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https://www.readbyqxmd.com/read/29131005/a-review-of-anesthetic-effects-on-renal-function-potential-organ-protection
#1
Negar Motayagheni, Sheshanna Phan, Crystal Eshraghi, Ala Nozari, Anthony Atala
BACKGROUND: Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#2
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29110788/worldwide-trends-in-heart-and-lung-transplantation-guarding-the-most-precious-gift-ever
#3
REVIEW
Vera von Dossow, Joseph Costa, Frank D'Ovidio, Nandor Marczin
Transplantation is sadly a therapy to die for. The survival of a recipient with end-stage heart or lung disease requires the demise of a human being through brain death or cessation of circulation, with the noblest final act of offering one's organs to another. However, transplantation is constrained by severe hemodynamic, regulatory, inflammatory, and metabolic stresses in the donor, rendering the majority of offered organs unsuitable for transplantation. Coupled with our inability to acquire exact molecular and cellular information and missed opportunities for effectively modulating deteriorations of donors and allografts, anesthesia and critical care contributes to ongoing organ shortages...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29107309/pain-management-in-obstetrics
#4
REVIEW
Jennifer G Hensley, Michelle R Collins, Claire L Leezer
Critical care clinicians may be called on to care for a laboring woman. Comprehension of the anatomic changes associated with pregnancy, and labor and birth, is essential. A working knowledge of the current options for pain management in labor, both pharmacologic and nonpharmacologic, is necessary to facilitate patient-centered care. Pharmacologic options include intravenous or intramuscular agents, inhalational agents, and neuraxial anesthesia. Each modality has contraindications, risks, and benefits that must be considered when choosing the most appropriate method...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29101950/use-of-anesthesiology-services-in-radiology
#5
REVIEW
Hansol Kim, Jason Lane, Rolf Schlichter, Michael S Stecker, Richard Taus
In the setting of technological advancements in imaging and intervention with concomitant rise in the use of non-operating room anesthesia (NORA) care, it has become even more critical for anesthesiologists to be aware of the needs and limitations of interventional procedures performed outside of the operating room. This article addresses the use of NORA services from the interventional radiologist's point of view and provides specific examples of preprocedural, intraprocedural, and postprocedural care patients may need for optimal outcome...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29101946/building-and-maintaining-organizational-infrastructure-to-attain-clinical-excellence
#6
REVIEW
Kelly Lebak, Jason Lane, Richard Taus, Hansol Kim, Michael S Stecker, Michael Hall, Meghan B Lane-Fall, Mark S Weiss
Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non-operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. The training should be supplemented with continuing education in this field for providers who find themselves working in the NORA space. As NORA continues to grow, robust NORA-specific quality assurance and improvement programs will empower anesthesiologists with the tools they need to best care for these patients...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29060849/audible-capnometric-cues-with-end-tidal-carbon-dioxide-improve-the-quality-of-patient-monitoring
#7
Toshiki Aoki, Masayuki Inoue, Kiyoyuki Miyasaka
The importance of capnometry and end-tidal carbon dioxide (ETCO2) has been underscored in recent years by guidelines as a method to continuously monitor adequacy of ventilation during sedation and anesthesia. Guidelines for cardiopulmonary resuscitation (CPR) recommend attempts to improve CPR quality if ETCO2 is lower than 10 mmHg. ETCO2 is thus a time-critical parameter that may benefit from being delivered in real time to health care providers. We performed a pilot study to investigate whether the addition of audible capnometric cues after each breath enhanced providers' ability to maintain appropriate ventilation over conventional capnography...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29053113/an-automated-critical-event-screening-and-notification-system-to-facilitate-preanesthesia-record-review
#8
David B Wax, Patrick J McCormick, Thomas T Joseph, Matthew A Levin
BACKGROUND: Anesthesia information management systems make prior anesthesia records readily available for review when patients return for a subsequent procedure but may create a problem of too much documentation to review in a limited amount of time. We implemented a screening tool to facilitate the identification of critical documentation for review. METHODS: An algorithm was developed to electronically search prior anesthesia records for predefined critical events and flag records containing these events...
June 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#9
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29030027/comparison-of-right-ventricular-measurements-by-perioperative-transesophageal-echocardiography-as-a-predictor-of-hemodynamic-instability-following-cardiac-surgery
#10
Pei-Chi Ting, An-Hsun Chou, Chia-Chih Liao, Victor Chien-Chia Wu, Feng-Chun Tsai, Jaw-Ji Chu, Min-Wen Yang, Shi-Chuan Chang
BACKGROUND: The relationship between perioperative right ventricular (RV) performance and hemodynamic instability after cardiac surgery seemed less portrayed. Therefore, we sought to elucidate this relationship and compare the accuracy of different RV systolic indices in predicting outcome of cardiac surgery. METHODS: This study enrolled consecutive patients referred for cardiac surgeries. Exclusion criteria were non-sinus rhythm or contraindications to transesophageal echocardiography (TEE)...
October 10, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29016368/perioperative-point-of-care-ultrasound-in-ambulatory-anesthesia-thinking-beyond-nerve-blocks
#11
Ranjit Deshpande, Davinder Ramsingh
PURPOSE OF REVIEW: Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. RECENT FINDINGS: Critical care and emergency physicians have embraced ultrasound in their respective fields. We as anesthesiologists and practitioners of acute care medicine are not immune to this penetration. There is been a lot of recent literature on the various uses of perioperative point of care ultrasound...
October 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28958272/inclusion-of-the-acute-care-surgeon-in-the-difficult-airway-protocol-a-nine-year-experience
#12
Seong K Lee, Andrew A Rosenthal, Dafney L Davare, Chauniqua Kiffin, Rafael Sanchez, Michael Hurtado, Eddy H Carrillo
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28957877/heart-rate-variability-implications-for-perioperative-anesthesia-care
#13
Thomas Anthony Anderson
PURPOSE OF REVIEW: Heart rate variability (HRV) is a measure of the balance between both the parasympathetic and sympathetic nervous system and may provide useful information for anesthesia care providers. HRV may offer predictive information about critically ill and operative patients. Further, HRV collection provides real-time information of patient autonomic nervous system status and may allow tailoring of the analgesia for patients in the ICU and operating room. RECENT FINDINGS: Reduced and abnormal resting HRV predict sudden and nonsudden cardiac death...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28956075/-polytrauma-following-a-truck-accident-how-to-save-lives-by-guideline-oriented-emergency-care
#14
M Kippnich, Y Jelting, C Markus, M Kredel, T Wurmb, P Kranke
BACKGROUND: Identification and immediate treatment of life-threatening conditions is fundamental in patients with multiple trauma. In this context, the S3 guidelines on polytrauma and the S1 guidelines on emergency anesthesia provide the scientific background on how to handle these situations. CASE STUDY: This case report deals with a seriously injured driver involved in a truck accident. The inaccessible patient showed a scalping injury of the facial skeleton with massive bleeding and partially blocked airway but with spontaneous breathing as well as centralized cardiovascular circulation conditions and an initial Glasgow coma scale (GCS) of 8...
September 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28953487/spontaneous-respiration-using-intravenous-anesthesia-and-high-flow-nasal-oxygen-strive-hi-management-of-acute-adult-epiglottitis-a-case-report
#15
Phillip Kwan-Giet Lee, Anton Willis Gerard Booth, Kim Vidhani
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to successfully manage acute adult epiglottitis with rapidly progressing airway obstruction. Oxygenation, carbon dioxide levels, and airway patency were maintained, which facilitated endotracheal intubation while the patient was spontaneously breathing during general anesthesia...
September 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28938302/anesthesia-information-management-clinical-decision-support
#16
Robert E Freundlich, Jesse M Ehrenfeld
PURPOSE OF REVIEW: Perioperative informatics tools continue to be developed at a rapid pace and offer clinicians the potential to greatly enhance clinical decision making. The goal of this review is to bring the reader updates on perioperative information management and discuss future research directions in the field. RECENT FINDINGS: Clinical decision support tools become more timely, accurate, and, in some instances, have been shown to improve patient outcomes...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#17
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28922229/micrornas-as-clinical-biomarkers-and-therapeutic-tools-in-perioperative-medicine
#18
Simone Kreth, Max Hübner, Ludwig Christian Hinske
Over the past decade, evolutionarily conserved, noncoding small RNAs-so-called microRNAs (miRNAs)-have emerged as important regulators of virtually all cellular processes. miRNAs influence gene expression by binding to the 3'-untranslated region of protein-coding RNA, leading to its degradation and translational repression. In medicine, miRNAs have been revealed as novel, highly promising biomarkers and as attractive tools and targets for novel therapeutic approaches. miRNAs are currently entering the field of perioperative medicine, and they may open up new perspectives in anesthesia, critical care, and pain medicine...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#19
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28916246/pre-clinical-toxicology-considerations-for-vaccine-development
#20
REVIEW
Nabil Al-Humadi
Vaccine development requires pre-clinical toxicology studies, following good laboratory practice (GLP), before first in human (phase I) use. Many factors are critical in the final outcome of any pre-clinical toxicology study. The study design is one of these critical factors and should be carefully planned to avoid any false negative and/or false positive results. Preparation is another most critical factor in a successful study. Major changes in any procedure during the course of study should be avoided by all means...
September 12, 2017: Vaccine
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