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Anaesthesia and intensive care

Gerhard Batz, Michael Dinkel
Echocardiography as an imaging method in anaesthesia and intensive care medicine has enabled a new dimension of hemodynamic monitoring: the direct visualization of the cardiac function and its disruptions. Preconditions for a broad application in this area was the development of mobile, high-definition ultrasonic devices and the origination of focused examination techniques. A successful application of this method requires the respective know-how of the examiner, in order to take relevant decisions and avoid misdiagnoses...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Kanchi Muralidhar, Deepak Tempe, Yatin Mehta, Poonam Malhotra Kapoor, Chirojit Mukherjee, Thomas Koshy, Prabhat Tewari, Naman Shastri, Satyajeet Misra, Kumar Belani
During current medical care, perioperative transesophageal echocardiography (TEE) has become a vital component of patient management, especially in cardiac operating rooms and in critical care medicine. Information derived from echocardiography has an important bearing on the patient's outcome. The Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA) has promoted the use of TEE during routine clinical care of patients undergoing cardiac surgery. An important mission of IACTA is to oversee training and certify anesthesiologists in the perioperative and intensive care use of TEE...
October 2016: Annals of Cardiac Anaesthesia
Priyamvada Gupta, Durga Jethava, Ruchika Choudhary, Dharam Das Jethava
BACKGROUND AND AIMS: Laryngoscopy and endotracheal intubation are considered as potent stimuli which lead to an increase in heart rate and blood pressure. Melatonin (N-acetyl-5-methoxytryptamine) has been studied for pre-operative anxiolysis and sedation in Intensive Care Unit. We made a hypothesis that melatonin can provide haemodynamic stability during laryngoscopy and intubation when given 120 min before the procedure. METHODS: Sixty American Society of Anesthesiologists physical status Grade I and II patients of either gender, 20-45 years old, 40-65 kg body weight, scheduled to undergo elective surgical procedures under general anaesthesia were assigned into two equal groups - Group C (control) and Group M (melatonin)...
October 2016: Indian Journal of Anaesthesia
Anthony G Messina, Michael Wang, Marshall J Ward, Chase C Wilker, Brett B Smith, Daniel P Vezina, Nathan Leon Pace
BACKGROUND: General anaesthesia is usually associated with unconsciousness. 'Awareness' is when patients have postoperative recall of events or experiences during surgery. 'Wakefulness' is when patients become conscious during surgery, but have no postoperative recollection of the period of consciousness. OBJECTIVES: To evaluate the efficacy of two types of anaesthetic interventions in reducing clinically significant awareness:- anaesthetic drug regimens; and- intraoperative anaesthetic depth monitors...
October 18, 2016: Cochrane Database of Systematic Reviews
Joël L'Hermite, Elisabeth Dubout, Sophie Bouvet, Laure-Hélène Bracoud, Philippe Cuvillon, Jean-Emmanuel de La Coussaye, Jacques Ripart
BACKGROUND: Sore throat is a common complaint after surgery. It affects patient satisfaction and can affect activity after discharge. The supraglottic airway device (SAD) offers an alternative to traditional tracheal intubation with potential benefit in preventing sore throat. OBJECTIVE: The aim of this study was to compare the incidence of sore throat following three different SADs, the laryngeal mask airway Unique (LMA-U) and the more recent LMA Supreme (LMA-S) and the I-gel...
October 15, 2016: European Journal of Anaesthesiology
Darren R W Holland
No abstract text is available yet for this article.
October 14, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Nikolaj Hjort Schmidt, Kasper Hansen, Henrik Lauridsen, Annie Vesterby, Jens Randel Nyengaard, Alf Brubakk, Michael Pedersen
OBJECTIVE: The most common complications of hyperbaric oxygen treatment (HBOT) are related to pressure changes on gas-containing cavities. Therefore, inability to auto-inflate the middle ear may result in transient or permanent hearing loss. However, it seems that middle ear barotrauma (MEBt) does not develop more often in mechanically ventilated patients than in ambulatory patients. This might be explained by deep sedation of these patients. Therefore, the aim of this study was to determine whether anaesthesia and/or neuromuscular blockade can influence Eustachian tube (ET) function...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
O O Ayandipo, O O Afuwape, D O Irabor, A I Abdurrazzaaq, N A Nwafulume
BACKGROUND: Peritonitis is a life-threatening condition and requires urgent surgical management. Despite improvements in the care of patients with peritonitis, its management is still challenging and associated with significant morbidity and mortality. The aim of this study was to determine factors influencing the outcome in patients managed for peritonitis in a tertiary health institution in Nigeria. METHOD: A retrospective study involving 302 patients managed for peritonitis over a 3- year period...
June 2016: Annals of Ibadan Postgraduate Medicine
Bjoern Hossfeld, Bertold Bein, Bernd W Boettiger, Andreas Bohn, Matthias Fischer, Jan-Thorsten Graesner, Jochen Hinkelbein, Clemens Kill, Carsten Lott, Erik Popp, Markus Roessler, Alin Schaumberg, Volker Wenzel, Michael Bernhard
No abstract text is available yet for this article.
September 14, 2016: European Journal of Anaesthesiology
V La Fauci, R Riso, A Facciolà, V Merlina, R Squeri
BACKGROUND: Healthcare associated infections are an important threat of Public Health. Several studies investigated the possible role played by the hospital environment in the transmission of nosocomial pathogens. In addition to the "classic" nosocomial surfaces, some researches focused their attention on "alternative" surfaces. Little is known about the protective lead garments used in operating rooms. STUDY DESIGN: This study was conducted in three phases to investigate the microbiological contamination and the normal use of these garments...
September 2016: Annali di Igiene: Medicina Preventiva e di Comunità
Mpoki Ulisubisya, Erik Dahlén, Henrik Jörnvall, Lars Irestedt, Tim Baker
The impact of an Anaesthesia and Intensive Care collaboration between Sweden and Tanzania Anaesthesia and intensive care is a neglected specialty in low-income countries. Many countries have less than 1 anaesthesia provider per 100,000 population and few hospitals in Africa have the resources for managing critically ill patients. Health partnerships between institutions in high- and low-income countries have been proposed as an effective way to strengthen health systems. This article describes a partnership in anaesthesia and intensive care between institutions in Sweden and Tanzania and its impact at regional and national levels...
2016: Läkartidningen
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
P S Myles
No abstract text is available yet for this article.
September 2016: Anaesthesia and Intensive Care
Praveer K Banerjee, Abhineet Jain, Bikram Behera
BACKGROUND AND AIMS: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. METHODS: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone...
August 2016: Indian Journal of Anaesthesia
M Schuers, M Timsit, A Gillibert, A Fred, N Griffon, J Bénichou, S J Darmoni, P Staccini
BACKGROUND: To evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record. METHODS: An e-mailed self-administered questionnaire was sent to all the pharmacists, anaesthesiologists, geriatricians and emergency physicians of the 55 hospitals involved in the patient pharmaceutical record experimentation...
September 2016: Revue D'épidémiologie et de Santé Publique
M St Pierre, G Breuer, D Strembski, C Schmitt, B Lütcke
BACKGROUND: Unanticipated airway problems in infants can rapidly develop into severe hypoxemia. Team members can provide support and suggest steps of action if a shared mental model of the next steps exists. Briefing prior to induction of anaesthesia may create such a shared mental model among all team members. OBJECTIVES: The aim of the study was to assess whether a short briefing on the recommendations for an unexpected difficult airway, developed by the Working Group on Paediatric Anaesthesia of the German Society for Anaesthesiology and Intensive Care Medicine, would influence the management of an unexpected difficult mask ventilation in an infant...
September 2016: Der Anaesthesist
Linda A Rasmussen, Pia K Ryhammer, Jacob Greisen, Rajesh R Bhavsar, Anne-Grethe Lorentzen, Carl-Johan Jakobsen
STUDY OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively...
September 2016: Journal of Clinical Anesthesia
David Whitaker, Guttorm Brattebø, Stefan Trenkler, Indulis Vanags, Flavia Petrini, Zuhal Aykac, Dan Longrois, Stephan Alexander Loer, Tomasz Gaszynski, Jurate Sipylaite, Elena Copaciu, Vladimir Cerny, Jonas Akeson, Jannicke Mellin-Olsen, Carmel Abela, Adela Stecher, Sibylle Kozek-Langenecker, Indrek Rätsep
These European Board of Anaesthesiology (EBA) recommendations for safe medication practice replace the first edition of the EBA recommendations published in 2011. They were updated because evidence from critical incident reporting systems continues to show that medication errors remain a major safety issue in anaesthesia, intensive care, emergency medicine and pain medicine, and there is an ongoing need for relevant up-to-date clinical guidance for practising anaesthesiologists. The recommendations are based on evidence wherever possible, with a focus on patient safety, and are primarily aimed at anaesthesiologists practising in Europe, although many will be applicable elsewhere...
October 3, 2016: European Journal of Anaesthesiology
Xian Su, Zhao-Ting Meng, Xin-Hai Wu, Fan Cui, Hong-Liang Li, Dong-Xin Wang, Xi Zhu, Sai-Nan Zhu, Mervyn Maze, Daqing Ma
BACKGROUND: Delirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery. METHODS: We did this randomised, double-blind, placebo-controlled trial in two tertiary-care hospitals in Beijing, China. We enrolled patients aged 65 years or older, who were admitted to intensive care units after non-cardiac surgery, with informed consent...
October 15, 2016: Lancet
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