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https://www.readbyqxmd.com/read/29778972/hypnotic-agents-for-induction-of-general-anesthesia-in-cesarean-section-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Kavita Houthoff Khemlani, Stephanie Weibel, Peter Kranke, Jan-Uwe Schreiber
STUDY OBJECTIVE: An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. DESIGN: A systematic review and meta-analysis, using PRISMA methodology, of randomized controlled trials (RCTs), comparing women undergoing CS using thiopentone with those undergoing CS with propofol, ketamine, or benzodiazepines as hypnotic agents...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29774167/complete-hypokalemic-quadriparesis-as-a-first-presentation-of-sj%C3%A3-gren-syndrome
#2
Jason An, Branko Braam
Rationale: We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishment. Presenting concerns: A 73-year-old female presented to a peripheral hospital with quadriparesis and a critically low serum potassium of 1.6 mmol/L with U waves on the electrocardiogram (ECG). The initial arterial blood gas showed a pH of 7.19, bicarbonate of 13 mEq/L, and a CO2 of 35 mm Hg...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29768360/clinical-efficacy-of-xenon-versus-propofol-a-systematic-review-and-meta-analysis
#3
Yimeng Xia, Hongwei Fang, Jindong Xu, Chenfei Jia, Guorong Tao, Buwei Yu
BACKGROUND: Interest in the anesthetic use of xenon, a noble gas, has waxed and waned for decades, and the clinical effects of xenon are still debated. We performed a meta-analysis to compare the clinical efficacy of xenon with that of propofol. METHODS: Electronic searches were performed through December 2017 using various databases, including PubMed, Embase, and the Cochrane Library. We identified thirteen trials that included a total of 817 patients. RESULTS: Patients treated with xenon had a lower bispectral index (BIS) (weighted mean difference (WMD): -6...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29739856/accuracy-of-transcutaneous-co-2-values-compared-with-arterial-and-capillary-blood-gases
#4
Laura L Lambert, Melissa B Baldwin, Cruz Velasco Gonzalez, Gary R Lowe, J Randy Willis
BACKGROUND: Transcutaneous monitors are utilized to monitor a patient's respiratory status. Some patients have similar values when comparing transcutaneous carbon dioxide ( P tcCO2 ) values with blood gas analysis, whereas others show extreme variability. A retrospective review of data was performed to determine how accurately P tcCO2 correlated with CO2 values obtained by arterial blood gas (ABG) or capillary blood gas. METHODS: To determine whether P tcCO2 values correlated with ABG or capillary blood gas values, subjects' records were retrospectively reviewed...
May 8, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29721250/congenital-methemoglobinemia-misdiagnosed-as-polycythemia-vera-case-report-and-review-of-literature
#5
Dina Sameh Soliman, Mohamed Yassin
Methemoglobinemia is a rare overlooked differential diagnosis in patients presented with cyanosis and dyspnea unrelated to cardiopulmonary causes. Our patient is 29 year old Indian non-smoker male, his story started 6 months prior to presentation to our center when he had generalized fatigue and discoloration of hands. He presented with persistent polycythemia with elevated hemoglobin level. The patient was misdiagnosed in another center as polycythemia and treated with Imatinib. The diagnosis of PV was revisited and ruled out in view of negative JAK2, normal erythropoietin level and absence of features of panmyelosis...
March 2, 2018: Hematology Reports
https://www.readbyqxmd.com/read/29716484/effect-on-neonatal-outcome-of-pharmacological-interventions-for-attenuation-of-the-maternal-haemodynamic-response-to-tracheal-intubation-a-systematic-review
#6
A Aman, B Salim, K Munshi, S A Raza, F A Khan
The primary aim of this systematic review was to assess the effect on neonatal outcome of pharmacological interventions used for attenuation of the haemodynamic response to tracheal intubation in patients undergoing caesarean section under general anaesthesia. A systematic search of randomised controlled trials from 1990 to 2015 was conducted. The primary outcome measure was the Apgar score at five minutes and secondary outcomes were umbilical arterial blood gas parameters and neurological adaptive capacity scores...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29712484/does-prenatal-diagnosis-of-critical-congenital-heart-diseases-influence-the-prereferral-mortality-in-a-center-without-surgical-intervention
#7
Buse Özer Bekmez, Evrim Alyamaç Dizdar, Nilüfer Okur, Mehmet Büyüktiryaki, Nurdan Uraş, Serife Suna Oğuz
BACKGROUND: Prenatal diagnosis ameliorates some preoperative and postoperative outcomes in critical congenital heart disease (CHD). Despite large variability among anatomical defect types, nearly half of them are diagnosed antenatally. We aimed to investigate the effect of the antenatal diagnosis on prereferral mortality of infants with critical CHD in a center without cardiovascular surgery clinic. METHODS: Medical records of the neonates who were diagnosed with critical CHD between the years 2010 and 2016 in Zekai Tahir Burak Women's health Education and Research Hospital were retrospectively reviewed for the study...
April 30, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29615483/incidence-of-hypocapnia-hypercapnia-and-acidosis-and-the-associated-risk-of-adverse-events-in-preterm-neonates
#8
Melissa K Brown, Deborah M Poeltler, Kasim O Hassen, Danielle V Lazarus, Vanessa K Brown, Jeremiah J Stout, Wade D Rich, Anup C Katheria
BACKGROUND: Permissive hypercapnia is a lung-protection strategy. We sought to review our current clinical practice for the range of permissive hypercapnia and identify the relationship between P aCO2 and pH and adverse outcomes. METHODS: A secondary analysis of a delayed cord-clamping clinical trial was performed on all arterial blood gas tests in the first 72 h in infants < 32 weeks gestational age. All arterial blood gas values were categorized into a clinical range to determine the percent likelihood of occurring in the total sample...
April 3, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29602665/relocation-of-blood-gas-laboratory-to-the-emergency-department-helps-decrease-lactic-acid-values
#9
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29582542/an-observational-cohort-study-of-outcomes-in-patients-admitted-to-the-intensive-care-unit-for-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#10
Sivanth Sivakumar, Angus McNally, Jonathan Tobin, Jonathan Williamson, A Anders Aneman
BACKGROUND: Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are often referred to the intensive care unit (ICU) for non-invasive respiratory support. AIMS: To describe the characteristics of patients with AECOPD admitted to ICU focusing on the performance of ICU prognostic systems, decisions to limit medical therapy and mortality outcomes. METHODS: Retrospective review of patients admitted between 2009-16, separately in patients with active treatment and limitation or withdrawal of medical therapy...
March 27, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29582442/relationship-between-fetal-peak-systolic-velocity-in-middle-cerebral-artery-and-umbilical-blood-gas-values-and-hemoglobin-levels-in-diabetic-pregnant-women
#11
Mehmet S Kutuk, Mehmet Dolanbay, Ayse F Gokmen Karasu, Mahmut T Ozgun
PURPOSE: To assess the relationship between peak systolic velocity in the middle cerebral artery (MCA-PSV) and fetal hypoxia in diabetic pregnant women requiring insulin therapy. METHODS: The data of diabetic pregnant women using insulin who were followed in our departments were reviewed retrospectively. The relationships between MCA-PSV and umbilical cord pO2, pCO2, base deficit, hemoglobin, and birth weight were analyzed. RESULTS: A total of 120 cases were included in the final analysis...
March 26, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#12
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29574504/ventilatory-and-cerebrovascular-regulation-and-integration-at-high-altitude
#13
REVIEW
Ryan L Hoiland, Connor A Howe, Geoff B Coombs, Philip N Ainslie
Ascent to high-altitude elicits compensatory physiological adaptations in order to improve oxygenation throughout the body. The brain is particularly vulnerable to the hypoxemia of terrestrial altitude exposure. Herein we review the ventilatory and cerebrovascular changes at altitude and how they are both implicated in the maintenance of oxygen delivery to the brain. Further, the interdependence of ventilation and cerebral blood flow at altitude is discussed. Following the acute hypoxic ventilatory response, acclimatization leads to progressive increases in ventilation, and a partial mitigation of hypoxemia...
March 24, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29560073/nasal-cannula-apneic-oxygenation-prevents-desaturation-during-endotracheal-intubation-an-integrative-literature-review
#14
REVIEW
Joshua M Gleason, Bill R Christian, Erik D Barton
Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e., arterial blood gas level, hemoglobin value, or chest radiograph). During pre-oxygenation, administering high-flow nasal oxygen in addition to a non-rebreather face mask can significantly boost the effective inspired oxygen...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29559357/relocation-of-blood-gas-laboratory-to-the-emergency-department-helps-decrease-lactic-acid-values
#15
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 12, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29555318/blood-gas-sample-spiking-with-total-parenteral-nutrition-lipid-emulsion-and-concentrated-dextrose-solutions-as-a-model-for-predicting-sample-contamination-based-on-glucose-result
#16
Jose C Jara-Aguirre, Steven W Smeets, Amy M Wockenfus, Brad S Karon
OBJECTIVE: Evaluate the effects of blood gas sample contamination with total parenteral nutrition (TPN)/lipid emulsion and dextrose 50% (D50) solutions on blood gas and electrolyte measurement; and determine whether glucose concentration can predict blood gas sample contamination with TPN/lipid emulsion or D50. DESIGN AND METHODS: Residual lithium heparin arterial blood gas samples were spiked with TPN/lipid emulsion (0 to 15%) and D50 solutions (0 to 2.5%). Blood gas (pH, pCO2, pO2), electrolytes (Na+, K+ ionized calcium) and hemoglobin were measured with a Radiometer ABL90...
March 16, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29502796/pulmonary-hypertension-in-congenital-diaphragmatic-hernia-patients-prognostic-markers-and-long-term-outcomes
#17
Matthew Wong, Janette Reyes, Eveline Lapidus-Krol, Monping Chiang, Tilman Humpl, Malikah Al-Faraj, Greg Ryan, Priscilla P L Chiu
Prenatal observed/expected lung-to-head ratio (O/E LHR) by ultrasound correlates with postnatal mortality for congenital diaphragmatic hernia (CDH) patients. The aim of this study is to determine if O/E LHR correlates with pulmonary hypertension (PH) outcomes for CDH patients. METHODS: A single center retrospective chart review was performed for CDH neonates from January 1, 2006, to December 31, 2015, (REB #1000053124) to include prenatal O/E LHR, liver position, first arterial blood gas, repair type, echocardiogram (ECHO), and lung perfusion scan (LPS) results up to 5years of age...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29346577/improved-success-rate-of-arterial-puncture-for-blood-gas-analysis-through-standardization
#18
Phillip R Jensen, Boaz A Markewitz
Background: Arterial puncture for blood gas analysis is a common procedure in hospitals. The aim of the study is to determine if standardizing technique elements of the arterial puncture process could improve the success rate of technicians through the full scope of an academic medical center. Methods: The study is conducted by the Blood Gas Laboratory at University of Utah Health's main campus. During the baseline period, technicians tallied whether arterial puncture attempts were successful or unsuccessful from December 2014 through February 2015...
March 21, 2018: Laboratory Medicine
https://www.readbyqxmd.com/read/29346176/rapid-response-to-scan-or-not-to-scan-the-utility-of-noncontrast-ct-head-for-altered-mental-status
#19
Purujit J Thacker, Mansha Sethi, Jonathan Sternlieb, Doron Schneider, Mary Naglak, Rajeshkumar R Patel
OBJECTIVES: The aims of the study were the following: (1) to determine how often computed tomography (CT) scans of the head are obtained on rapid responses called for altered mental status (AMS), (2) to determine whether CT imaging of the head is required during all rapid responses called for AMS, (3) to determine which patients would benefit from CT scans of the head in this setting, (4) to note whether an adequate neurologic exam was documented, (5) to determine the cost of CT scans that did not change management, and (6) to examine the role of medications leading to AMS...
January 17, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29342464/risk-factors-for-intraoperative-hypocapnia-in-pediatric-neurosurgical-patients-a-retrospective-cohort-study
#20
In-Kyung Song, Soolyoen Choi, Seohee Lee, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
BACKGROUND: Hypocapnia has been associated with an increased risk and adverse outcomes in the injured brain. This study aimed to identify risk factors of intraoperative hypocapnia in pediatric neurosurgical patients when tidal volumes and respiratory rates were determined based on their weight and age, respectively. METHODS: Electronic medical records of pediatric patients (≤18 years) who underwent neurosurgery from December 2014 to January 2016 were retrospectively reviewed...
January 18, 2018: Pediatric Neurosurgery
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