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Guideline anesthesiology

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https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#1
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#2
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29665588/current-technique-and-application-of-percutaneous-cryotherapy
#3
Andreas H Mahnken, Alexander Marc König, Jens Holger Figiel
PURPOSE:  Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. It has some unique characteristics with regard to technology and mechanism of action. MATERIALS AND METHODS:  A systematic literature search using the terms cryotherapy, cryosurgery and cryoablation was performed...
April 17, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#4
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#5
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/29619782/introduction-to-systematic-review-and-meta-analysis
#6
EunJin Ahn, Hyun Kang
Systematic reviews and meta-analyses present results by combining and analyzing data from different studies conducted on similar research topics. In recent years, systematic reviews and meta-analyses have been actively performed in various fields including anesthesiology. These research methods are powerful tools that can overcome the difficulties in performing large-scale randomized controlled trials. However, the inclusion of studies with any biases or improperly assessed quality of evidence in systematic reviews and meta-analyses could yield misleading results...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29572858/red-blood-cell-transfusion-in-perioperative-pediatric-anesthesia-a-survey-of-current-practice-in-germany
#7
Eva Wittenmeier, Claudius Troeber, Ulrike Zier, Irene Schmidtmann, Nina Pirlich, Karin Becke, Tim Piepho
BACKGROUND: Little is known about the current practice of the perioperative transfusion of red blood cells (RBCs) in pediatric patients. This study was performed to evaluate the practice of RBC transfusion in German pediatric anesthesia. STUDY DESIGN AND METHODS: An online survey was conducted among members of the German Society of Anesthesiology and Intensive Care. Participants were asked to indicate the hemoglobin (Hb) thresholds for starting RBC transfusion in six cases of different bleeding situations in pediatric anesthesia...
March 23, 2018: Transfusion
https://www.readbyqxmd.com/read/29533256/use-of-survey-and-delphi-process-to-understand-trauma-anesthesia-care-practices
#8
Catherine M Kuza, Monica S Vavilala, Rebecca M Speck, Richard P Dutton, Maureen McCunn
BACKGROUND: Few trauma guidelines evaluate and recommend anesthesiology practices and there are no trauma anesthesia-specific guidelines. There is no information on how anesthesiologists perceive clinical practice patterns. Our objective was to understand the perceptions of anesthesiologists regarding trauma anesthesia practices. METHODS: A survey assessing anesthesia management of trauma patients was distributed to 21,491 anesthesiologists. A subset of 10 of these questions was subsequently reviewed by a trauma anesthesiology focus group through a 3-round web-based Delphi process...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29530049/guidelines-on-pediatric-day-surgery-of-the-italian-societies-of-pediatric-surgery-sicp-and-pediatric-anesthesiology-sarnepi
#9
REVIEW
Ugo de Luca, Giovanni Mangia, Simonetta Tesoro, Ascanio Martino, Maria Sammartino, Alessandro Calisti
The Italian Society of Pediatric Surgery (SICP) together with The Italian Society of Pediatric Anesthesia (SARNePI) through a systematic analysis of the scientific literature, followed by a consensus conference held in Perugia on 2015, have produced some evidence based guidelines on the feasibility of day surgery in relation to different pediatric surgical procedures. The main aspects of the pre-operative assessment, appropriacy of operations and discharge are reported.
March 12, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29514510/inaction-over-retractions-of-identified-fraudulent-publications-ongoing-weakness-in-the-system-of-scientific-self-correction
#10
Christian J Wiedermann
Published articles may be retracted when their findings are no longer considered reliable due to honest error, publication misconduct, or research misconduct. This article focuses on the case of a single serial violator of research and publication ethics in anesthesiology and critical care, which is widely publicized. A chain of events led to detection of misconduct that had substantial impact on the evidence base for the safety of hydroxyethyl starch, an intravenous artificial colloid solution, which is reflected in current guidelines on fluid management and volume resuscitation...
2018: Accountability in Research
https://www.readbyqxmd.com/read/29327135/acquiring-and-maintaining-point-of-care-ultrasound-pocus-competence-for-anesthesiologists
#11
REVIEW
T Jared McCormick, Elizabeth Clarke Miller, Robert Chen, Viren N Naik
PURPOSE: Point-of-care ultrasound (POCUS) involves the bedside use of ultrasound to answer specific diagnostic questions and to assess real-time physiologic responses to treatment. Although POCUS has become a well-established resource for emergency and critical care physicians, anesthesiologists are still working to obtain POCUS skills and to incorporate them into routine practice. This review defines the benefits of POCUS to anesthesia practice, identifies challenges to establishing POCUS in routine anesthesia care, and offers solutions to help guide its incorporation going forward...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#12
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29285834/evidence-for-increased-use-of-the-society-of-pediatric-anesthesia-critical-events-checklist-in-resource-limited-environments-a-retrospective-observational-study-of-app-data
#13
Vikas N O'Reilly-Shah, Jamie Kitzman, Craig S Jabaley, Grant C Lynde
BACKGROUND: Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. AIMS: We sought to combine demographics with usage information to elucidate important patterns in the rate of use of the Society of Pediatric Anesthesia Critical Events Checklist, as measured by in-app accesses of the checklist via the freely available anesthesia calculator app anesthesiologist...
February 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29218778/examination-of-sacral-tissue-oxygen-saturation-among-immobile-patients
#14
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/29209789/-novel-aspects-of-the-guidelines-for-hemotherapy-2017-implications-for-anesthesiology
#15
REVIEW
I Pekrul, G Wittmann, P Möhnle
Based on the German Transfusion Law, the periodically updated guidelines "Richtlinien zur Gewinnung von Blut und Blutbestandteilen und zur Anwendung von Blutprodukten" ("Hämotherapierichtlinien") are intended to provide the current knowledge and state of the art of blood transfusion practice in Germany. The novel update 2017 contains relevant changes for blood donation, especially the extension of the exclusion period of persons at risk for sexually transmitted HBV, HCV and HIV diseases to 12 months...
January 2018: Der Anaesthesist
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
#16
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/29051136/using-google-glass-in-nonsurgical-medical-settings-systematic-review
#17
Bryn Dougherty, Sherif M Badawy
BACKGROUND: Wearable technologies provide users hands-free access to computer functions and are becoming increasingly popular on both the consumer market and in various industries. The medical industry has pioneered research and implementation of head-mounted wearable devices, such as Google Glass. Most of this research has focused on surgical interventions; however, other medical fields have begun to explore the potential of this technology to support both patients and clinicians. OBJECTIVE: Our aim was to systematically evaluate the feasibility, usability, and acceptability of using Google Glass in nonsurgical medical settings and to determine the benefits, limitations, and future directions of its application...
October 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29049076/fatigue-risk-management-the-impact-of-anesthesiology-residents-work-schedules-on-job-performance-and-a-review-of-potential-countermeasures
#18
Lily R Wong, Erin Flynn-Evans, Keith J Ruskin
Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28794841/reporting-and-methodologic-evaluation-of-meta-analyses-published-in-the-anesthesia-literature-according-to-amstar-and-prisma-checklists-a-preliminary-study
#19
Jae Hoon Oh, Woo Jong Shin, Suin Park, Jae Soon Chung
BACKGROUND: There have been few recent reports on the methodological quality of meta-analysis, despite the enormous number of studies using meta-analytic techniques in the field of anesthesia. The purpose of this study was to evaluate the quality of meta-analyses and systematic reviews according to the Assessment of Multiple Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the anesthesia literature. METHODS: A search was conducted to identify all meta-analyses ever been published in the British Journal of Anaesthesia (BJA), Anaesthesia, and Korean Journal of Anesthesiology (KJA) between Jan...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28767599/investigation-of-the-status-quo-of-massive-blood-transfusion-in-china-and-a-synopsis-of-the-proposed-guidelines-for-massive-blood-transfusion
#20
MULTICENTER STUDY
Jiang-Cun Yang, Qiu-Shi Wang, Qian-Li Dang, Yang Sun, Cui-Xiang Xu, Zhan-Kui Jin, Ting Ma, Jing Liu
The aim of this study was to provide an overview of massive transfusion in Chinese hospitals, identify the important indications for massive transfusion and corrective therapies based on clinical evidence and supporting experimental studies, and propose guidelines for the management of massive transfusion. This multiregion, multicenter retrospective study involved a Massive Blood Transfusion Coordination Group composed of 50 clinical experts specializing in blood transfusion, cardiac surgery, anesthesiology, obstetrics, general surgery, and medical statistics from 20 tertiary general hospitals across 5 regions in China...
August 2017: Medicine (Baltimore)
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