeding-after-scalp-infiltration-of-dexmedetomidine-with-lidocaine-in-neurosurgical-patients
#2
Hyunzu Kim, Seung-Ho Choi, Sang-Hee Ha, Won-Seok Chang, Gyoung-A Heo, Jimyeong Jeong, Kyeong Tae Min
BACKGROUND: The purpose of this randomised controlled study is to compare the haemodynamic changes and the degree of incisional bleeding after scalp infiltration of lidocaine and dexmedetomidine versus lidocaine and epinephrine for patients with hemi-facial spasm undergoing microvascular decompression. METHODS: Fifty-two patients were injected with 5 mL of 1% lidocaine with either dexmedetomidine (2 μg/mL) or epinephrine (1:100,000 dilution) to reduce scalp bleeding...
October 27, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30366119/management-of-antiplatelet-therapy-for-non-elective-invasive-procedures-of-bleeding-complications-proposals-from-the-french-working-group-on-perioperative-haemostasis-gihp-in-collaboration-with-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar
#3
A Godier, D Garrigue, D Lasne, P Fontana, F Bonhomme, J P Collet, E de Maistre, B Ickx, Y Gruel, M Mazighi, P Nguyen, A Vincentelli, P Albaladejo, T Lecompte
The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR) drafted up-to-date proposals on the management of antiplatelet therapy for non-elective invasive procedures or bleeding complications. The proposals were discussed and validated by a vote; all proposals could be assigned with a high strength. Emergency management of oral antiplatelet agents (APA) requires knowledge on their pharmacokinetic/pharmacodynamics parameters, evaluation of the degree of the alteration of haemostatic competence and the associated bleeding risk...
October 23, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30359771/understanding-the-impact-of-pathophysiological-alterations-during-critical-illness-on-drug-pharmacokinetics
#4
EDITORIAL
Janattul-Ain Jamal, Claire Roger, Jason A Roberts
No abstract text is available yet for this article.
October 22, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30347254/we-should-move-forward-by-using-our-knowledge-to-improve-surgical-patient-care
#5
EDITORIAL
Pierre-Grégoire Guinot
No abstract text is available yet for this article.
October 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30347253/coming-to-an-agreement-with-recent-guidelines-and-real-life-about-airway-management-and-future-challenges
#6
EDITORIAL
Robin Florian, Guen Morgan Le
No abstract text is available yet for this article.
October 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30347252/measure-it-to-manage-it-a-bevy-of-icu-quality-of-care-indicators
#7
EDITORIAL
Eric Kipnis, Marc Leone
No abstract text is available yet for this article.
October 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30347251/the-deliberate-clinical-inertia-a-source-of-professional-satisfaction-for-the-end-of-life-decision-makers
#8
EDITORIAL
Armelle Nicolas-Robin
No abstract text is available yet for this article.
October 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30347250/crrt-and-ecmo-dialysis-catheter-or-connection-to-the-ecmo-circuit
#9
EDITORIAL
Miet Schetz, Matthieu Legrand
No abstract text is available yet for this article.
October 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30342104/admission-to-surgical-intensive-care-unit-in-time-with-intensivist-coverage-and-its-association-with-postoperative-30-day-mortality-the-role-of-intensivists-in-a-surgical-intensive-care-unit
#10
Oh Tak Kyu, Eunjeong Ji, Soyeon Ahn, Dong Jung Kim, In-Ae Song
BACKGROUND: This study aimed to investigate the association between postoperative surgical Intensive Care Unit (ICU) admission during a time when there was intensivist coverage and 30-day mortality after ICU admission. METHODS: This was a retrospective observational study in a tertiary care academic hospital ICU, with daytime intensivist coverage. We collected the electronic medical records for all patients who were admitted to the postoperative ICU after undergoing a surgery between January 1, 2007 and December 31, 2016...
October 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30342103/levosimendan-in-patients-with-low-cardiac-output-syndrome-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis
#11
Junchen Zhu, Yu Zhang, Lvlin Chen, Yan He, Xiaoming Qing
Levosimendan is an inotropic agent that has been shown in small studies to treat low cardiac output syndrome in cardiac surgery. However, large randomised controlled trials (RCTs) have been recently published and presented neutral results. We sought to determine the effect of levosimendan on mortality in adults with low ejection fraction undergoing cardiac surgery. We searched different databases: Medline, Embase, Cochrane Central Register of Controlled Trials, and clinical trial registries. We included RCTs comparing events in the levosimendan versus placebo in adult patients with ejection fraction≤ 35% undergoing cardiac surgery...
October 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30342102/acute-respiratory-distress-syndrome-after-chest-trauma-epidemiology-specific-physiopathology-and-ventilation-strategies
#12
REVIEW
Severin Ramin, Jonathan Charbit, Samir Jaber, Xavier Capdevila
No abstract text is available yet for this article.
October 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30339893/big-data-and-targeted-machine-learning-in-action-to-assist-medical-decision-in-the-icu
#13
REVIEW
Romain Pirracchio, Mitchell J Cohen, Ivana Malenica, Jonathan Cohen, Antoine Chambaz, Maxime Cannesson, Christine Lee, Matthieu Resche-Rigon, Alan Hubbard
Historically, personalised medicine has been synonymous with pharmacogenomics and oncology. We argue for a new framework for personalised medicine analytics that capitalises on more detailed patient-level data and leverages recent advances in causal inference and machine learning tailored towards decision support applicable to critically ill patients. We discuss how advances in data technology and statistics are providing new opportunities for asking more targeted questions regarding patient treatment, and how this can be applied in the intensive care unit to better predict patient-centred outcomes, help in the discovery of new treatment regimens associated with improved outcomes, and ultimately how these rules can be learned in real-time for the patient...
October 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30339892/perioperative-pain-and-post-operative-nausea-and-vomiting-ponv-management-after-day-case-surgery-the-sfar-opera-national-study
#14
Frédéric Aubrun, Claude Ecoffey, Dan Benhamou, Laurent Jouffroy, Pierre Diemunsch, Kristina Skaare, Jean Luc Bosson, Pierre Albaladejo
OBJECTIVES: Since pain and post-operative nausea and vomiting (PONV) are the main reasons for failed discharge after day-case surgery, assessing pain and PONV is important. The aim was to describe the perioperative pain and PONV management within selected day-case surgical procedures in France. METHODS: The OPERA trial was carried out on given days between December 2013 and December 2014. Each participating centre was required to fill out 3 separate questionnaires aiming at describing (1) protocols about pain and PONV, (2) patients' characteristics and procedures, (3) analgesic and PONV practice patterns for selected procedures...
October 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30339891/sedation-with-dexmedetomidine-prolongs-the-analgesic-duration-of-brachial-plexus-block-a-randomised-controlled-trial
#15
Boohwi Hong, Choonho Jung, Yumin Jo, Hyemin Kang, Woosuk Chung, Yoon-Hee Kim, ChaeSeong Lim, YoungKwon Ko
PURPOSE: Dexmedetomidine, an alpha 2 receptor agonist, prolongs nerve block duration when administered in conjunction with peripheral nerve blocks. We hypothesised that sedation with dexmedetomidine could also significantly prolong the analgesic duration of brachial plexus block (BPB) during orthopaedic surgery on the upper extremities. MATERIALS AND METHODS: One hundred and two patients received upper extremity surgery under BPB. The patients were randomly sedated with dexmedetomidine (D group) or midazolam (M group) following BPB using 25 mL of local anaesthetics (1:1 mixture of 1% lidocaine and 0...
October 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30336274/a-giant-thoracic-aortic-aneurysm-causing-multiple-fistulas-and-mediastinitis
#16
LETTER
Dorget Amandine, Vodovar Dominique, Dessalle Thomas, Desgranges Pascal, Mongardon Nicolas
No abstract text is available yet for this article.
October 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30336273/choosing-appropriate-size-of-i-gel-%C3%A2-for-initial-success-insertion-a-prospective-comparative-study
#17
Gilles Guerrier, Christine Agostini, Marion Antona, Fiorella Sponzini, Anne Paoletti, Isabelle Martin, Jean-Michel Ekherian, Christophe Baillard
PURPOSE: The optimal size of the I-Gel® remains unclear since the manufacturer's weight-based formula (size 3 for weight < 50 kg, size 4 for weight 50-90 kg, and size 5 for weight > 90 kg) for the laryngeal mask airway I-Gel® is not evidence-based. We hypothesised that sex may also guide the choice of I-Gel® size. METHODS: Insertion success rates of the I-Gel® chosen according to the weight-based formula were prospectively recorded and compared with those of a patients' cohort ventilated with an I-Gel® chosen according to the sex-based formula recorded...
October 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30308243/process-and-organisation-of-in-hospital-emergencies-in-france
#18
LETTER
Romain Jouffroy, Xavier Bobbia, Tobias Gauss, Pierre Bouzat, Michelet Pierre
No abstract text is available yet for this article.
October 9, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30292488/serious-adverse-events-and-deaths-linked-to-poor-ventilator-use-a-report-of-four-closed-claims
#19
A Theissen, V Piriou, F Fuz, M Autran, P Albaladejo, P Trouiller
Through this series of four closed claims, we highlight examples of accidents stemming from poor ventilator use. We then review the main issues in this regard as reported in the literature and by learned societies. This case series has led us to emphasise the need for safety procedures involving systematic checks prior to use, declaration and analysis of the risk, as well as feedback and teaching regarding ventilation systems.
October 4, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30292487/prolonged-continuous-wound-infiltration-with-a-local-anaesthetic-after-total-mastectomy-pharmacokinetics-and-preliminary-results-on-postoperative-pain
#20
LETTER
Daniel Francon, Camille Riff, Olivier Blin, Monique Cohen, Romain Guilhaumou
No abstract text is available yet for this article.
October 4, 2018: Anaesthesia, Critical Care & Pain Medicine
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