keyword
https://read.qxmd.com/read/38524021/intraoperative-acute-cardiac-tamponade-as-a-result-of-intracardiac-perforation-requiring-emergency-continuous-pericardiocentesis-and-open-sternotomy-a-case-report-and-literature-review-of-a-rare-but-fatal-complication
#1
Christopher M Russo, Mitchell E Harrison, Nathaniel M Harry, John R Benjamin, Christian Popa
Intraoperative acute cardiac tamponade associated with iatrogenic intracardiac perforation from percutaneous interventional cardiac procedures is a rare but potentially catastrophic complication. We report a case of intraoperative acute hemopericardium caused by a left atrial (LA) perforation resulting in cardiac tamponade in a patient undergoing a baffling procedure for the correction of two anomalous pulmonary veins draining into her superior vena cava (SVC) that required continuous pericardiocentesis with autologous blood transfusion via the femoral vein and an emergency intraoperative transfer from the interventional cardiology cath lab to the cardiac operating room for an open sternotomy and primary repair...
February 2024: Curēus
https://read.qxmd.com/read/38512360/non-invasive-technology-for-brain-monitoring-definition-and-meaning-of-the-principal-parameters-for-the-international-practice-on-technology-neuro-monitoring-group-i-protect
#2
REVIEW
Stefano Romagnoli, Francisco A Lobo, Edoardo Picetti, Frank A Rasulo, Chiara Robba, Basil Matta
Technologies for monitoring organ function are rapidly advancing, aiding physicians in the care of patients in both operating rooms (ORs) and intensive care units (ICUs). Some of these emerging, minimally or non-invasive technologies focus on monitoring brain function and ensuring the integrity of its physiology. Generally, the central nervous system is the least monitored system compared to others, such as the respiratory, cardiovascular, and renal systems, even though it is a primary target in most therapeutic strategies...
March 21, 2024: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/38459889/cold-induced-anaphylaxis-triggered-by-drinking-cold-water
#3
Abdulaziz S Alrafiaah, Elena Netchiporouk, Moshe Ben-Shoshan
Cold urticaria is an inducible urticaria in which hives and angioedema appear after exposure to cold. The symptoms of cold urticaria often are limited to hives/angioedema. However, in up to 20% of cases, cold exposure may trigger anaphylaxis. We report the case of an 11-year-old boy previously diagnosed with chronic spontaneous urticaria who developed facial swelling, itchy hives, difficulty in breathing, vomiting and abdominal pain within 5 minutes of drinking cold water. He received a standard dose of non-sedating second-generation antihistamines at home...
2024: Allergologia et Immunopathologia
https://read.qxmd.com/read/38451341/electroencephalographic-guided-propofol-remifentanil-tci-anesthesia-with-and-without-dexmedetomidine-in-a-geriatric-population-electroencephalographic-signatures-and-clinical-evaluation
#4
JOURNAL ARTICLE
Dominik M Mehler, Matthias Kreuzer, David P Obert, Luis F Cardenas, Ignacio Barra, Fernando Zurita, Francisco A Lobo, Stephan Kratzer, Gerhard Schneider, Pablo O Sepúlveda
Elderly and multimorbid patients are at high risk for developing unfavorable postoperative neurocognitive outcomes; however, well-adjusted and EEG-guided anesthesia may help titrate anesthesia and improve postoperative outcomes. Over the last decade, dexmedetomidine has been increasingly used as an adjunct in the perioperative setting. Its synergistic effect with propofol decreases the dose of propofol needed to induce and maintain general anesthesia. In this pilot study, we evaluate two highly standardized anesthetic regimens for their potential to prevent burst suppression and postoperative neurocognitive dysfunction in a high-risk population...
March 7, 2024: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/38422091/live-music-in-the-intensive-care-unit-a-beautiful-experience
#5
JOURNAL ARTICLE
Pia Dreyer, Linette Thorn, Trine Højfeldt Lund, Margrethe Langer Bro
BACKGROUND: The growing number of lightly or non-sedated patients who are critically ill means that more patients experience the noisy and stressful environment. Live music may create positive and meaningful moments. PURPOSE: To explore non-sedated patients' experiences of patient-tailored live music interventions in the intensive care unit. DESIGN: A qualitative study using a phenomenological-hermeneutic approach. Data were collected at two intensive care units from September 2019 to February 2020 exploring 18 live music interventions performed by music students from The Royal Academy of Music, Aarhus, Denmark...
December 2024: International Journal of Qualitative Studies on Health and Well-being
https://read.qxmd.com/read/38406128/pure-open-ankle-dislocation-leading-to-isolated-lateral-ligament-complex-tear-a-rare-case
#6
Taha El Aissaoui, Aboubacar Lawan, Adnane Lachkar, Najib Abdeljaouad, Hicham Yacoubi
Pure open ankle dislocation is a rare orthopedic emergency characterized by the absence of associated bony lesions, necessitating prompt and immediate management to prevent disastrous complications. This article details a distinctive case of open pure ankle dislocation in an 18-year-old female following a motorcycle accident, resulting in a 6-cm wound and a dislocated left ankle with a concurrent tear of the anterior talofibular ligament and calcaneofibular ligament. Immediate reduction under sedation was performed, followed by intensive debridement and ligament repair in the operating room...
January 2024: Curēus
https://read.qxmd.com/read/38373992/overview-of-best-practices-for-buprenorphine-initiation-in-the-emergency-department
#7
JOURNAL ARTICLE
Terence Hughes, Nicholas Nasser, Avir Mitra
In recent decades, opioid overdoses have increased dramatically in the United States and peer countries. Given this, emergency medicine physicians have become adept in reversing and managing complications of acute overdose. However, many remain unfamiliar with initiating medication for opioid use disorder such as buprenorphine, a high-affinity partial opioid agonist. Emergency department-based buprenorphine initiation is supported by a significant body of literature demonstrating a marked reduction in mortality in addition to increased engagement in care...
February 19, 2024: International Journal of Emergency Medicine
https://read.qxmd.com/read/38270173/inappropriate-pediatric-orthopaedic-emergency-department-transfers-a-burden-on-the-health-care-system
#8
JOURNAL ARTICLE
Lisa A Cao, Brandon Hull, Marilyn Elliott, Kevin J Orellana, Benjamin Schell, Anthony I Riccio
BACKGROUND: Though the importance of level 1 pediatric trauma has repeatedly been shown to lessen both morbidity and mortality in critically injured children, these same tertiary referral centers also receive numerous transfers of patients with less severe injuries. This not only leads to increased costs and use of limited facility resources but, oftentimes, frustration and unnecessary expense to those families for whom transfer was avoidable. Prior work has demonstrated that half of all inappropriate pediatric interfacility transfers are due to orthopedic injuries...
January 25, 2024: Journal of Pediatric Orthopedics
https://read.qxmd.com/read/38205822/comparison-of-recovery-profiles-between-total-intravenous-anaesthesia-with-propofol-or-remimazolam-reversed-with-flumazenil-in-patients-undergoing-breast-surgery-a-randomised-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Jaemoon Lee, Dong Hyouk Kim, Jae-Woo Ju, Karam Nam, Youn Joung Cho, Yunseok Jeon, Seohee Lee
BACKGROUND: Remimazolam, a short acting benzodiazepine, is being used for general anaesthesia. The results of studies comparing recovery after propofol with that of remimazolam are inconsistent. Given that flumazenil reverses the sedative effects of remimazolam, we hypothesised that it would speed up recovery from remimazolam general anaesthesia. OBJECTIVES: The aim of this trial was to compare the speed of recovery from general anaesthesia between propofol and remimazolam reversed with flumazenil in patients undergoing minimally invasive breast surgery...
March 1, 2024: European Journal of Anaesthesiology
https://read.qxmd.com/read/38202213/a-near-fatal-encounter-with-acute-suicidal-behavior-in-anti-n-methyl-d-aspartate-autoimmune-encephalitis
#10
Eunmi Lee, Minjee Kim, Kyu-Hyouck Kyoung, Jin Yong Jun
Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) is a complex neuropsychiatric syndrome known for its diverse neurological manifestations, often involving psychiatric symptoms and seizures that elevate the risk of suicidal ideation and behavior. We present a case illustrating the potentially lethal nature of anti-NMDARE, wherein an unexpected suicide attempt occurred 10 days after the onset of seizures in a 21-year-old man. Upon arrival at the emergency room, immediate interventions addressed hypovolemic shock, followed by subsequent neurosurgical and orthopedic procedures...
December 29, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/38112493/modification-in-icu-design-may-affect-delirium-and-circadian-melatonin-a-proof-of-concept-pilot-study
#11
JOURNAL ARTICLE
Claudia Spies, Helmut Piazena, Maria Deja, Klaus-Dieter Wernecke, Thomas Willemeit, Alawi Luetz
OBJECTIVES: Nonpharmacologic delirium management is recommended by current guidelines, but studies on the impact of ICU design are still limited. The study's primary purpose was to determine if a multicomponent change in room design prevents ICU delirium. Second, the influence of lighting conditions on serum melatonin was assessed. DESIGN: Prospective observational cohort pilot study. SETTING: The new design concept was established in two two-bed ICU rooms of a university hospital...
December 19, 2023: Critical Care Medicine
https://read.qxmd.com/read/38071937/retrospective-comparison-between-mri-examinations-during-radiographer-administered-intranasal-sedation-or-general-anesthesia
#12
JOURNAL ARTICLE
I Håkansson, B-M Ahlander, A Höök, J Kihlberg
INTRODUCTION: In order for young children to be able to undergo a Magnetic Resonance Imaging (MRI) examination, general anesthesia is often required. The aim of this study was to compare the image quality, times, and costs of the examinations of infant brains performed with MRI either during sedation with dexmedetomidine administered by radiographers or anesthesia with propofol administered by anesthesia staff. METHODS: This study was a quantitative retrospective study of 27 consecutive standard brain examinations performed under sedation or anesthesia, involving 15 children under sedation and 12 under anesthesia...
December 9, 2023: Radiography
https://read.qxmd.com/read/38048550/combination-of-intranasal-dexmedetomidine-and-midazolam-for-sedation-in-pediatric-magnetic-resonance-imaging-a-retrospective-observational-study
#13
JOURNAL ARTICLE
Salvatore Palmese, Giancarlo Bilancio, Vittorio Caterino, Anna Giulia De Anseris, Stanislao Perciato, Antonio Siglioccolo, Renato Gammaldi
BACKGROUND: Intranasal dexmedetomidine associated with midazolam has been used for pediatric magnetic resonance imaging studies because immobility is a fundamental requirement for correct execution. Many studies have shown dexmedetomidine to be a good option for non-operating room sedation. However, identifying the optimal dose remains a key challenge, especially for pediatric patients. METHODS: All medical records of 139 pediatric patients who underwent sedation for magnetic resonance imaging studies between September 2021 and November 2022 at the University Hospital of Salerno, Italy, were retrospectively reviewed about success rate and adverse events...
December 4, 2023: Pediatric Emergency Care
https://read.qxmd.com/read/38025146/an-unusual-case-of-delayed-midazolam-anaphylaxis-and-a-review-of-the-current-literature
#14
JOURNAL ARTICLE
Nicholas C Cochran-Caggiano, Deborah Mann, Peter J Aiello
Midazolam is a commonly used, well-tolerated, anxiolytic, sedative, anesthesia induction agent, and an adjunct for procedural sedation that is used widely in the emergency department. The ability to administer midazolam via multiple routes, including intranasal, makes it a particularly common choice for use in children. Intranasal administration is safe, easy, and well tolerated and has been shown to be an effective method of obtaining anxiolysis and/or sedation. Adverse drug reactions, including allergic reactions, can occur with any medication...
2023: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://read.qxmd.com/read/38024006/the-role-of-dexmedetomidine-in-airway-management-for-tracheostomy-in-pediatric-patient-with-obstructed-airway-due-to-diphtheria-a-case-report
#15
Andy Omega, Faradila Ramadian, Putri Nurra Kusumawardhany Hakim
INTRODUCTION: Diphtheria is an infectious disease caused by exotoxin-producing Corynebacterium diphteriae and was a leading cause of death in childhood during the prevaccine era. This toxin is usually localized in the upper respiratory tract and may cause fatal airway obstruction. Many have used orotracheal intubation to secure the airway in diphtheria cases. However, the efficacy of tracheostomy under sedation while maintaining spontaneous ventilation and analgesia using trans-tracheal and superficial cervical block remains to be elucidated...
August 2023: Anesthesiology and Pain Medicine
https://read.qxmd.com/read/38001507/awareness-with-paralysis-and-symptoms-of-post-traumatic-stress-disorder-among-mechanically-ventilated-emergency-department-survivors-ed-awareness-2-trial-study-protocol-for-a-pragmatic-multicenter-stepped-wedge-cluster-randomized-trial
#16
JOURNAL ARTICLE
Brian M Fuller, Brian E Driver, Michael B Roberts, Christa A Schorr, Kathryn Thompson, Brett Faine, Julianne Yeary, Nicholas M Mohr, Ryan D Pappal, Robert J Stephens, Yan Yan, Nicholas J Johnson, Brian W Roberts
BACKGROUND: Awareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1-0.2%. By contrast, AWP in mechanically ventilated emergency department (ED) patients is common, with estimated prevalence of 3.3-7.4% among survivors given NMB. Longer-acting NMB use is a critical risk for AWP, and we have shown an association between ED rocuronium use and increased AWP prevalence...
November 25, 2023: Trials
https://read.qxmd.com/read/37888047/the-current-situation-of-anaesthesia-for-hysteroscopy-in-mainland-china-a-national-survey
#17
JOURNAL ARTICLE
Lili Huang, Qing Yu, Ziyu Zhu, Ping Huang, Xibing Ding, Xiaowen Ma, Yuwen Chen, Diansan Su
Purpose: The need for anaesthesia or analgesia for performing hysteroscopy remains debatable. This study aimed to conduct an overview of the situation of anaesthesia for hysteroscopy in mainland China. Methods: Two questionnaires were separately designed for anaesthesiologists and gynaecologists and distributed to every medical institution that performed hysteroscopic procedures on patients with infertility in mainland China. Electronic questionnaires were distributed via WeChat, and data on anaesthesia regimen, monitoring parameters, procedure number, and other information were collected...
September 26, 2023: Journal of Personalized Medicine
https://read.qxmd.com/read/37873715/-effect-of-improved-nursing-strategy-on-prognosis-of-older-immunosuppressed-patients-with-pneumonia-and-sepsis
#18
JOURNAL ARTICLE
Wen Han, Hongbo Luo, Jiahui Zhang, Wei Cheng, Dongkai Li, Mingxi Zhao, Na Cui, Huadong Zhu
OBJECTIVE: To investigate the effect of improved nursing strategy on prognosis of older immunosuppressed patients with pneumonia and sepsis. METHODS: A prospective study was conducted. The older immunosuppressed patients with pneumonia and sepsis admitted to the department of intensive care medicine and emergency intensive care unit (ICU) of Peking Union Medical College Hospital from January 2017 to July 2022 were enrolled. In the first stage (from January 2017 to December 2019), patients received the original nursing strategy (original nursing strategy group), including: (1) nurses were randomly assigned; (2) routine terminal cleaning; (3) ICU environmental cleaning twice a day; (4) oral care was performed with chlorhexidine twice a day; (5) original lung physiotherapy [head of bed elevated at 30 degree angle-45 degree angle, maintaining a Richmond agitation-sedation scale (RASS) -2 to 1, sputum aspiration as needed]...
October 2023: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/37816587/british-society-of-gastroenterology-guidelines-on-sedation-in-gastrointestinal-endoscopy
#19
JOURNAL ARTICLE
Reena Sidhu, David Turnbull, Hasan Haboubi, John S Leeds, Chris Healey, Srisha Hebbar, Paul Collins, Wendy Jones, Mohammad Farhad Peerally, Sara Brogden, Laura J Neilson, Manu Nayar, Jacqui Gath, Graham Foulkes, Nigel J Trudgill, Ian Penman
Over 2.5 million gastrointestinal endoscopic procedures are carried out in the United Kingdom (UK) every year. Procedures are carried out with local anaesthetic r with sedation. Sedation is commonly used for gastrointestinal endoscopy, but the type and amount of sedation administered is influenced by the complexity and nature of the procedure and patient factors. The elective and emergency nature of endoscopy procedures and local resources also have a significant impact on the delivery of sedation. In the UK, the vast majority of sedated procedures are carried out using benzodiazepines, with or without opiates, whereas deeper sedation using propofol or general anaesthetic requires the involvement of an anaesthetic team...
January 5, 2024: Gut
https://read.qxmd.com/read/37758452/dissociative-seizures-in-the-emergency-room-room-for-improvement
#20
JOURNAL ARTICLE
Ozan Cengiz, Johannes Jungilligens, Rosa Michaelis, Jörg Wellmer, Stoyan Popkirov
BACKGROUND: Dissociative seizures, also known as functional or psychogenic non-epileptic seizures, account for 11%-27% of all emergency seizure presentations. Misdiagnosis as epileptic seizures is common and leads to ineffective and potentially harmful treatment escalations. We assess the potential for diagnostic improvement at different stages of emergency workup and estimate the utility of benzodiazepines. METHODS: A retrospective study of all emergency presentations with a discharge diagnosis of acute dissociative seizures seen at a university hospital 2010-2022 was performed to assess clinical characteristics and emergency decision-making...
September 27, 2023: Journal of Neurology, Neurosurgery, and Psychiatry
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