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https://www.readbyqxmd.com/read/28643320/revised-protocol-of-extracorporeal-membrane-oxygenation-ecmo-therapy-in-severe-ards-recommendations-of-the-veno-venous-ecmo-expert-panel-appointed-in-february-2016-by-the-national-consultant-on-anesthesiology-and-intensive-care
#1
Romuald Lango, Zbigniew Szkulmowski, Dariusz Maciejewski, Andrzej Sosnowski, Krzysztof Kusza
Extracorporeal Membrane Oxygenation (ECMO) has become well established technique of the treatment of severe acute respiratory failure (Veno-Venous ECMO) or circulatory failure (Veno-Arterial ECMO) which enables effective blood oxygenation and carbon dioxide removal for several weeks. Veno-Venous ECMO (V-V ECMO ) is a lifesaving treatment of patients in whom severe ARDS makes artificial lung ventilation unlikely to provide satisfactory blood oxygenation for preventing further vital organs damage and progression to death...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28604996/one-lung-ventilation-for-thoracic-surgery-current-perspectives
#2
Filippo Bernasconi, Federico Piccioni
One-lung ventilation (OLV) is an anesthesiological technique that is increasingly being used beyond thoracic surgery. This requires specific skills and knowledge about airway management, maintenance of gas exchange and prevention of acute lung injury. Sometimes maintaining adequate gas exchange and minimizing acute lung injury may be opposing processes. Parameters validated for OLV titration still have not been found, but a multimodal approach based on low tidal volume, end-expiratory pressure application and alveolar recruitment maneuvers is considered the best way to ensure protective ventilation and reduce lung damage...
June 7, 2017: Tumori
https://www.readbyqxmd.com/read/28570294/blind-intubation-through-self-pressurized-disposable-supraglottic-airway-laryngeal-intubation-masks-an-international-multicenter-prospective-cohort-study
#3
Kurt Ruetzler, Sandra Esther Guzzella, David Werner Tscholl, Tanja Restin, Marco Cribari, Alparslan Turan, Jing You, Daniel I Sessler, Burkhardt Seifert, Tomasz Gaszynski, Michael T Ganter, Donat R Spahn
INTRODUCTION: Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device...
June 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28367291/learning-curves-for-three-specific-procedures-by-anesthesiology-residents-using-the-learning-curve-cumulative-sum-lc-cusum-test
#4
Gregoire Weil, Cyrus Motamed, David J Biau, Marie Laurence Guye
BACKGROUND: The learning curve cumulative sum (LC-CUSUM) test is an innovative tool that allows quantitative monitoring of individual medical performance during the learning process by determining when a predefined acceptable level of performance is reached. This study used the LC-CUSUM test to monitor the learning process and failure rate of anesthesia residents training for specific subspecialty anesthesia procedures. METHODS: The study included 490 tracheal punctures (TP) for jet ventilation, 340 thoracic epidural analgesia (TEA) procedures, and 246 fiberoptic nasal intubations (FONI) performed by 18 residents during their single 6-month rotation...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28301888/geburtshilfe-an%C3%A3-sthesie-bei-fetaler-chirurgie
#5
Emmanuel Schneck, Christian Koch, Christoph Arens, Rainer Schürg, Thomas Zajonz, Anastasiia Khaleeva, Thomas Kohl, Markus A Weigand, Michael Sander
Due to the responsibility for the mother and the unborn child, fetal surgery represents a challenging task for the anesthesiologist. Maternal changes during pregnancy have to be considered as well as the fetal physiology and the surgeon's needs. Main principles of the anesthesiological management of fetal surgery include the stabilization of the mean arterial pressure in order to preserve a sufficient placental blood flow, sustainment of an adequate oxygenation and ventilation as well as thorough temperature surveillance...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28256331/-deep-versus-moderate-neuromuscular-block-during-one-lung-ventilation-in-lung-resection-surgery
#6
Javier Casanova, Patricia Piñeiro, Francisco De La Gala, Luis Olmedilla, Patricia Cruz, Patricia Duque, Ignacio Garutti
BACKGROUND AND OBJECTIVES: Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in one-lung ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during one-lung ventilation is not deleterious...
May 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28193455/assessment-of-the-effectiveness-of-a-ventilator-associated-pneumonia-prevention-bundle-that-contains-endotracheal-tube-with-subglottic-drainage-and-cuff-pressure-monitorization
#7
Ozlem Akdogan, Yasemin Ersoy, Ciğdem Kuzucu, Ender Gedik, Turkan Togal, Funda Yetkin
The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients...
February 11, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28169512/nurses-can-play-an-active-role-in-the-early-diagnosis-of-exposure-keratopathy-in-intensive-care-patients
#8
Elem Kocaçal Güler, İsmet Eşer, Sait Eğrilmez
AIM: This study was conducted in order to determine nurses' ability to diagnose exposure keratopathy reliably in the early stage in intensive care patients. METHODS: This methodological and descriptive study was carried out between 2011 and 2012 in the Neurology and Anesthesiology and Reanimation Intensive Care Units of a teaching hospital in western Turkey. The sample consisted of 4354 ocular assessments in 156 corneas of 78 patients. A patient identification form and a fluorescein test patient tracking chart were used in the data collection...
February 7, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/27957514/goal-oriented-anesthesia-week-for-ms-iii-students
#9
Margaret A O'Donoghue, Jeffrey Martel
BACKGROUND: Third year medical students at our institution are required to complete a one-week rotation in anesthesia as part of their required twelve week surgery clerkship. During this constrained time, our aim was to provide students with a focused and goal-oriented preview of anesthesiology which would allow students going into various fields to have an appreciation of the field. CURRICULUM DESIGN: The one-week curriculum is a combination of lecture, simulation, operating room teaching and hands on experience aimed at providing students with some fundamentals of procedural skills and a knowledge base of anesthesia...
July 2016: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/27787571/-anesthesia-for-medical-students-a-brief-guide-to-practical-anesthesia-in-adults-with-a-web-based-video-illustration
#10
REVIEW
S Mathis, O Schlafer, J Abram, J Kreutziger, P Paal, V Wenzel
In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27760527/outcome-of-cardiac-surgery-in-patients-with-low-preoperative-ejection-fraction
#11
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27678137/-simulation-based-training-and-or-apprenticeship-for-medical-students-a%C3%A2-prospective-randomized-single-blind-study-of-clinical-skills
#12
RANDOMIZED CONTROLLED TRIAL
T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
November 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27669670/evaluation-of-american-society-of-anesthesiologists-classification-as-30-day-morbidity-predictor-after-single-level-elective-anterior-cervical-discectomy-and-fusion
#13
Seokchun Lim, Louanne M Carabini, Robert B Kim, Ryan Khanna, Nader S Dahdaleh, Zachary A Smith
BACKGROUND CONTEXT: Higher American Society of Anesthesiologists (ASA) classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF). PURPOSE: This study aimed to evaluate the predictive value of ASA classification system on 30-day morbidity following SLE-ACDF. DESIGN/SETTING: Patients who underwent SLE-ACDF between 2011 and 2013 were selected from the American College of Surgeons National Surgical Quality Improvement Program database...
March 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27466988/anaesthesiological-strategies-to-improve-outcome-in-liver-transplantation-recipients
#14
V Perilli, P Aceto, T Sacco, C Modesti, P Ciocchetti, F Vitale, A Russo, G Fasano, A Dottorelli, L Sollazzi
Graft and patients survival are the main goal of anesthesiological management in patients undergoing liver transplantation (LT). Even if anesthesiological practice sustained major developments over time, some evidence-based intraoperative strategies have not yet been widely applied. The aim of this review was to summarize intraoperative anesthesiological strategies which could have the potential to improve LT graft and/or recipient survival. Monitoring must be as accurate as possible in order to manage intraoperative hemodynamic changes...
July 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27435067/cytomegalovirus-and-epstein-barr-virus-reactivation-in-the-intensive-care-unit
#15
O Coşkun, E Yazici, F Şahiner, A Karakaş, S Kiliç, M Tekin, C Artuk, L Yamanel, B A Beşirbellioğlu
AIM: The purpose of this work was to evaluate the reactivation of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in immunocompetent patients in the intensive care unit (ICU) and to identify risk factors associated with reactivation. MATERIALS AND METHODS: In this observational prospective study, 60 adult immunocompetent patients who stayed at least 7 days in an ICU were evaluated. During hospitalization, the viral load was monitored at admission and on day 7 with polymerase chain reaction to detect viral reactivation and weekly thereafter on days 14, 21, and 28 if hospitalization continued...
July 19, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27384980/a-comparison-of-measurements-of-change-in-respiratory-status-in-spontaneously-breathing-volunteers-by-the-exspiron-noninvasive-respiratory-volume-monitor-versus-the-capnostream-capnometer
#16
George W Williams, Christy A George, Brian C Harvey, Jenny E Freeman
BACKGROUND: Current respiratory monitoring technologies such as pulse oximetry and capnography have been insufficient to identify early signs of respiratory compromise in nonintubated patients. Pulse oximetry, when used appropriately, will alert the caregiver to an episode of dangerous hypoxemia. However, desaturation lags significantly behind hypoventilation and alarm fatigue due to false alarms poses an additional problem. Capnography, which measures end-tidal CO2 (EtCO2) and respiratory rate (RR), has not been universally used for nonintubated patients for multiple reasons, including the inability to reliably relate EtCO2 to the level of impending respiratory compromise and lack of patient compliance...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27333725/the-impact-of-tracheotomy-on-the-clinical-course-of-ventilator-associated-pneumonia
#17
Tihana Magdić Turković, Anita Lukić, Iva Pažur, Ognjen Ožegić, Melanija Obraz
Ventilator-associated pneumonia (VAP) is the most common infection among intensive care unit (ICU) patients. The aim of the present study was to evaluate the impact of tracheotomy on VAP clinical course. The study was conducted in a 15-bed Surgical and Neurosurgical ICU, Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center in Zagreb, Croatia. All patients developing VAP during ICU stay were eligible for the study. In VAP patients not tracheotomized during ICU stay, the mortality rate was approximately two times higher as compared with patients tracheotomized either before or after VAP onset (crude risk ratio 1...
March 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/27048842/-monitoring-of-pco2-during-ventilation
#18
REVIEW
F S Magnet, W Windisch, J H Storre
Respiratory insufficiency type 2 (ventilatory failure) is characterized by hypercapnia due to alveolar hypoventilation. Therefore, the monitoring of pCO2 is essential for diagnostic and surveillance purposes. Various techniques which differ in the way of measurement (e.g., invasive/noninvasive, continuous/noncontinuous) and their indication are available. Arterial blood gas analysis (ABG) as an invasive procedure is the gold standard procedure and is mostly used in emergency medicine or intensive care units (ICUs)...
April 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27025137/-comparative-study-of-the-tactics-of-surgical-fixation-with-the-closed-injury-of-the-chest-the-view-of-the-resuscitator-economic-aspects
#19
N P Shen, N S Davidova, P G Boltaev, S Yu Lukin, S A Uchacov, L A Skorokhodova, S Yu Muhacheva, P B Vasilenko
The closed injury of chest with the breaks of edges is the vital problem of traumatology, anesthesiology and resuscitation For the change to conservative treatment with the aid of mechanical ventilation of lungs today come the methods of surgical fixation with the closed injury of chest. The conducted investigation showed the clinical and economic expediency of introducing the method of active surgical tactics.
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26986188/the-effect-of-transcutaneous-electrical-nerve-stimulation-on-post-thoracotomy-pain
#20
RANDOMIZED CONTROLLED TRIAL
Sevilay Erden, Sevilay Senol Celik
BACKGROUND: Pain guidelines suggest transcutaneous electrical nerve stimulation (TENS) as a reliable analgesic method in postoperative pain. OBJECTIVES: This study was conducted as a randomized controlled study to determine the effect of TENS on postoperative pain and analgesic consumption in patients who have undergone posterolateral thoracotomy (PLT). DESIGN: The study was conducted in the Thoracic Surgery Clinic of a university hospital with 40 patients (test group: 20, control group: 20) and its power was 99%...
October 2015: Contemporary Nurse
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