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Anaesthesiology Interventions

Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
September 30, 2016: Anaesthesiology Intensive Therapy
R N Werner, A F Nikkels, B Marinović, M Schäfer, M Czarnecka-Operacz, A M Agius, Z Bata-Csörgő, J Breuer, G Girolomoni, G E Gross, S Langan, R Lapid-Gortzak, T H Lesser, U Pleyer, J Sellner, G M Verjans, P Wutzler, C Dressler, R Erdmann, S Rosumeck, A Nast
BACKGROUND: Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. OBJECTIVE: The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localisations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of PHN and other complications...
August 31, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
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
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
2016: Cochrane Database of Systematic Reviews
L Quecedo Gutiérrez, R Ruiz Abascal, J M Calvo Vecino, A I Peral García, E Matute González, L E Muñoz Alameda, E Guasch Arévalo, F Gilsanz Rodríguez
In April 2013 the Ministry of Health (MSSSI) adopted the project called "Commitment to Quality by Scientific Societies in Spain", in response to social and professional demands for sustainability of the health system. The initiative is part of the activities of the Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System, and is coordinated jointly by the Quality and Cohesion Department, the Aragon Institute of Health Sciences (IACS), and the Spanish Society of Internal Medicine (SEMI)...
July 11, 2016: Revista Española de Anestesiología y Reanimación
Vanessa Cartier, Cigdem Inan, Walter Zingg, Cecile Delhumeau, Bernard Walder, Georges L Savoldelli
BACKGROUND: Multimodal educational interventions have been shown to improve short-term competency in, and knowledge of central venous catheter (CVC) insertion. OBJECTIVE: To evaluate the effectiveness of simulation-based medical education training in improving short and long-term competency in, and knowledge of CVC insertion. DESIGN: Before and after intervention study. SETTING: University Geneva Hospital, Geneva, Switzerland, between May 2008 and January 2012...
August 2016: European Journal of Anaesthesiology
J Claesson, M Freundlich, I Gunnarsson, J H Laake, M H Møller, P O Vandvik, T Varpula, T A Aasmundstad
BACKGROUND: The objective of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force on fluid and drug therapy in adults with acute respiratory distress syndrome (ARDS) was to provide clinically relevant, evidence-based treatment recommendations according to standards for trustworthy guidelines. METHODS: The guideline was developed according to standards for trustworthy guidelines, including a systematic review of the literature and use of the GRADE methodology for assessment of the quality of evidence and for moving from evidence to recommendations...
July 2016: Acta Anaesthesiologica Scandinavica
Johannes Prottengeier, Marlen Petzoldt, Nikola Jess, Andreas Moritz, Christine Gall, Joachim Schmidt, Georg Breuer
BACKGROUND: Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty. OBJECTIVES: We introduced and validated a quantifiable source of divided attention and investigated its effects on performance and workload in airway management. DESIGN: A randomised, crossover, interventional simulation study...
March 2016: European Journal of Anaesthesiology
Jochen Renner, Christian Frerker, Karl-Heinz Kuck, Berthold Bein
Recent advancements in the field of cardiovascular surgery have been dominated by 3 aspects that comparably challenge a sophisticated cardiological, surgical and anaesthesiological management of this patient population. The proportion of elderly patients with relevant comorbidities increases steadily, and the number of combined cardiac surgical procedures is rising in this elderly population. A very important innovation in the last decade pertaining to the treatment of elderly patients at high risk suffering from significant aortic stenosis is the minimally invasive transcatheter aortic valve implantation (TAVI)...
November 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Ismail Gögenur
Identification of patients with high risk for post-operative complications is instrumental in all surgical specialities. Proper identification can in some cases lead to preoperative or intraoperative optimization resulting in reduced morbidity and morbidity. Several scoring systems exist for assessing overall mortality risk. Preoperative functional tests and biochemical risk markers have shown to be effective in predicting post-operative medical complications and mortality. Optimization can be done by medical interventions, improved anaesthesiological care and optimization directed towards improved communication in the surgical team...
August 17, 2015: Ugeskrift for Laeger
Laurence Rozen, David Faraoni, Cristel Sanchez Torres, Ariane Willems, Denis C F Noubouossie, Dragos Barglazan, Philippe Van der Linden, Anne Demulder
BACKGROUND: Although recent studies have assessed tranexamic acid (TXA) pharmacokinetics in different subgroups, the effective concentration of TXA required to completely inhibit fibrinolysis remains to be determined. OBJECTIVE: An in-vitro determination of the effective TXA concentration needed for 95% inhibition (EC95) of tissue-type plasminogen activator (t-PA) activated fibrinolysis, using an experimental model designed for thromboelastometry (ROTEM). DESIGN: A prospective interventional study...
December 2015: European Journal of Anaesthesiology
Denise P Veelo, Suzanne S Gisbertz, Rebekka A Hannivoort, Susan van Dieren, Bart F Geerts, Mark I van Berge Henegouwen, Markus W Hollmann
BACKGROUND: Deep muscle relaxation has been shown to facilitate operating conditions during laparoscopic surgery. Minimally invasive esophageal surgery is a high-risk procedure in which the use of deep neuromuscular block (NMB) may improve conditions in the thoracic phase as well. Neuromuscular antagonists can be given on demand or by continuous infusion (deep NMB). However, the positioning of the patient often hampers train-of-four (TOF) monitoring. A continuous infusion thus may result in a deep NMB at the end of surgery...
2015: Trials
S M McHugh, T Aherne, T Goetz, J Byrne, E Boyle, M Allen, A Leahy, D Moneley, P Naughton
INTRODUCTION: Endovascular aneurysm repair (EVAR) is a comparatively less invasive technique than open repair (OR). Debate remains with regard to the benefit of EVAR for patients with ruptured abdominal aortic aneurysm (RAAA). We sought to evaluate and report outcomes of EVAR for RAAA in an Irish tertiary vascular referral centre. METHODS: Patients undergoing emergency surgery for ruptured or symptomatic AAA were identified from theatre logbooks and HIPE database...
October 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Matthias Grünewald
Due to the demographic and medical development, the number of patients with heart failure needing anaesthesiological care will continue to grow in the upcoming years. For the optimal care of these patients close coordination between the surgically treating, the cardiology and the anesthesiological department is important. Cardiac function and structural characters, such as cardiac valve defects should be known preoperatively. Thus, the anaesthetic management, intraoperative monitoring, as well as necessary pharmacological interventions can be tailored...
May 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Jonas Nordquist, Kristina Sundberg
This review focuses on simulation in anaesthesiology as an educational intervention from a learning perspective. Simulation-based education in anaesthesiology has implications for both faculty development and institutional needs. However, in order to find evidence for the implications of these areas, it is necessary to turn to the literature on anaesthesiology simulations, health-care simulations and also the medical education and pedagogical literature. The most important factor for successful simulation-based education on an institutional level is curriculum integration of simulation, closely connected with defined learning outcomes...
March 2015: Best Practice & Research. Clinical Anaesthesiology
Stefano Andreoli, Renzo Moretti, Ferdinando Luca Lorini, Mariavittoria Lagrotta
Sometimes, cardiac catheterisation and electrophysiological procedures, diagnostic and interventional, require an anaesthesiological support. The anaesthesiologist receives radiation doses depending on various factors, such as type of procedure and exposure modality, anaesthesiological technique, individual protective devices and operator experience. The aim of this study was to investigate the dose per procedure, the exposure inhomogeneity and the effective dose, E, of a senior anaesthesiologist in the haemodynamic laboratory of Ospedali Riuniti, Bergamo...
January 2016: Radiation Protection Dosimetry
E Grossmann, T Ninke, S Probst, U X Kaisers
In late summer 2014, the joint working group of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA) presented new guidelines for the evaluation and treatment of cardiovascular risk patients undergoing noncardiac surgery. In addition to the preoperative collation of patient and intervention-specific risks, the guidelines deal with anaesthesiological and cardiological aspects of the perioperative management of patients with diseases of the heart and common comorbidities...
April 2015: Der Anaesthesist
Pablo Rama-Maceiras, Johanna Jokinen, Peter Kranke
PURPOSE OF REVIEW: Stress and burnout have arisen as relevant problems to the healthcare workers and the health systems themselves. As anaesthesiologists work in stressful areas of the hospitals, we are exposed to these problems. In this review, we summarize recent studies regarding stress and burnout, exploring possible solutions. RECENT FINDINGS: Almost 50% of anaesthesiologists scored positive for some of the burnout domains in different surveys, with one-third reporting high levels...
April 2015: Current Opinion in Anaesthesiology
M Ranucci, A Jeppsson, E Baryshnikova
BACKGROUND: Pre-operative fibrinogen levels are negatively associated with postoperative bleeding in cardiac surgery patients. The guidelines of the European Society of Anaesthesiology consider the possibility of a prophylactic pre-operative supplementation in patients with fibrinogen levels<`3.8 g/l. The present study is a reanalysis of published data aimed to define the diagnostic accuracy of different values of pre-operative fibrinogen levels in predicting severe post-operative bleeding...
April 2015: Acta Anaesthesiologica Scandinavica
Eric A Bruder, Ian M Ball, Stacy Ridi, William Pickett, Corinne Hohl
BACKGROUND: The use of etomidate for emergency airway interventions in critically ill patients is very common. In one large registry trial, etomidate was the most commonly used agent for this indication. Etomidate is known to suppress adrenal gland function, but it remains unclear whether or not this adrenal gland dysfunction affects mortality. OBJECTIVES: The primary objective was to assess, in populations of critically ill patients, whether a single induction dose of etomidate for emergency airway intervention affects mortality...
January 8, 2015: Cochrane Database of Systematic Reviews
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