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38 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27646054/surgical-intervention-during-a-can-t-intubate-can-t-oxygenate-cico-event-emergency-front-of-neck-airway-fona
#1
J P Pracy, L Brennan, T M Cook, A J Hartle, R J Marks, B A McGrath, A Narula, A Patel
No abstract text is available yet for this article.
September 19, 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26446688/anesthetic-considerations-in-hellp-syndrome
#2
REVIEW
M del-Rio-Vellosillo, J J Garcia-Medina
BACKGROUND: HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is an obstetric complication with heterogonous presentation and multisystemic involvement. It is characterized by microangiopathic hemolytic anemia, elevated liver enzymes by intravascular breakdown of fibrin in hepatic sinusoids and reduction of platelet circulation by its increased consumption. METHODS: In terms of these patients' anesthetic management, it is essential to consider some details: (1) effective, safe perioperative management by a multidisciplinary approach, and quick, good communication among clinical specialists to achieve correct patient management; (2) neuroaxial block, particularly spinal anesthesia, is the first choice to do the cesarean if there is only moderate, but not progressive thrombocytopenia; (3) if a general anesthesia is required, it is necessary to control the response to stress produced by intubation, especially in patients with either severe high blood pressure or neurological signs, or to prevent major cerebral complications; (4) invasive techniques, e...
February 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26178308/a-national-common-massive-transfusion-protocol-mtp-is-a-feasible-and-advantageous-option-for-centralized-blood-services-and-hospitals
#3
J Chay, M Koh, H H Tan, J Ng, H J Ng, N Chia, P Kuperan, J Tan, E Lew, L K Tan, P L Koh, K A Desouza, S Bin Mohd Fathil, P M Kyaw, A L Ang
BACKGROUND: A common national MTP was jointly implemented in 2011 by the national blood service (Blood Services Group) and seven participating acute hospitals to provide rapid access to transfusion support for massively haemorrhaging patients treated in all acute care hospitals. METHODS: Through a systematic clinical workflow, blood components are transfused in a ratio of 1:1:1 (pRBC: whole blood-derived platelets: FFP), together with cryoprecipitate for fibrinogen replacement...
January 2016: Vox Sanguinis
https://www.readbyqxmd.com/read/25888032/detection-of-acute-traumatic-coagulopathy-and-massive-transfusion-requirements-by-means-of-rotational-thromboelastometry-an-international-prospective-validation-study
#4
MULTICENTER STUDY
Jostein S Hagemo, Sarah C Christiaans, Simon J Stanworth, Karim Brohi, Pär I Johansson, J Carel Goslings, Paal A Naess, Christine Gaarder
INTRODUCTION: The purpose of this study was to re-evaluate the findings of a smaller cohort study on the functional definition and characteristics of acute traumatic coagulopathy (ATC). We also aimed to identify the threshold values for the most accurate identification of ATC and prediction of massive transfusion (MT) using rotational thromboelastometry (ROTEM) assays. METHODS: In this prospective international multicentre cohort study, adult trauma patients who met the local criteria for full trauma team activation from four major trauma centres were included...
March 23, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27546565/anemia-or-blood-transfusions-there-is-no-winner
#5
Andra E Duncan
No abstract text is available yet for this article.
November 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27503067/palliative-care-and-cardiovascular-disease-and-stroke-a-policy-statement-from-the-american-heart-association-american-stroke-association
#6
Lynne T Braun, Kathleen L Grady, Jean S Kutner, Eric Adler, Nancy Berlinger, Renee Boss, Javed Butler, Susan Enguidanos, Sarah Friebert, Timothy J Gardner, Phil Higgins, Robert Holloway, Madeleine Konig, Diane Meier, Mary Beth Morrissey, Tammie E Quest, Debra L Wiegand, Barbara Coombs-Lee, George Fitchett, Charu Gupta, William H Roach
The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions...
September 13, 2016: Circulation
https://www.readbyqxmd.com/read/27446611/a-clinical-experimental-model-to-evaluate-analgesic-effect-of-remote-ischemic-preconditioning-in-acute-postoperative-pain
#7
Francisco Elano Carvalho Pereira, Irene Lopes Mello, Fernando Heladio de Oliveira Medeiros Pimenta, Debora Maia Costa, Deysi Viviana Tenazoa Wong, Claudia Regina Fernandes, Roberto César Lima Junior, Josenília M Alves Gomes
This study aims to evaluate the viability of a clinical model of remote ischemic preconditioning (RIPC) and its analgesic effects. It is a prospective study with twenty (20) patients randomly divided into two groups: control group and RIPC group. The opioid analgesics consumption in the postoperative period, the presence of secondary mechanical hyperalgesia, the scores of postoperative pain by visual analog scale, and the plasma levels interleukins (IL-6) were evaluated. The tourniquet applying after spinal anesthetic block was safe, producing no pain for all patients in the tourniquet group...
2016: Pain Research and Treatment
https://www.readbyqxmd.com/read/27413479/tapentadol-can-it-kill-two-birds-with-one-stone-without-breaking-windows
#8
REVIEW
Eun Jung Chang, Eun Ji Choi, Kyung Hoon Kim
Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the µ-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys...
July 2016: Korean Journal of Pain
https://www.readbyqxmd.com/read/27397454/anesthetic-challenges-in-minimally-invasive-cardiac-surgery-are-we-moving-in-a-right-direction
#9
REVIEW
Vishwas Malik, Ajay Kumar Jha, Poonam Malhotra Kapoor
Continuously growing patient's demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS). Patient's demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27040102/the-standard-of-care-of-patients-with-ards-ventilatory-settings-and-rescue-therapies-for-refractory-hypoxemia
#10
REVIEW
Thomas Bein, Salvatore Grasso, Onnen Moerer, Michael Quintel, Claude Guerin, Maria Deja, Anita Brondani, Sangeeta Mehta
PURPOSE: Severe ARDS is often associated with refractory hypoxemia, and early identification and treatment of hypoxemia is mandatory. For the management of severe ARDS ventilator settings, positioning therapy, infection control, and supportive measures are essential to improve survival. METHODS AND RESULTS: A precise definition of life-threating hypoxemia is not identified. Typical clinical determinations are: arterial partial pressure of oxygen < 60 mmHg and/or arterial oxygenation < 88 % and/or the ratio of PaO2/FIO2 < 100...
May 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26897642/paravertebral-block-versus-thoracic-epidural-for-patients-undergoing-thoracotomy
#11
REVIEW
Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
February 21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26806145/opioid-switching-in-cancer-pain-from-the-beginning-to-nowadays
#12
REVIEW
Sebastiano Mercadante, Eduardo Bruera
Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations...
March 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/26620145/peri-operative-fluid-management-to-enhance-recovery
#13
REVIEW
R Gupta, T J Gan
'Enhanced recovery after surgery' protocols implement a series of peri-operative interventions intended to improve recovery after major operations, one aspect of which is fluid management. The pre-operative goal is to prepare a hydrated, euvolaemic patient by avoiding routine mechanical bowel preparation and by encouraging patients to drink clear liquids up to two hours before induction of anaesthesia. The intra-operative goal is to achieve a 'zero' fluid balance at the end of uncomplicated surgery: goal-directed fluid therapy is recommended for poorly prepared or sick patients or those undergoing more complex surgery...
January 2016: Anaesthesia
https://www.readbyqxmd.com/read/26390160/massive-transfusion-red-blood-cell-to-plasma-and-platelet-unit-ratios-for-resuscitation-of-massive-hemorrhage
#14
REVIEW
Colin H Murphy, John R Hess
PURPOSE OF REVIEW: The aim of this short study is to review recently published data bearing on how to resuscitate massive uncontrolled hemorrhage. RECENT FINDINGS: New data inform our understanding of the mechanisms of the acute coagulopathy of trauma, the median time to death of trauma patients with uncontrolled hemorrhage, the effects of blood product composition on the coagulation capacity of infused resuscitation mixtures, the outcomes of patients resuscitated according to common massive transfusion protocols in clinical situations associated with massive hemorrhage, and who might benefit from balanced, blood-product-based resuscitation...
November 2015: Current Opinion in Hematology
https://www.readbyqxmd.com/read/26250726/risk-of-acute-kidney-injury-dialysis-and-mortality-in-patients-with-chronic-kidney-disease-after-intravenous-contrast-material-exposure
#15
Jennifer S McDonald, Robert J McDonald, John C Lieske, Rickey E Carter, Richard W Katzberg, Eric E Williamson, David F Kallmes, David E Kallmes
OBJECTIVE: To examine the effect of intravenous iodinated contrast material administration on the subsequent development of acute kidney injury (AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of computed tomographic scan recipients with chronic kidney disease (CKD). PATIENTS AND METHODS: In this institutional review board-approved retrospective study, all patients with CKD who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) computed tomographic scan from January 1, 2000, to August 1, 2013 were identified...
August 2015: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/26107026/analgesic-management-of-acute-pain-in-the-opioid-tolerant-patient
#16
REVIEW
Samir Shah, Shruti Kapoor, Brian Durkin
PURPOSE OF REVIEW: The management of acute pain in the opioid-tolerant patient is an area in perioperative medicine that is growing, as the use of opioids for chronic noncancer pain has been tolerated in the USA. Adding to this population is an increase in opioid abusers, addicts and those in recovery and maintenance programmes. These patients will continue to present for surgery and with acute pain that anaesthesiologists and other members of the healthcare team must become more adept at managing...
August 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25732447/aspiration-related-pulmonary-syndromes
#17
Xiaowen Hu, Joyce S Lee, Paolo T Pianosi, Jay H Ryu
Aspiration of foreign matter into the airways and lungs can cause a wide spectrum of pulmonary disorders with various presentations. The type of syndrome resulting from aspiration depends on the quantity and nature of the aspirated material, the chronicity, and the host responses. Aspiration is most likely to occur in subjects with a decreased level of consciousness, compromised airway defense mechanisms, dysphagia, gastroesophageal reflux, and recurrent vomiting. These aspiration-related syndromes can be categorized into airway disorders, including vocal cord dysfunction, large airway obstruction with a foreign body, bronchiectasis, bronchoconstriction, and diffuse aspiration bronchiolitis, or parenchymal disorders, including aspiration pneumonitis, aspiration pneumonia, and exogenous lipoid pneumonia...
March 2015: Chest
https://www.readbyqxmd.com/read/25665174/antibiotics-just-in-case-in-a-patient-with-aspiration-pneumonitis
#18
Raed A Joundi, Brian M Wong, Jerome A Leis
No abstract text is available yet for this article.
April 2015: JAMA Internal Medicine
https://www.readbyqxmd.com/read/24940115/perioperative-hypoxemia-is-common-with-horizontal-positioning-during-general-anesthesia-and-is-associated-with-major-adverse-outcomes-a-retrospective-study-of-consecutive-patients
#19
C Michael Dunham, Barbara M Hileman, Amy E Hutchinson, Elisha A Chance, Gregory S Huang
BACKGROUND: Reported perioperative pulmonary aspiration (POPA) rates have substantial variation. Perioperative hypoxemia (POH), a manifestation of POPA, has been infrequently studied beyond the PACU, for patients undergoing a diverse array of surgical procedures. METHODS: Consecutive adult patients with ASA I-IV and pre-operative pulmonary stability who underwent a surgical procedure requiring general anesthesia were investigated. Using pulse oximetry, POH was documented in the operating room and during the 48 hours following PACU discharge...
2014: BMC Anesthesiology
https://www.readbyqxmd.com/read/24911122/aspiration-related-lung-diseases
#20
REVIEW
Andrew D Prather, Tristan R Smith, Dana M Poletto, Fabio Tavora, Jonathan H Chung, Leelakrishna Nallamshetty, Todd R Hazelton, Carlos A Rojas
Aspiration is a common but underrecognized clinicopathologic entity, with varied radiographic manifestations. Aspiration represents a spectrum of diseases, including diffuse aspiration bronchiolitis, aspiration pneumonitis, airway obstruction by foreign body, exogenous lipoid pneumonia, interstitial fibrosis, and aspiration pneumonia with or without lung abscess formation. Many patients who aspirate do not present with disease, suggesting that pathophysiology is related to a variety of factors, including decreased levels of consciousness, dysphagia, impaired mucociliary clearance, composition of aspirate, and impaired host defenses...
September 2014: Journal of Thoracic Imaging
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