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Anesthesia Safety

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https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#1
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#2
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28210760/-risk-management-in-anesthesia-and-critical-care-medicine
#3
C Eisold, A R Heller
Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture...
February 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28205467/a-rare-type-of-upper-extremity-injury-penetrating-injuries-caused-by-blunt-edged-items
#4
Hakan Şirinoğlu, Furkan Certel, Nebil Yeşïloğlu, Gökhan Temïz, Kübra Ece Kalafatlar, Murat Sarici, Özhan Çelebïler
BACKGROUND: Penetrating upper extremity injury is a common encountered cause of significant loss of labor force and it is generally caused by sharp items. This article presents five rare cases of penetrating hand and forearm injury caused by blunt-edged items in conjunction with a detailed discussion of the mechanism and management of the injury. METHODS: Five patients with a mean age of 37.6 were treated for upper extremity trauma caused by "blunt-edged items" such as corrugated iron fence, garden wires, iron stick or iron safety fence between 2009 to 2014...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28203558/cerebral-monitoring-during-carotid-endarterectomy-by-transcranial-doppler-ultrasonography
#5
Woo-Sung Yun
PURPOSE: To evaluate the efficacy and safety of cerebral monitoring by transcranial Doppler ultrasonography (TCD) for the detection of cerebral ischemia during carotid endarterectomy (CEA). METHODS: From August 2004 to December 2013, 159 CEAs were performed in a tertiary hospital. All procedures were performed under general anesthesia. Intraoperative TCD was routinely used to detect cerebral ischemia. Of the 159 patients, 102 patients were included in this study, excluding 27 patients who had a poor transtemporal isonation window and 30 patients who used additional cerebral monitoring systems such as electroencephalography or somatosensory evoked potentials...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28197031/efficacy-of-preprocedural-diclofenac-in-men-undergoing-double-j-stent-removal-under-local-anesthesia-a-double-blind-randomized-control-trial
#6
Vilvapathy Senguttuvan Karthikeyan, Ramaiah Keshavamurthy, Ashwin Mallya, Manohar Chikka Moga Siddaiah, Sumit Kumar, Chulai Rajabahadhur Chandrashekar
INTRODUCTION: Double J (DJ) stents are often removed under local anesthesia using a rigid cystoscope. Patients experience significant pain during this procedure and also continue to have discomfort during voiding for a few days. We assessed the efficacy and safety of preemptive oral diclofenac in pain relief in patients undergoing DJ stent removal (DJSR) by rigid cystoscopy compared to placebo. METHODS: Consecutive consenting male patients undergoing DJSR under local anesthesia between March 2014 and July 2015 were enrolled...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28196610/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-for-nodal-staging-in-non-small-cell-lung-carcinoma
#7
D Coutinho, A Oliveira, S Campainha, S Neves, M Guerra, J Miranda, A Furtado, D Tente, A Sanches, J Almeida, J Moura E Sá
INTRODUCTION: Lung cancer staging has recently evolved to include endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for nodal assessment. AIM: Evaluate the performance and safety of EBUS-TBNA as a key component of a staging algorithm for non-small cell lung carcinoma (NSCLC) and as a single investigation technique for diagnosis and staging of NSCLC. METHODS: Patients undergoing EBUS-TBNA for NSCLC staging at our institution between April 1, 2010 and December 31, 2014 were consecutively included with prospective data collection...
February 9, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28196085/what-device-would-be-best-for-early-infant-male-circumcision-in-east-and-southern-africa-provider-experiences-and-opinions-with-three-different-devices-in-kenya
#8
Robert C Bailey, Irene Nyaboke, Fredrick O Otieno
Voluntary medical male circumcision (VMMC) reduces risk of HIV acquisition in heterosexual men by approximately 60%. As some countries approach targets for proportions of adolescents and adults circumcised, some are considering early infant male circumcision (EIMC) as a means to achieve sustainability of VMMC for long term reduction of HIV incidence. Evaluations of specialized devices for EIMC are important to provide programs with information required to make informed decisions about how to design safe, effective EIMC programs...
2017: PloS One
https://www.readbyqxmd.com/read/28195897/base-of-skull-blocks-for-open-reduction-and-internal-fixation-of-faciomaxillary-fractures
#9
Sandeep Mehrotra, Sunil Anand
INTRODUCTION: Faciomaxillary fractures (FMF) occur in a significant proportion of trauma patients. Nearly all polytrauma patients and even those with isolated FMF are managed under general anesthesia for definitive management. We propose the use of regional nerve blocks as a safe and effective means for open reduction and fixation of isolated FMF. AIM AND OBJECTIVES: The aim is to evaluate the feasibility, effectiveness and safety of base of skull maxillomandibular and distal trigeminal nerve blocks in the management of FMF...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28191497/carbon-dioxide-versus-room-air-insufflation-during-balloon-assisted-enteroscopy-a-systematic-review-with-meta-analysis
#10
Ashok Shiani, Seth Lipka, Andrew Lai, Andrea C Rodriguez, Christian M Andrade, Ambuj Kumar, Patrick Brady
Background and study aims Carbon dioxide (CO2) insufflation has been suggested to be an ideal alternative to room air insufflation to reduce trapped air within the bowel lumen after balloon assisted enteroscopy (BAE). We performed a systematic review and meta-analysis to assess the safety and efficacy of utilizing CO2 insufflation as compared to room air during BAE. Patients and methods The primary outcome is mean change in visual analog scale (VAS; 10 cm) at 1, 3, and 6 hours to assess pain. Secondary outcomes include insertion depth (anterograde or retrograde), adverse events, total enteroscopy rate, diagnostic yield, mean anesthetic dosage, and PaCO2 at procedure completion...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28190371/occupational-radiation-exposure-of-anesthesia-providers
#11
Rachel R Wang, Amanda H Kumar, Pedro Tanaka, Alex Macario
Anesthesia providers are frequently exposed to radiation during routine patient care in the operating room and remote anesthetizing locations. Eighty-two percent of anesthesiology residents (n = 57 responders) at our institution had a "high" or "very high" concern about the level of ionizing radiation exposure, and 94% indicated interest in educational materials about radiation safety. This article highlights key learning points related to basic physical principles, effects of ionizing radiation, radiation exposure measurement, occupational dose limits, considerations during pregnancy, sources of exposure, factors affecting occupational exposure such as positioning and shielding, and monitoring...
February 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28186470/image-guidance-based-on-mri-for-spinal-interstitial-laser-thermotherapy-technical-aspects-and-accuracy
#12
Claudio E Tatsui, Clarissa N G Nascimento, Dima Suki, Behrang Amini, Jing Li, Amol J Ghia, Jonathan G Thomas, R Jason Stafford, Laurence D Rhines, Juan P Cata, Ashok J Kumar, Ganesh Rao
OBJECTIVE Image guidance for spinal procedures is based on 3D-fluoroscopy or CT, which provide poor visualization of soft tissues, including the spinal cord. To overcome this limitation, the authors developed a method to register intraoperative MRI (iMRI) of the spine into a neuronavigation system, allowing excellent visualization of the spinal cord. This novel technique improved the accuracy in the deployment of laser interstitial thermal therapy probes for the treatment of metastatic spinal cord compression...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28185643/oral-triiodothyronine-for-infants-and-children-undergoing-cardiopulmonary-bypass
#13
Eva M Marwali, Cindy E Boom, Novik Budiwardhana, Dicky Fakhri, Poppy S Roebiono, Anwar Santoso, Sudigdo Sastroasmoro, April Slee, Michael A Portman
BACKGROUND: This study evaluated the efficacy and safety of oral triiodothyronine (T3; Tetronine, Dalim BioTech, Korea) for infants and children undergoing cardiopulmonary bypass in an Indonesian population. METHODS: We performed a single-center, randomized, double-blind, and placebo-controlled trial in children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass. We administered oral T3 (1 μg/kg per body weight/dose) or placebo (saccharum lactis) by nasogastric tube every 6 hours for 60 hours after induction of anesthesia...
February 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28178898/deciphering-sources-of-variability-in-clinical-pathology-it-s-not-just-about-the-numbers
#14
Nancy E Everds
Preanalytical variables can have significant impacts on clinical pathology parameters evaluated during the conduct of a nonclinical safety or toxicity study. These preanalytical variables can be controlled by careful attention to factors such as animal dietary status (diet composition, fasted, and fed state), restraint and anesthesia, intercurrent procedures, timing of clinical pathology collections, and proficiency of animal technicians. The impact of preanalytical variables on test results can be significant enough to result in difficult interpretations and/or regulatory questions or can obfuscate the effects of a test article...
February 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28174658/making-safer-preoperative-arrangements-for-patients-using-vitamin-k-antagonists
#15
Joris van Fessem, Jessica Willems, Marieke Kruip, Sanne Hoeks, Robert Jan Stolker
Use of vitamin K antagonists creates a risk for patient health and safety. The Dutch framework "Nationwide Standard Integrated Care of Anticoagulation" propagates a shared plan and responsibility by surgeon and anesthesiologist together in the preoperative setting. In our institution, this framework had not been implemented. Therefore, a quality-improvement project was started at the Anesthesia Department to improve perioperative safety. After exploration of barriers, multiple interventions were carried out to encourage co-workers at the preoperative screening department to take shared responsibility: distribution of prints, adjustments in electronic patient records, introduction of a protocol and education sessions...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#16
REVIEW
Sasima Dusitkasem, Blair H Herndon, Monsicha Somjit, David L Stahl, Emily Bitticker, John C Coffman
PURPOSE: To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. SOURCE: An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28162930/a-randomized-study-of-autologous-bone-marrow-derived-stem-cells-in-pediatric-cardiomyopathy
#17
E Sian Pincott, Deborah Ridout, Margaret Brocklesby, Angus McEwan, Vivek Muthurangu, Michael Burch
BACKGROUND: Bone marrow mononuclear cell fraction has been used as therapy for dilated cardiomyopathy in adults. Although case series are reported, there are no randomized controlled studies in children. METHODS: We designed a randomized, crossover, controlled pilot study to determine safety and feasibility of intracoronary stem cell therapy in children. The primary safety end-point was freedom from death and transplantation or any complication that could be considered related to bone marrow injection or anesthesia (e...
January 5, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28161928/two-port-pars-plana-anterior-and-central-core-vitrectomy-lam-floaterectomy-in-combination-with-phacoemulsification-and-intraocular-lens-implantation-under-topical-anesthesia-for-patients-with-cataract-and-significant-floaters-results-of-the-first-50-consecutive
#18
Dennis S C Lam, Hiu Ying Leung, Shu Liu, Nishant Radke, Ye Yuan, Vincent Y W Lee
PURPOSE: To study the safety and efficacy of 2-port pars plana anterior and central core vitrectomy (Lam floaterectomy) in combination with phacoemulsification (phaco) and intraocular lens implantation (IOL) for patients with cataract and significant floaters under topical anesthesia. DESIGN: Retrospective review of the first 50 consecutive cases. METHODS: Astandardized treatment protocol was used for patients with cataract and significant (moderate to severe) floaters (duration > 3 months)...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28160986/beat-to-beat-a-measured-look-at-the-history-of-pulse-oximetry
#19
REVIEW
Antoinette Van Meter, Uduak Williams, Acsa Zavala, Joshua Kee, Elizabeth Rebello, January Tsai, Ifeyinwa Ifeanyi, Joseph Ruiz, Jeffery Lim, Pascal Owusu-Agyemang
It can be argued that pulse oximetry is the most important technological advancement ever made in monitoring the well-being and safety of patients undergoing anesthesia. Before its development, the physical appearance of the patient and blood gas analysis were the only methods of assessing hypoxemia in patients. The disadvantages of blood gas analysis are that it is not without pain, complications, and most importantly does not provide continuous, real-time data. Although it has become de rigueur to use pulse oximetry for every anesthetic, the road leading to pulse oximetry began long ago...
January 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/28158162/potential-beneficial-effects-of-probiotics-on-human-migraine-headache-a-literature-review
#20
Yu-Jie Dai, Hai-Yan Wang, Xi-Jian Wang, Alan D Kaye, Yong-Hai Sun
BACKGROUND: Recent studies have shown that migraine headache is often associated with concomitant gastrointestinal diseases. There is a higher prevalence of headaches in patients with gastrointestinal disorders. These associations between migraine and gastrointestinal disorders suggest a potential link to a bidirectional modulation of gut microbiota and brain function. The underlying working mechanistic links between migraine and gastrointestinal diseases may include increased intestinal epithelial permeability and inflammation...
February 2017: Pain Physician
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