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Anaesthesia and intensive care

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https://www.readbyqxmd.com/read/29740019/feasibility-and-safety-of-using-local-anaesthesia-with-conscious-sedation-during-complex-cardiac-implantable-electronic-device-procedures
#1
Elif Kaya, Hendrik Südkamp, Julia Lortz, Tienush Rassaf, Rolf Alexander Jánosi
We assessed the feasibility and safety of using local anaesthesia with conscious sedation as an alternative to general anaesthesia during complex and noncomplex cardiac implantable device procedures. We enrolled 279 consecutive patients who underwent cardiac device implantation/replacement at our tertiary/quaternary cardiac specialist hospital during a 17-month study period. Continuous combined intravenous conscious sedation with propofol and midazolam plus fentanyl and local anaesthesia were used for all procedures...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29730073/a-profile-of-surgical-burden-and-anaesthesia-services-at-mozambique-s-central-hospital-a-review
#2
REVIEW
J Matthew Kynes, Camila B Walters, Emilia Pinto, Emilia Jeque, Ka Kelly McQueen
BACKGROUND: Surgical and anaesthesia data, including outcomes, remain limited in low-income countries (LIC). This study reviews the surgical burden and anaesthesia services at a tertiary care hospital in Mozambique. METHODS: Information on activities within the department of anaesthesia at XXX Central Hospital for 2014-15 was collected from its annual report and verified by the Chairman of Anaesthesia. Personnel information and health care metrics for the hospital in 2015 were collected and verified by hospital leadership...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29726317/anaesthesia-practice-in-denmark-for-relocation-of-the-dislocated-hip-after-total-hip-arthroplasty
#3
Christine P Holler, Nicolai Lohse, Nicolai B Foss
INTRODUCTION: The prevalence of hip dislocations after total hip arthroplasty (THA) is 2-4% in Denmark. Patients with a dislocated THA are often elderly citizens with comorbidities and severe pain in the pre-reposition phase. Evidence as to which method of anaesthesia and airway management is best for hip relocation is lacking. The aim of this study was to determine how anaesthesiologists in Denmark provide anaesthesia for relocation of THAs, and if a local guideline is available. METHODS: A questionnaire was distributed by e-mail to all members of the Danish Association of Anaesthesiology and Intensive Care and the Danish Society of Young Anaesthesiologists...
May 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29721645/midazolam-increases-preload-dependency-during-endotoxic-shock-in-rabbits-by-affecting-venous-vascular-tone
#4
Jianxiao Chen, Tao Yu, Federico Longhini, Xiwen Zhang, Songqiao Liu, Ling Liu, Yi Yang, Haibo Qiu
BACKGROUND: Septic patients often require sedation in intensive care unit, and midazolam is one of the most frequently used sedatives among them. But the interaction between midazolam and septic shock is not known. The aim of this study is to investigate the effects of midazolam on preload dependency in an endotoxic shock model by evaluating systemic vascular tone and cardiac function. METHODS: Eighteen rabbits were randomly divided into three groups: Control group, MID1 group and MID2 group...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#5
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29695029/paediatric-acute-care-highlights-from-the-paediatric-acute-care-advanced-paediatric-life-support-conference-gold-coast-2017
#6
Stephen Ss Teo, Arjun Rao, Jason Acworth
The Paediatric Acute Care Conference is an annual conference organised by APLS Australia to advance paediatric acute care topics for clinicians in pre-hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The Conference 2017 was held at Surfers Paradise, Queensland. We provide a summary of some of the presentations.
April 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29678158/dexmedetomidine-infusion-as-an-analgesic-adjuvant-during-laparoscopic-%C3%B1-holecystectomy-a-randomized-controlled-study
#7
Kateryna Bielka, Iurii Kuchyn, Volodymyr Babych, Kseniia Martycshenko, Oleksii Inozemtsev
BACKGROUND: Dexmedetomidine (DEX) has sedative, sympatholytic and analgesic effects and might be beneficial if used as an adjuvant to: improve analgesia; modulate haemodynamic responses to intubation and pneumoperitoneum and; reduce the number of opioid-associated adverse events. The aim of this study was to evaluate the efficacy and safety of DEX infusion during elective laparoscopic cholecystectomy (LC). METHODS: A randomized, single-centre, parallel-group, placebo-controlled study was carried out between May 2016 and June 2017...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29628841/appearance-of-population-intervention-comparison-and-outcome-as-research-question-in-the-title-of-articles-of-three-different-anesthesia-journals-a-pilot-study
#8
Abdelazeem Eldawlatly, Hussain Alshehri, Abdullah Alqahtani, Abdulaziz Ahmad, Fatma Al-Dammas, Amir Marzouk
Background: It is well known in the evidence-based medicine practice that framing the research question is the most important and crucial part of the research integrity. Population, Intervention, Comparison, and Outcome (PICO) is a specialized framework used by most researchers to formulate a research question and to facilitate literature review. The aim of this study is to investigate the representation of the PICO frame in the title of published articles in three different anesthesia journals...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29606090/application-of-intraoperative-lung-protective-ventilation-varies-in-accordance-with-the-knowledge-of-anaesthesiologists-a-single-centre-questionnaire-study-and-a-retrospective-observational-study
#9
Seung Hyun Kim, Sungwon Na, Woo Kyung Lee, Hyunwoo Choi, Jeongmin Kim
BACKGROUND: The benefits of lung-protective ventilation (LPV) with a low tidal volume (6 mL/kg of ideal body weight [IBW]), limited plateau pressure (< 28-30 cm H2 O), and appropriate positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome have become apparent and it is now widely adopted in intensive care units. Recently evidence for LPV in general anaesthesia has been accumulated, but it is not yet generally applied by anaesthesiologists in the operating room...
April 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29572099/a-ten-year-analysis-of-the-reasons-for-death-following-ambulatory-surgery-nine-closed-claims-declared-to-the-sham-insurance
#10
A Theissen, F Fuz, M Bouregba, M Autran, M Beaussier
INTRODUCTION: The constant development of ambulatory surgery (AS) raises the problem of monitoring patients after discharge and the risk of death in the case of delays in the management of a serious complication. PATIENTS AND METHODS: The aim of this retrospective study was to describe the deaths observed within the 30-day period following AS declared to the SHAM insurance (Société hospitalière d'assurance mutuelle) over the last 10 years. RESULTS: During the study period 33,962 claims were surgery-related and 11 were for deaths after AS...
March 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29571592/risk-of-maternal-mortality-in-women-with-severe-anaemia-during-pregnancy-and-post-partum-a-multilevel-analysis
#11
Jahnavi Daru, Javier Zamora, Borja M Fernández-Félix, Joshua Vogel, Olufemi T Oladapo, Naho Morisaki, Özge Tunçalp, Maria Regina Torloni, Suneeta Mittal, Kapila Jayaratne, Pisake Lumbiganon, Ganchimeg Togoobaatar, Shakila Thangaratinam, Khalid S Khan
BACKGROUND: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. METHODS: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia...
May 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29567130/perioperative-management-of-patients-with-coronary-artery-disease-undergoing-non-cardiac-surgery-summary-from-the-french-society-of-anaesthesia-and-intensive-care-medicine-2017-convention
#12
REVIEW
Jean-Luc Fellahi, Anne Godier, Deborah Benchetrit, Francis Berthier, Guillaume Besch, Thomas Bochaton, Eric Bonnefoy-Cudraz, Pierre Coriat, Etienne Gayat, Alex Hong, Sophie Jenck, Arthur Le Gall, Dan Longrois, Anne-Céline Martin, Sébastien Pili-Floury, Vincent Piriou, Sophie Provenchère, Bertrand Rozec, Emmanuel Samain, Rémi Schweizer, Valérie Billard
This review summarises the specific stakes of preoperative, intraoperative, and postoperative periods of patients with coronary artery disease undergoing non-cardiac surgery. All practitioners involved in the perioperative management of such high cardiac risk patients should be aware of the modern concepts expected to decrease major adverse cardiac events and improve short- and long-term outcomes. A multidisciplinary approach via a functional heart team including anaesthesiologists, cardiologists and surgeons must be encouraged...
March 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29559406/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#13
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29559211/tracheotomy-in-the-intensive-care-unit-guidelines-from-a-french-expert-panel-the-french-intensive-care-society-and-the-french-society-of-anaesthesia-and-intensive-care-medicine
#14
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29555548/postoperative-period
#15
(no author information available yet)
Follow on from continuous intravenous administration of insulin with an electronic syringe (IVES) is an important element in the postoperative management of a diabetic patient. The basal-bolus scheme is the most suitable taking into account the nutritional supply and variable needs for insulin, reproducing the physiology of a normal pancreas: (i) slow (long-acting) insulin (=basal) which should immediately take over from IVES insulin simulating basal secretion; (ii) ultra-rapid insulin to simulate prandial secretion (=bolus for the meal); and (iii) correction of possible hyperglycaemia with an additional ultra-rapid insulin bolus dose...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29555547/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#16
Cheisson Gaëlle, Jacqueminet Sophie, Cosson Emmanuel, Ichai Carole, Leguerrier Anne-Marie, Nicolescu-Catargi Bogdan, Ouattara Alexandre, Tauveron Igor, Valensi Paul, Benhamou Dan
Perioperative hyperglycaemia (>1.80g/L or 10 mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasing blood sugar levels with insulin between 0.90 and 1.80g/l but it may occur more frequently when the goal is strict normoglycaemia. We propose continuous administration of insulin therapy via an electronic syringe (IVES) in type-1 diabetes (T1D) and type-2 diabetes (T2D) patients if required or in cases of stress hyperglycaemia...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29551224/family-presence-during-resuscitation-the-experiences-and-views-of-polish-nurses
#17
Aleksandra Gutysz-Wojnicka, Dorota Ozga, Danuta Dyk, Wioletta Mędrzycka-Dąbrowska, Marek Wojtaszek, John Albarran
Understanding healthcare professionals perceptions of family presence during resuscitation (FPDR) may help in choosing an effective strategy of implementing this concept in everyday clinical practice. OBJECTIVES: To determine the experiences and views of Polish nurses about family witnessed resuscitation. DESIGN: A cross sectional survey study. SETTING: Delegates (n = 720) attending the Polish Association of Anaesthesia and Intensive Care Nurses conference participated in the study...
March 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29521661/spinal-anaesthesia-with-chloroprocaine-1-versus-total-intravenous-anaesthesia-for-outpatient-knee-arthroscopy-a-randomised-controlled-trial
#18
Volker Gebhardt, Vera Zawierucha, Oliver Schöffski, Anke Schwarz, Christel Weiss, Marc D Schmittner
BACKGROUND: Both general and spinal anaesthesia with short-acting local anaesthetics are suitable and reliable for knee arthroscopy as an ambulatory procedure. Chloroprocaine (CP) 1% seems to be the ideal spinal local anaesthetic for this indication. OBJECTIVE: The aim of this study was to compare spinal anaesthesia using CP 1% with general for outpatient knee arthroscopy with regard to procedure times, occurrence of pain, patient satisfaction and recovery, and also costs...
March 7, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29519222/should-ongoing-airway-education-be-a-mandatory-component-of-continuing-professional-development-for-college-of-intensive-care-medicine-fellows
#19
D J Brewster, C P Nickson, J J Gatward, M Staples, F Hawker
This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Questionnaire data collection and post-collection data analysis was used to determine basic respondent demographics, frequency of certain airway procedures in the past 12 months, confidence with advanced airway practices in ICU, participation in airway education in the past three years, knowledge of can't intubate, can't oxygenate (CICO) algorithms, preference for certain airway equipment/techniques, and support for required airway education as a component of the CICM CPD program...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29492547/are-slow-waves-of-intracranial-pressure-suppressed-by-general-anaesthesia
#20
Despina Afroditi Lalou, Marek Czosnyka, Joseph Donnelly, Andrea Lavinio, John D Pickard, Matthew Garnett, Zofia Czosnyka
OBJECTIVES: Slow waves of intracranial pressure (ICP) are spontaneous oscillations with a frequency of 0.3-4 cycles/min. They are often associated with pathological conditions, following vasomotor activity in the cranial enclosure. This study quantifies the effects of general anaesthesia (GA) on the magnitude of B-waves compared with natural sleep and the conscious state. MATERIALS AND METHODS: Four groups of 30 patients each were formed to assess the magnitude of slow waves...
2018: Acta Neurochirurgica. Supplement
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