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Anesthesiology intensive care

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https://www.readbyqxmd.com/read/29352365/-anesthesia-problem-cards-indispensable-yet-problematic-nationwide-survey-on-experiences-from-clinical-practice
#1
M Schieren, A Böhmer, W Golbeck, J Defosse, F Wappler, H E Marcus
BACKGROUND: Anesthetic procedures may lead to severe and potentially life-threatening complications (e. g. difficult airway, allergic reactions, malignant hyperthermia). Most complications can be avoided in future anesthetic procedures with adequate preparation (e. g. awake intubation, trigger-free anesthesia). In Germany, anesthesia problem cards were introduced two decades ago to identify patients at risk and to increase patient safety by creating a standardized documentation system for anesthesia-related complications...
January 19, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29335823/-drugs-for-intravenous-induction-of-anesthesia-propofol
#2
D Bolkenius, C Dumps, E Halbeck
In a series of articles dealing with hypnotics for induction of anesthesia, this article describes the development and current value of propofol. Its significance far exceeds that of a pure induction hypnotic (sedation in diagnostic and therapeutic procedures and on the intensive care unit). Propofol is also used for sedation in diagnostic and therapeutic procedures and on the intensive care unit. In the field of induction of anesthesia, the alternatives are barely used. Some contraindications are still controversial whereas others are no longer sufficiently anchored in the users' awareness (widespread off-label use)...
February 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29307207/the-role-of-clinical-hypnosis-and-self-hypnosis-to-relief-pain-and-anxiety-in-severe-chronic-diseases-in-palliative-care-a-2-year-long-term-follow-up-of-treatment-in-a-nonrandomized-clinical-trial
#3
Maria Paola Brugnoli, Giancarlo Pesce, Emanuela Pasin, Maria Francesca Basile, Stefano Tamburin, Enrico Polati
BACKGROUND: Patients with severe chronic diseases and advanced cancer receiving palliative care, have a complex range of pain and anxiety that can arise early in the course of illness. We studied two groups of patients with severe chronic diseases who participated in a nonrandomized clinical trial of early integration of clinical hypnosis in palliative care versus standard pharmacological care. The purpose of this investigation was to evaluate whether a long-term intervention of 2 years with clinical hypnosis and self-hypnosis as an adjuvant therapy in chronic pain and anxiety, is more effective than pharmacological therapy alone...
January 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29284443/readiness-to-change-and-therapy-outcomes-of-an-innovative-psychotherapy-program-for-surgical-patients-results-from-a-randomized-controlled-trial
#4
Henning Krampe, Anna-Lena Salz, Léonie F Kerper, Alexander Krannich, Tatjana Schnell, Klaus-Dieter Wernecke, Claudia D Spies
BACKGROUND: Readiness to change is a pivotal construct for psychotherapy research and a major target of motivational interventions. Our primary objective was to examine whether pre-treatment readiness to change moderated therapy effects of Bridging Intervention in Anesthesiology (BRIA), an innovative psychotherapy approach for surgical patients. This stepped care program aims at motivating and supporting surgical patients with mental disorders to engage in psychosocial mental health care...
December 29, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29247307/attitudes-towards-end-of-life-issues-in-intensive-care-unit-among-italian-anesthesiologists-a-nation-wide-survey
#5
Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano, Sebastiano Mercadante
BACKGROUND: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). METHODS: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. RESULTS: Eight hundred and five persons responded to the full list of questions...
December 15, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29239945/error-grid-analysis-for-arterial-pressure-method-comparison-studies
#6
Bernd Saugel, Oliver Grothe, Julia Y Nicklas
The measurement of arterial pressure (AP) is a key component of hemodynamic monitoring. A variety of different innovative AP monitoring technologies became recently available. The decision to use these technologies must be based on their measurement performance in validation studies. These studies are AP method comparison studies comparing a new method ("test method") with a reference method. In these studies, different comparative statistical tests are used including correlation analysis, Bland-Altman analysis, and trending analysis...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29218778/examination-of-sacral-tissue-oxygen-saturation-among-immobile-patients
#7
Burcu Ceylan, Ulku Yapucu Gunes, Mehmet Uyar
AIMS AND OBJECTIVES: This research was conducted to explore the effect of immobility on sacral tissue oxygen saturation in patients lying on a supporting surface in supine position. BACKGROUND: Guidelines in regard to preventing pressure ulcers recommend that patients lying on a standard bed should change their positions every two hours and that patients on a supporting surface should change their positions every four hours. But there is no strong evidence that justifies this practice...
December 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#8
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
December 5, 2017: Der Anaesthesist
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
#9
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/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#10
Natalie Moryl, Vinnidhy Dave, Paul Glare, Ali Bokhari, Vivek T Malhotra, Amitabh Gulati, Joseph Hung, Vinay Puttanniah, Yvona Griffo, Roma Tickoo, Alison Wiesenthal, Susan D Horn, Charles E Inturrisi
The Memorial Sloan Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1,534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EuroQOL 5 dimensions) was inversely related to average pain intensity category, whereas measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
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
#11
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/29098342/preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#12
REVIEW
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#13
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29046901/chirurgia-e-management-delle-pazienti-anziane-affette-da-carcinoma-ovarico
#14
Paolo Scollo, Giuseppe Scibilia, Basilio Pecorino
The median life expectancy of population among industrialized countries has dramatically expanded in recent years. On the other hand, the risk of developing cancer increases with age.The treatment for gynaecological malignancies is well defined with respect to the surgery, radiation treatment and chemotherapy. However, elderly patients receives substandard treatment when compared to the younger people, generally due to the presence of associated medical conditions. The assessment of the co-morbidity is an important aspect of the surgical decision-making process...
2017: Argomenti di Oncologia Geriatrica
https://www.readbyqxmd.com/read/28990685/national-trends-in-otolaryngology-intern-curricula-following-accreditation-council-for-graduate-medical-education-changes
#15
Kevin J Kovatch, Rebecca S Harvey, Mark E P Prince, Marc C Thorne
OBJECTIVES/HYPOTHESIS: In 2016, Accreditation Council for Graduate Medical Education (ACGME) requirements for curriculum and resident experiences were modified to require entering postgraduate year (PGY)-1 residents to spend 6 months of structured education on otolaryngology-head and neck surgery (ORL-HNS) rotations. We aimed to determine how ORL-HNS training programs have adapted curricula in response to 2016 ACGME curriculum requirement changes. STUDY DESIGN: Survey study...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28967626/nuclear-dna-as-predictor-of-acute-kidney-injury-in-patients-undergoing-coronary-artery-bypass-graft-a-pilot-study
#16
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...
May 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28891705/-why-would-doctors-from-debrecen-go-abroad-results-of-a-questionnaire
#17
Zoltán Szekanecz, Zoltán Tóth, Attila Hamar, Levente Lánczi
INTRODUCTION: Numerous beliefs have arisen in relation to the emigration of doctors. First of all, in most cases emigration has been attributed to, almost exclusively, low salaries. There are a number of non-financial issues that could possibly be more easily addressed. METHOD: In order to get closer to these issues, we sent out a 37-item questionnaire to doctors, who originally graduated from the University of Debrecen. Altogether 82 of them sent back the questionnaire...
September 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28886611/-mass-casualty-incident-special-features-of-threatening-situations
#18
Björn Hossfeld, Thomas Wurmb, Florent Josse, Matthias Helm
Terrorist attacks or amok runs may cause "threatening situations" for emergency medical services (EMS), fire fighters and physicians. Cooperation with the police is of paramount importance. In order to minimize the risk to rescue personnel and affected persons, emergency medical care has to follow tactical principles. So, the strategy in such "threatening situations" is "Stop the bleeding and clear the scene". The police define three areas of danger: unsafe, partly safe and secure. Medical care in these areas follows the concept of Tactical Combat Casualty Care...
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28828300/generalizable-items-and-modular-structure-for-computerised-physician-staffing-calculation-on-intensive-care-units
#19
REVIEW
Manfred Weiss, Gernot Marx, Thomas Iber
Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28776177/-rudolf-frey-a-biographical-sketch-on-the-occasion-of-his-100th%C3%A2-birthday
#20
REVIEW
M Goerig, J P A H Jantzen
The life of an outstanding human being, a creative personality, will find the interest of posterity if he is acknowledged not only as a representative of his time but also decades later can be described as a formative character. This applies to Rudolf Frey who, like no other, has deeply influenced the development of German language anesthesiology after the Second World War. In the 1950s and 1960s as a visionary he already portrayed the four pillars of our discipline as the future field of work of anesthetists: anesthesiology, intensive care, emergency medicine and pain therapy...
August 3, 2017: Der Anaesthesist
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