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Anesthesia simulation

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https://www.readbyqxmd.com/read/28734531/event-based-control-of-depth-of-hypnosis-in-anesthesia
#1
Luca Merigo, Manuel Beschi, Fabrizio Padula, Nicola Latronico, Massimiliano Paltenghi, Antonio Visioli
BACKGROUND AND OBJECTIVE: In this paper, we propose the use of an event-based control strategy for the closed-loop control of the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. METHODS: A new event generator with high noise-filtering properties is employed in addition to a PIDPlus controller. The tuning of the parameters is performed off-line by using genetic algorithms by considering a given data set of patients...
August 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28713258/relationship-of-topology-multiscale-phase-synchronization-and-state-transitions-in-human-brain-networks
#2
Minkyung Kim, Seunghwan Kim, George A Mashour, UnCheol Lee
How the brain reconstitutes consciousness and cognition after a major perturbation like general anesthesia is an important question with significant neuroscientific and clinical implications. Recent empirical studies in animals and humans suggest that the recovery of consciousness after anesthesia is not random but ordered. Emergence patterns have been classified as progressive and abrupt transitions from anesthesia to consciousness, with associated differences in duration and electroencephalogram (EEG) properties...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#3
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anesthesia and critical care medicine. Learning this procedure is a complex task, but the use of simulation-based training provides significant advantages like enhanced patient safety. Access to bronchoscopy simulators may be limited in low resources settings. We developed a low-cost 3D printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28704284/evaluation-of-a-simpler-tool-to-assess-nontechnical-skills-during-simulated-critical-events
#4
Scott C Watkins, David A Roberts, John R Boulet, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Management of critical events requires teams to employ nontechnical skills (NTS), such as teamwork, communication, decision making, and vigilance. We sought to estimate the reliability and provide evidence for the validity of the ratings gathered using a new tool for assessing the NTS of anesthesia providers, the behaviorally anchored rating scale (BARS), and compare its scores with those of an established NTS tool, the Anaesthetists' Nontechnical Skills (ANTS) scale. METHODS: Six previously trained raters (4 novices and 2 experts) reviewed and scored 18 recorded simulated pediatric crisis management scenarios using a modified ANTS and a BARS tool...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28695248/divergent-effects-of-anesthetics-on-lipid-bilayer-properties-and-sodium-channel-function
#5
REVIEW
Karl F Herold, Olaf S Andersen, Hugh C Hemmings
General anesthetics revolutionized medicine by allowing surgeons to perform more complex and much longer procedures. This widely used class of drugs is essential to patient care, yet their exact molecular mechanism(s) are incompletely understood. One early hypothesis over a century ago proposed that nonspecific interactions of anesthetics with the lipid bilayer lead to changes in neuronal function via effects on membrane properties. This model was supported by the Meyer-Overton correlation between anesthetic potency and lipid solubility and despite more recent evidence for specific protein targets, in particular ion-channels, lipid bilayer-mediated effects of anesthetics is still under debate...
July 10, 2017: European Biophysics Journal: EBJ
https://www.readbyqxmd.com/read/28678068/anesthesia-adverse-events-voluntarily-reported-in-the-veterans-health-administration-and-lessons-learned
#6
Julia Neily, Elda S Silla, Sam John T Sum-Ping, Roberta Reedy, Douglas E Paull, Lisa Mazzia, Peter D Mills, Robin R Hemphill
BACKGROUND: Anesthesia providers have long been pioneers in patient safety. Despite remarkable efforts, anesthesia errors still occur, resulting in complications, injuries, and even death. The Veterans Health Administration (VHA) National Center of Patient Safety uses root cause analysis (RCA) to examine why system-related adverse events occur and how to prevent future similar events. This study describes the types of anesthesia adverse events reported in VHA hospitals and their root causes and preventative actions...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#7
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
June 30, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28648752/physiological-and-self-assessed-psychological-stress-induced-by-a-high-fidelity-simulation-course-among-third-year-anaesthesia-and-critical-care-residents-an-observational-study
#8
Pr Thomas Geeraerts
INTRODUCTION: The use of high-fidelity simulators in Medicine can improve knowledge, behavior and practice but may be associated with significant stress. Our objective was to measure physiological and psychological self-assessed intensity of stress before and after a planned simulation training session among third year anesthesia and critical care residents. METHODS: A convenience sample of 27 residents participating in a simulation training course was studied. Stress was evaluated by self-assessment using a numerical scale and by salivary amylase concentration before and after the session...
June 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28641713/assessment-tools-for-use-during-anesthesia-centric-pediatric-advanced-life-support-training-and-evaluation
#9
Scott C Watkins, Paul J Nietert, Elisabeth Hughes, Eric T Stickles, Tracy E Wester, Matthew D McEvoy
BACKGROUND: Pediatric perioperative cardiac arrests are rare events that require rapid, skilled and coordinated efforts to optimize outcomes. We developed an assessment tool for assessing clinician performance during perioperative critical events termed Anesthesia-centric Pediatric Advanced Life Support (A-PALS). Here, we describe the development and evaluation of the A-PALS scoring instrument. METHODS: A group of raters scored videos of a perioperative team managing simulated events representing a range of scenarios and competency...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28638983/treatment-of-benign-thyroid-nodules-by-high-intensity-focused-ultrasound-hifu-at-different-acoustic-powers-a-study-on-in-silico-phantom
#10
Fabiano Bini, Pierpaolo Trimboli, Franco Marinozzi, Luca Giovanella
BACKGROUND: The non-surgical therapies of benign thyroid nodules are gaining momentum due to the possibility to reduce the nodule's volume and avoid surgery. As the last technique introduced, high intensity focused ultrasound allows the thermal tissue treatment by directing energy inside the targeted nodule with no invasive instruments. In the present study we applied the Food and Drug Administration high intensity focused ultrasound simulator to in-silico phantom to evaluate the effects obtained by different acoustic powers...
June 21, 2017: Endocrine
https://www.readbyqxmd.com/read/28632531/a-descriptive-survey-of-anesthesiology-residency-simulation-programs-how-are-programs-preparing-residents-for-the-new-american-board-of-anesthesiology-applied-certification-examination
#11
Robert S Isaak, Fei Chen, Harendra Arora, Susan M Martinelli, David A Zvara, Marjorie P Stiegler
BACKGROUND: Anesthesiology residency programs may need new simulation-based programs to prepare residents for the new Objective Structured Clinical Examination (OSCE) component of the American Board of Anesthesiology (ABA) Primary Certification process. The design of such programs may require significant resources, including faculty time, expertise, and funding, as are currently needed for structured oral examination (SOE) preparation. This survey analyzed the current state of US-based anesthesiology residency programs regarding simulation-based educational programming for SOE and OSCE preparation...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#12
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28582277/simulation-based-assessment-identifies-longitudinal-changes-in-cognitive-skills-in-an-anesthesiology-residency-training-program
#13
Avner Sidi, Nikolaus Gravenstein, Terrie Vasilopoulos, Samsun Lampotang
OBJECTIVES: We describe observed improvements in nontechnical or "higher-order" deficiencies and cognitive performance skills in an anesthesia residency cohort for a 1-year time interval. Our main objectives were to evaluate higher-order, cognitive performance and to demonstrate that simulation can effectively serve as an assessment of cognitive skills and can help detect "higher-order" deficiencies, which are not as well identified through more traditional assessment tools. We hypothesized that simulation can identify longitudinal changes in cognitive skills and that cognitive performance deficiencies can then be remediated over time...
June 2, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28580083/implementation-of-clinical-practice-changes-by-experienced-anesthesiologists-after-simulation-based-ultrasound-guided-regional-anesthesia-training
#14
T Edward Kim, Toni Ganaway, T Kyle Harrison, Steven K Howard, Cynthia Shum, Alex Kuo, Edward R Mariano
BACKGROUND: Anesthesiologists who have finished formal training and want to learn ultrasound-guided regional anesthesia (UGRA) commonly attend 1 day workshops. However, it is unclear whether participation actually changes clinical practice. We assessed change implementation after completion of a 1 day simulation-based UGRA workshop. METHODS: Practicing anesthesiologists who participated in a 1 day UGRA course from January 2012 through May 2014 were surveyed. The course consisted of clinical observation of UGRA procedures, didactic lectures, ultrasound scanning, hands-on perineural catheter placement, and mannequin simulation...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28566223/oxidative-and-biochemical-responses-in-brycon-amazonicus-anesthetized-and-sedated-with-myrcia-sylvatica-g-mey-dc-and-curcuma-longa-l-essential-oils
#15
Etiane M H Saccol, Érika P Londero, Caroline A Bressan, Joseânia Salbego, Luciane T Gressler, Lenise V F Silva, Rosa H V Mourão, Ricardo B Oliveira, Susana F Llesuy, Bernardo Baldisserotto, Maria A Pavanato
OBJECTIVE: To investigate the effects of rapid anesthesia and long-term sedation with the essential oils (EOs) of Myrcia sylvatica (EOMS) and Curcuma longa (EOCL) on biochemical and oxidative parameters in matrinxã. STUDY DESIGN: Prospective, randomized, laboratory experiment. ANIMALS: A total of 72 matrinxã (Brycon amazonicus) adults weighing 404.8 ± 27.9 g were divided into eight groups of nine fish. METHODS: Biochemical and oxidative effects were investigated in plasma and tissues of matrinxã subjected to rapid anesthesia (5 minutes) or long-term sedation (360 minutes, simulating the practice of transport) with EOMS (200 μL L(-1) and 10 μL L(-1), respectively) and EOCL (500 μL L(-1) and 40 μL L(-1), respectively)...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#16
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28518117/simultaneous-evaluation-of-cerebral-hemodynamics-and-light-scattering-properties-of-the-in-vivo-rat-brain-using-multispectral-diffuse-reflectance-imaging
#17
Izumi Nishidate, Afrina Mustari, Satoko Kawauchi, Shunichi Sato, Manabu Sato
The simultaneous evaluation of cerebral hemodynamics and the light scattering properties of in vivo rat brain tissue is demonstrated using a conventional multispectral diffuse reflectance imaging system. This system is constructed from a broadband white light source, a motorized filter wheel with a set of narrowband interference filters, a light guide, a collecting lens, a video zoom lens, and a monochromatic charged-coupled device (CCD) camera. An ellipsoidal cranial window is made in the skull bone of a rat under isoflurane anesthesia to capture in vivo multispectral diffuse reflectance images of the cortical surface...
May 7, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28484741/effects-of-clove-oil-and-lidocaine-hcl-anesthesia-on-water-parameter-during-simulated-transportation-in-the-marine-medaka-oryzias-dancena
#18
In-Seok Park, Hyun Woo Gil, Tae Ho Lee, Yoon Kwon Nam, Sang Gu Lim, Dong Soo Kim
Optimum concentrations of anesthetic clove oil and anesthetic lidocaine-HCl were determined for a species of adult marine medaka, Oryzias dancena, over a range of salinity conditions, and investigated in a transport simulation experiment by analyzing various water and physiological parameters. Research indicated that the higher the concentration of anesthetic at each salinity, the shorter the anesthesia time at each salinity. At each concentration, fish were anesthetized slower at water salinities over 10 ppt (P<0...
March 2017: Balsaeng'gwa Saengsig
https://www.readbyqxmd.com/read/28457421/later-evaluation-of-ischemia-and-reperfusion-by-the-pringle-maneuver-in-wistar-rats-demonstrating-that-hepatic-lesions-can-be-reversible
#19
G de Lourdes Jorge, R Dos Reis Tártaro, C A Fazzio Escanhoela, I F S F Boin
OBJECTIVE: There has been much research on hepatic ischemia and reperfusion by means of short or longer interruption of the portal triad. The aim of this work was to evaluate the mitochondrial respiratory activity and liver histology at 2 different times after the Pringle maneuver. METHODS: Twenty-eight male Wistar rats, weighing ∼308 g, with histologic and mitochondrial study: immediate ischemic group (IIG; 40 minutes; 9 animals) and late ischemic group (LIG; 28 days; 9 animals)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28456368/bone-penetrance-of-locally-administered-vancomycin-powder-in-a-rat-femur-fracture-model
#20
Zachary M Working, Hunter Frederiksen, Alex Drew, Catherine Loc-Carrillo, Erik N Kubiak
INTRODUCTION: Locally delivered, crystalline vancomycin has been suggested as a potential prophylactic measure against the development of deep and superficial surgical site infection. Clinical expectations regarding the duration and peak of drug concentration in local tissues following administration are unknown. Our goal was to develop concentration vs time curves for locally administered vancomycin powder in a high-energy, open femur fracture rat model in local tissues and to compare that data to two well performed similar, systemic administration studies...
April 21, 2017: Injury
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