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Anesthesiologist

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https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#1
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341336/identification-of-perioperative-pulmonary-aspiration-in-children-using-quality-assurance-and-hospital-administrative-billing-data
#2
Lisa Eisler, Grace Huang, Ka-Eun M Lee, Jennifer A Busse, Ming Sun, Albert Y Lin, Lena S Sun, Caleb Ing
BACKGROUND: Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source...
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29340856/core-point-of-care-ultrasound-curriculum-what-does-every-anesthesiologist-need-to-know
#3
REVIEW
Massimiliano Meineri, Gregory L Bryson, Ramiro Arellano, Nikolaos Skubas
Point-of-care ultrasound (POCUS) is becoming an integral part of anesthesia practice throughout the world. Despite the growing interest in POCUS among trainees and faculty, POCUS training is variable among universities across Canada. This suggests a need for curriculum development and standardization. International guidelines for Emergency Medicine and Critical Care have common frameworks and may be used as a reference to model anesthesia-specific curricula. The Royal College of Anaesthetists of the United Kingdom currently offers the only nationally approved POCUS curriculum for anesthesia and critical care trainees...
January 16, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29338895/feasibility-of-total-intravenous-anesthesia-by-cardiologists-with-the-support-of-anesthesiologists-during-catheter-ablation-of-atrial-fibrillation
#4
Takanori Yamaguchi, Yusuke Shimakawa, Shinji Mitsumizo, Akira Fukui, Yuki Kawano, Toyokazu Otsubo, Yuya Takahashi, Kei Hirota, Takeshi Tsuchiya, Kenichi Eshima
BACKGROUND: The optimal methodology for sedation and anesthesia during atrial fibrillation (AF) ablation has not been well established. We assessed the feasibility of total intravenous anesthesia (TIVA) by cardiologists with support from anesthesiologists during AF ablation and quality of pulmonary vein isolation (PVI) and single procedure success rate at 12 months. METHODS: TIVA was performed by cardiologists using IV propofol and fentanyl under controlled ventilation via i-gel™ without neuromuscular blocking drugs in 160 consecutive patients (80 nonparoxysmal) with no anticipated difficult airway or other severe diseases...
January 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29338605/noteworthy-articles-in-2017-for-cardiothoracic-critical-care
#5
Natalia S Ivascu, Liang Shen, Edward Noguera, Brigid C Flynn
In 2017, many high-impact articles appeared in the literature. This is the third edition of an annual review of articles related to postoperative cardiac critical care that may affect the cardiac anesthesiologist. This year explores vasopressor and inotropic support, timing of renal replacement therapy, management of postoperative respiratory insufficiency, and targeted temperature therapy.
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29338549/sedation-in-cardiac-arrhythmias-management
#6
Federico Guerra, Giulia Stronati, Alessandro Capucci
Procedural sedation is of paramount importance for a plethora of electrophysiological procedures. From electrical cardioversion to electrophysiology studies, device implantations, and catheter ablations, intraprocedural sedation and anesthesia have a pivotal role in allowing procedural success while ensuring patient safety and avoiding discomfort. Areas covered: The present review will discuss the current state-of-the-art in sedation and anesthesia during electrical cardioversion, cardiac implantable electronic device implantation, catheter ablation and electrophysiology studies...
January 17, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29338146/the-effect-of-various-doses-of-infusion-solutions-on-the-endothelial-glycocalyx-layer-in-laparoscopic-cholecystectomy-patients
#7
Matija Belavić, Vlatka Sotošek Tokmadžić, Elizabeta Fišić, Antonija Brozovic Krijan, Nedjeljko Strikić, Mirjana Lončarić Katušin, Josip Žunić
BACKGROUND: The endothelial glycocalyx is located on the luminal side of blood vessels and maintains vessel integrity. This study analysed how various dosages of infusion affected the secretion of atrial natriuretic peptide (ANP) and potential glycocalyx damage in patients undergoing laparoscopic cholecystectomy. We hypothesised that the liberal administration of Ringer's solution during the operation can cause iatrogenic hypervolemia with releasing of ANP and glycocalyx damage. METHODS: The study included 90 patients with American Society of Anesthesiologists' (ASA) class I and II, in good cardiopulmonary health, who were assigned to one of three groups: Restrictive group, which received 1 ml/kg/hr intraoperatively and six hours postoperatively; Low liberal group, which received 5 ml/kg/hr of Ringer's solution intraoperatively and six hours postoperatively and High liberal group, which received 15 ml/kg/hr intraoperatively and 10 ml/kg/hr six hours postoperatively...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29338143/anesthesiology-residents-induction-month-a-pilot-study-showing-an-effective-and-safe-way-to-train-novice-residents-through-simulation
#8
Federico L Barra, Luca Carenzo, Jeffrey Franc, Claudia Montagnini, Flavia Petrini, Francesco Della Corte, Pier L Ingrassia
BACKGROUND: The transition of new residents from medical school to the post-graduate clinical environment remains challenging. We hypothesized that an introductory simulation course could improve new residents' performance in anesthesiology. METHODS: "Anesthesiology Residents Induction Month" (ARIM) was designed as a non-clinical simulation training program aiming at providing the theoretical and practical skills to safely approach, as junior anesthesiologists, the operating rooms...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336755/incorporation-of-anterior-lumbosacral-spine-exposure-into-a-general-surgical-practice
#9
Michael S Champney, Yousef H Abuhakmeh, Andrew S Chung
Many spine surgeons enlist the aid of an "access surgeon" to provide anterior exposure of the lumbosacral spine. We proposed that a single, community hospital general surgery practice can successfully develop an anterior spine exposure program with acceptable clinical outcomes. One hundred and forty-three consecutive anterior exposures were performed between 2008 and 2014. Morbidity and 30-day mortality were recorded. The effects of American Society of Anesthesiologists Physical Status classification (ASA class) and number of levels exposed on length of stay (LOS) and estimated blood loss (EBL) was reported...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336625/the-clavien-dindo-classification-in-pancreatic-surgery-a-clinical-and-economic-validation
#10
Patrick Téoule, Felix Bartel, Emrullah Birgin, Felix Rückert, Torsten J Wilhelm
BACKGROUND/AIMS: In 2004 P. A. Clavien and D. Dindo published the well-known grading system of postoperative complications. It is established in several surgical disciplines. The aim of this study was to assess its validity in pancreatic surgery. The impact of complication grade on economic resources was investigated as well. METHODS: From a prospective database, we retrospectively evaluated all patients who underwent pancreatic resection between January 2009 and December 2014 at our department...
January 16, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29336403/superior-vena-cava-clamping-during-thoracic-surgery-implications-for-the-anesthesiologist
#11
Monish S Raut, Swetanka Das, Rohitash Sharma, Elvin Daniel, Amit Motihar, Arvind Verma, Sibashankar Kar, Arun Maheshwari, Ganesh Shivnani, Arvind Kumar
Resection and reconstruction of the SVC is a challenging Intraoperative situation owing to the potential complications after clamping a patent vessel. Hemodynamic imbalance and neurological effects of SVC clamping can be life threatening. These complications can be prevented by careful intraoperative monitoring and management. Anaesthesiologist must be aware of different options to manage such challenging situations.
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336401/bleeding-in-the-lung-complicates-a-routine-intracardiac-repair-what-went-wrong
#12
Neeti Makhija, Rohan Magoon, Minati Choudhury, Sivasubramanian Ramakrishnan
Cyanotic congenital heart disease presents an increased tendency to bleed in view of subtle coagulation defects. Airway bleeding can be particularly difficult to manage while maintaining an adequate ventilation. An isolated lung bleed with the exclusion of possible traumatic, medical and surgical causes of bleeding, should alert the attending anesthesiologist to the possibility of the collateral-related bleeding. Preoperative coil embolization remains an important initial management step in a case of tetralogy of Fallot (TOF) with major aortopulmonary collaterals...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336393/cardiac-surgery-in-a-patient-with-implanted-vagal-nerve-stimulator
#13
Aashish Jain, Dheeraj Arora, Yatin Mehta
The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. The surgical option for temporal lobe epilepsy is temporal lobectomy, which has its inherent risk of neurological deficits after the surgery. Patients who are either refractory to combination therapy or do not want surgical temporal lobectomy are the candidates for electrical stimulation therapy...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336387/dexmedetomidine-for-prevention-of-skeletal-muscle-ischaemia-reperfusion-injury-in-patients-with-chronic-limb-ischaemia-undergoing-aortobifemoral-bypass-surgery-a-prospective-double-blind-randomized-controlled-study
#14
Tanveer Singh Kundra, Ashwini Thimmarayappa, Manasa Dhananjaya, N Manjunatha
BACKGROUND: Dexmedetomidine is a selective α-2 agonist used for sedation. It has also been shown to have myocardial protective effect and prevent ischemia-reperfusion injury in off-pump coronary artery bypass patients. The aim of our study was to assess the effect of dexmedetomidine for prevention of skeletal muscle ischemia-reperfusion injury in patients undergoing aortobifemoral bypass surgery. METHODOLOGY: Sixty adult patients (Group dexmedetomidine n = 30, Group normal saline n = 30) undergoing aortobifemoral bypass surgery were recruited over 3 months...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336006/the-place-of-frailty-and-vulnerability-in-the-surgical-risk-assessment-should-we-move-from-complexity-to-simplicity
#15
Mario Barbagallo, Ligia J Dominguez, Domenico Cucinotta
Due to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical patients...
January 15, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29335609/prognostic-significance-of-halp-hemoglobin-albumin-lymphocyte-and-platelet-in-patients-with-bladder-cancer-after-radical-cystectomy
#16
Ding Peng, Cui-Jian Zhang, Yan-Qing Gong, Han Hao, Bao Guan, Xue-Song Li, Li-Qun Zhou
The outcome of bladder cancer after radical cystectomy is heterogeneous. We aim to evaluate the prognostic value of HALP (hemoglobin, albumin, lymphocyte and platelet) and explore novel prognostic indexes for patients with bladder cancer after radical cystectomy. In this retrospective study, 516 patients with bladder cancer after radical cystectomy were included. The median follow-up was 37 months (2 to 99 mo). Risk factors of decreased overall survival were older age, high TNM stage, high American Society of Anesthesiologists (ASA) grade and low HALP score...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29334501/practice-guidelines-for-moderate-procedural-sedation-and-analgesia-2018-a-report-by-the-american-society-of-anesthesiologists-task-force-on-moderate-procedural-sedation-and-analgesia-the-american-association-of-oral-and-maxillofacial-surgeons-american-college
#17
https://www.readbyqxmd.com/read/29333775/-effect-of-dexmedetomidine-on-emergence-agitation-after-general-anesthesia-in-children-undergoing-odontotherapy-in-day-surgery-operating-room
#18
Luo Lin, Zhang Yueming, Li Meisheng, Wang Jiexue, Ji Yang
OBJECTIVE: To study the effectiveness of dexmedetomidine used for general anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room in reducing the incidence of emergence agitation (EA). METHODS: Eighty children undergoing odontotherapy and under general anesthesia in day-surgery operating room were randomized into two groups, group A (n=40) and group B (n=40). Each patient in group A was administered with a bolus dose of dexmedetomidine (1...
December 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29332544/the-possible-use-of-preoperative-natriuretic-peptides-for-discriminating-low-versus-moderate-high-surgical-risk-patient
#19
Luigi Vetrugno, Daniele Orso, Carola Matellon, Marilù Giaccalone, Tiziana Bove, Elena Bignami
Perioperative risk scores for patients undergoing noncardiac surgery are generally considered inaccurate, poor, or, at best, modest. We propose estimating a patient's pretest and posttest probability of cardiac morbidity and death using the preoperative scoring system plus the negative likelihood ratio from brain natriuretic peptide (BNP) or N-terminal proB-type natriuretic peptide (NT-proBNP) plasma levels. Our clinical challenge scenario showed a pretest probability of postoperative major cardiac complications with the patient risk factor as 6...
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29332350/short-and-long-term-outcomes-of-minimally-invasive-esophagectomy-in-elderly-patients-with-esophageal-squamous-cell-carcinoma
#20
H Zhao, Gang Liu, S Wei, H Liu
PURPOSE: In recent years, there has been an increase in the number of elderly patients undergoing surgery for esophageal squamous cell carcinoma (ESCC). However, there are few studies on short- and long-term outcomes of minimally invasive esophagectomy (MIE) in such patients. The purpose of this study was to report both short- and long-term outcomes of MIE in elderly patients with ESCC. METHODS: A total of 273 patients with ESCC underwent MIE at our hospital from January 2010 to December 2016...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
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