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Cardiac anesthesiology

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https://www.readbyqxmd.com/read/29679123/-wide-awake-hand-surgery-based-on-application-examples
#1
P Kaiser, M Keller, J Dörler, G Schmidle
OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...
April 20, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#2
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#3
M U Ziegler, H Reinelt
BACKGROUND: Patients undergoing cardiac surgery need extensive and invasive monitoring, which needs to be individually adapted for each patient and requires a diligent risk-benefit analysis. The use of a pulmonary artery catheter (PAC) seems to be justifiable in certain cases; therefore, the preoperative diagnosis of pulmonary hypertension represents an indication for perioperative monitoring with PAC in the S3 guidelines of the German Society for Anesthesiology and Intensive Care Medicine (DGAI)...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29523995/the-role-of-simulation-training-in-anesthesiology-resident-education
#4
REVIEW
Kazuma Yunoki, Tetsuro Sakai
An increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents' performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology...
March 9, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29441169/perioperative-stroke-pathophysiology-and-management
#5
REVIEW
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29388810/knowledge-gaps-in-the-perioperative-management-of-adults-with-obstructive-sleep-apnea-and-obesity-hypoventilation-syndrome-an-official-american-thoracic-society-workshop-report
#6
Najib T Ayas, Cheryl R Laratta, John M Coleman, Anthony G Doufas, Matthias Eikermann, Peter C Gay, Daniel J Gottlieb, Indira Gurubhagavatula, David R Hillman, Roop Kaw, Atul Malhotra, Babak Mokhlesi, Timothy I Morgenthaler, Sairam Parthasarathy, Satya Krishna Ramachandran, Kingman P Strohl, Patrick J Strollo, Michael J Twery, Phyllis C Zee, Frances F Chung
The purpose of this workshop was to identify knowledge gaps in the perioperative management of obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS). A single-day meeting was held at the American Thoracic Society Conference in May, 2016, with representation from many specialties, including anesthesiology, perioperative medicine, sleep, and respiratory medicine. Further research is urgently needed as we look to improve health outcomes for these patients and reduce health care costs. There is currently insufficient evidence to guide screening and optimization of OSA and OHS in the perioperative setting to achieve these objectives...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29366746/how-cardiac-anesthesiology-can-help-stem-the-tide-of-under-representation-of-minorities-in-science-and-medicine
#7
Elliott Woodward, Yvonne Lai, Christyanna Egun, Michael G Fitzsimons
The field of medicine is built upon science, technology, engineering, and math (STEM), yet the United States is rapidly falling behind when it comes to educating the next generation in these disciplines, especially under-represented populations. The authors reflect on existing educational literature surrounding efforts to promote interest in STEM among students and under-represented populations. The authors advocate for greater efforts toward the development of youth programing. Cardiac anesthesia is uniquely positioned as a subspecialty to advance the goal of promoting interest in STEM in diverse groups of young students...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29362652/single-center-experience-in-laparoscopic-treatment-of-gallbladder-perforation
#8
Nuri Alper Sahbaz, Kivanc Derya Peker, Hamit Ahmet Kabuli, Alpen Yahya Gumusoglu, Halil Alis
Introduction: Gallbladder perforation (GBP) is a rare disease with potential mortality. Previous series have reported an incidence of approximately 2-11% and it still continues to be a significant problem for surgeons. Aim: To present our clinical experience with gallbladder perforation. Material and methods: The records of 2754 patients who received surgical treatment for cholelithiasis between 2010 and 2016 were reviewed retrospectively...
December 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29352416/point-of-care-ultrasound-in-pediatric-anesthesiology-and-critical-care-medicine
#9
REVIEW
Erik Su, Nicholas Dalesio, Aliaksei Pustavoitau
Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29284836/cardiopulmonary-resuscitation-evaluation-of-knowledge-efficacy-and-retention-in-young-doctors-joining-postgraduation-program
#10
Vidhu Bhatnagar, Urvashi Tandon, Kavitha Jinjil, Deepak Dwivedi, S Kiran, Rohit Verma
Background: High-quality cardiopulmonary resuscitation (CPR) and rapid defibrillation the cornerstone for resuscitation from cardiac arrest and increase the incidence of return of spontaneous circulation. Regular CPR training imparted to health-care personnel increases knowledge and helps in skill enhancing. Aims: The aim of this study is to evaluate background knowledge, percentage improvement in the skills, and residual knowledge after a period of 6 months of postgraduate (PG) students as well as the efficacy of the designed teaching program for CPR...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#11
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29200065/cardiac-arrest-in-the-operating-room-part-2-special-situations-in-the-perioperative-period
#12
Matthew D McEvoy, Karl-Christian Thies, Sharon Einav, Kurt Ruetzler, Vivek K Moitra, Mark E Nunnally, Arna Banerjee, Guy Weinberg, Andrea Gabrielli, Gerald A Maccioli, Gregory Dobson, Michael F O'Connor
As noted in part 1 of this series, periprocedural cardiac arrest (PPCA) can differ greatly in etiology and treatment from what is described by the American Heart Association advanced cardiac life support algorithms, which were largely developed for use in out-of-hospital cardiac arrest and in-hospital cardiac arrest outside of the perioperative space. Specifically, there are several life-threatening causes of PPCA of which the management should be within the skill set of all anesthesiologists. However, previous research has demonstrated that continued review and training in the management of these scenarios is greatly needed and is also associated with improved delivery of care and outcomes during PPCA...
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29200062/is-compliance-with-surgical-care-improvement-project-cardiac-scip-card-2-measures-for-perioperative-%C3%AE-blockers-associated-with-reduced-incidence-of-mortality-and-cardiovascular-related-critical-quality-indicators-after-noncardiac-surgery
#13
Miklos D Kertai, Mary Cooter, Richard J Pollard, William Buhrman, Solomon Aronson, Joseph P Mathew, Mark Stafford-Smith
BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a contemporary cohort of patients undergoing noncardiac surgery. METHODS: For this retrospective study, the quality assurance database of a large community-based anesthesiology group practice was used to identify 410,288 surgical cases, 18 years of age or older, who underwent elective or emergent noncardiac surgical procedures between January 1, 2009, and December 31, 2014...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#14
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29112023/behavior-of-anesthesiology-residents-in-a-situation-of-intravenous-route-occlusion-during-syringe-pump-use-in-a-simulated-intensive-care-unit
#15
Takayuki Kariya, Tetsuya Miyashita, Hitoshi Sato, Hiromasa Kawakami, Takahisa Goto
INTRODUCTION: Unintentional catecholamine flush caused by inappropriate release of an intravenous occlusion during use of a syringe pump in the intensive care unit (ICU) can have dangerous consequences in patients receiving critical care. We investigated whether anesthesiology residents understood how to deal with syringe pump occlusion in a simulated ICU setting. METHODS: We set up a mannequin that virtually simulated a sedated patient under mechanical ventilation after cardiac surgery, with epinephrine and dopamine being infused by syringe pumps to maintain blood pressure at 100/50 mm Hg...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29082218/evaluation-of-radiation-exposure-pattern-and-radiation-absorbed-dose-resulting-from-occupational-exposure-of-anesthesiologists-to-ionizing-radiation
#16
B Maghsoudi, S M J Mortazavi, S Khademi, P Vatankhah
INTRODUCTION: Little information is available concerning the radiation exposure of anesthesiologists, and no such data have previously been collected in Iran. This prospective study was performed to determine the amount of radiation exposure of anesthesiologists for the purpose of assessing whether or not dangerous levels of radiation exposures were being reached, and to identify factors that correlate with excessive risk. PARTICIPANTS AND METHODS: The radiation exposure of all anesthesiology residents and the attending of Shiraz University of Medical Sciences during a 3-month period (from June to August 2016) was measured using a film badge with monthly readings...
September 2017: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/29016439/examining-the-ability-of-artificial-neural-networks-machine-learning-models-to-accurately-predict-complications-following-posterior-lumbar-spine-fusion
#17
Jun S Kim, Robert K Merrill, Varun Arvind, Deepak Kaji, Sara D Pasik, Chuma C Nwachukwu, Luilly Vargas, Nebiyu S Osman, Eric K Oermann, John M Caridi, Samuel K Cho
STUDY DESIGN: Cross-sectional database study. OBJECTIVE: To train and validate machine learning models to identify risk factors for complications following posterior lumbar spine fusion. SUMMARY OF BACKGROUND DATA: Machine learning models such as artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex datasets. ANNs have yet to be used for risk factor analysis in orthopedic surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent posterior lumbar spine fusion...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28967626/nuclear-dna-as-predictor-of-acute-kidney-injury-in-patients-undergoing-coronary-artery-bypass-graft-a-pilot-study
#18
Valery V Likhvantsev, Giovanni Landoni, Oleg A Grebenchikov, Yuri V Skripkin, Tatiana S Zabelina, Liudmila A Zinovkina, Anastasia S Prikhodko, Vladimir V Lomivorotov, Roman A Zinovkin
OBJECTIVE: To measure the release of plasma nuclear deoxyribonucleic acid (DNA) and to assess the relationship between nuclear DNA level and acute kidney injury occurrence in patients undergoing cardiac surgery. SETTING: Cardiovascular anesthesiology and intensive care unit of a large tertiary-care university hospital. DESIGN: Prospective observational study. PARTICIPANTS: Fifty adult patients undergoing cardiac surgery...
December 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28932497/evaluation-of-amiodarone-versus-metoprolol-in-treating-atrial-fibrillation-after-coronary-artery-bypass-grafting
#19
Alireza Kamali, Amir Sanatkar, Mehrzad Sharifi, Esmaeil Moshir
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia affecting patients in open heart ICU after coronary artery bypass grafting (CABG). Most cardiac surgery textbooks recommend beta blockers as the drug of choice for treating such a condition while many experienced physicians and a number of anesthesiology references offer amiodarone as the drug of choice. Therefore, because of insufficient evidence and the aforementioned controversy, we decided to conduct a study evaluating these two antiarrhythmic medicines...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28922234/consensus-statement-by-the-congenital-cardiac-anesthesia-society-milestones-for-the-pediatric-cardiac-anesthesia-fellowship
#20
Viviane G Nasr, Nina A Guzzetta, Wanda C Miller-Hance, Mark Twite, Gregory J Latham, Luis Zabala, Susan C Nicolson, Emad B Mossad, James A DiNardo
Pediatric cardiac anesthesiology has evolved as a subspecialty of both pediatric and cardiac anesthesiology and is devoted to caring for individuals with congenital heart disease ranging in age from neonates to adults. Training in pediatric cardiac anesthesia is a second-year fellowship with variability in both training duration and content and is not accredited by the Accreditation Council on Graduate Medical Education. Consequently, in this article and based on the Accreditation Council on Graduate Medical Education Milestones Model, an expert panel of the Congenital Cardiac Anesthesia Society, a section of the Society of Pediatric Anesthesiology, defines 18 milestones as competency-based developmental outcomes for training in the pediatric cardiac anesthesia fellowship...
January 2018: Anesthesia and Analgesia
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