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Anestesiología

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47 papers 0 to 25 followers
https://www.readbyqxmd.com/read/28601274/rocuronium-should-be-the-default-paralytic-in-rapid-sequence-intubation
#1
Anand K Swaminathan, Haney Mallemat
No abstract text is available yet for this article.
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26809929/ketamine-propofol-combination-ketofol-vs-propofol-for-procedural-sedation-and-analgesia-systematic-review-and-meta-analysis
#2
REVIEW
Mohammad Jalili, Maryam Bahreini, Amin Doosti-Irani, Rasoul Masoomi, Mona Arbab, Hadi Mirfazaelian
OBJECTIVE: This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA). METHODS: Medline, EMBASE, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trial. The administration complications were the key outcomes of interest. RESULT: Eighteen clinical trials that met our criteria were included in the analysis...
March 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26899459/ketamine-as-rescue-treatment-for-difficult-to-sedate-severe-acute%C3%A2-behavioral-disturbance-in-the-emergency-department
#3
Geoffrey Kennedy Isbister, Leonie A Calver, Michael A Downes, Colin B Page
STUDY OBJECTIVE: We investigate the effectiveness and safety of ketamine to sedate patients with severe acute behavioral disturbance who have failed previous attempts at sedation. METHODS: This was a prospective study of patients given ketamine for sedation who had failed previous sedation attempts. Patients with severe acute behavioral disturbance requiring parenteral sedation were treated with a standardized sedation protocol including droperidol. Demographics, drug dose, observations, and adverse effects were recorded...
May 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26911672/delayed-sequence-intubation-is-it-ready-for-prime-time
#4
John A Taylor, Corinne Michele Hohl
Clinical question Does delayed sequence intubation (DSI) improve preoxygenation and safety when intubating otherwise uncooperative patients? Article chosen Weingart SD, Trueger S, Wong N, et al. Delayed sequence intubation: a prospective observational study. Ann Emerg Med 2015;65(4):349-55. doi:10.1016/j.annemergmed.2014.09.025 OBJECTIVE: To investigate whether the administration of ketamine 3 minutes prior to the administration of a muscle relaxant allows for optimal preoxygenation in uncooperative patients undergoing intubation...
January 2017: CJEM
https://www.readbyqxmd.com/read/27707527/chemical-agents-for-the-sedation-of-agitated-patients-in-the-ed-a-systematic-review
#5
REVIEW
Viola Korczak, Adrienne Kirby, Naren Gunja
OBJECTIVE: Chemical agents commonly used to sedate agitated patients in the emergency department include benzodiazepines, antipsychotics, or a combination of the 2 classes. Our objective was to determine if a class or combination therapy is (1) more effective, as measured by the proportion sedated at 15-20 minutes and the need for repeat sedation, and (2) safer, as measured by the proportion of reported adverse events. METHODS: Systematic literature review and meta-analysis of studies comparing 2 or more chemical agents for sedation of agitated patients in the emergency department were carried out in PubMed, PsycINFO, Embase, and the Cochrane database...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27864394/bet-2-low-dose-ketamine-for-acute-pain-in-the-ed
#6
REVIEW
Colby Duncan, Brad Riley
A short cut review was carried out to establish whether low-dose ketamine is better than morphine at safely and effectively reducing pain scores in ED patients with acute pain who do not respond to conventional therapies. One hundred and thirty-two papers were found using the reported searches, of these three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated...
December 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/19825491/fat-embolism
#7
REVIEW
Shamsuddin Akhtar
Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. The pathologic consequences of fat embolism are well recognized. Fat embolism is most often associated with trauma and orthopedic injuries. Fat embolism syndrome (FES) is a serious manifestation of fat embolism that involves a cascade of clinical signs such as petechial rash, deteriorating mental status, and progressive respiratory insufficiency, usually occurring within 24 hours of injury...
September 2009: Anesthesiology Clinics
https://www.readbyqxmd.com/read/11167474/fat-embolism
#8
REVIEW
A Mellor, N Soni
Fat embolism syndrome is a collection of respiratory, haematological, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of the clinical syndrome is low (< 1% in retrospective reviews) whilst the embolisation of marrow fat appears to be an almost inevitable consequence of long bone fractures. There is debate over the pathogenesis of fat embolism syndrome and it seems a variety of factors interact to produce a spectrum of end organ damage...
February 2001: Anaesthesia
https://www.readbyqxmd.com/read/8908217/thromboprophylaxis-coagulation-disorders-and-regional-anaesthesia
#9
REVIEW
H Haljamäe
The surgery and trauma-induced modulation of the coagulation system includes a considerable risk of perioperative thromboembolic complications unless effective thromboprophylactic treatment is given. In the present survey the patient at risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) is characterized and the documented efficacy of different currently used thromboprophylactic regimens is summarized. Systemic thromboprophylactic treatment may include a risk of an increased bleeding tendency which may lead to haemorrhagic complications...
September 1996: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/20007735/multidisciplinary-approach-to-the-challenge-of-hemostasis
#10
REVIEW
Jerrold H Levy, Richard P Dutton, J Claude Hemphill, Aryeh Shander, David Cooper, Michael J Paidas, Craig M Kessler, John B Holcomb, Jeffrey H Lawson
A multidisciplinary panel consisting of experts chosen by the 2 chairs of the group representing experts in anesthesiology, blood banking, hematology, critical care medicine, and various surgical disciplines (trauma, cardiac, pediatric, neurologic, obstetrics, and vascular) convened in January 2008 to discuss hemostasis and management of the bleeding patient across different clinical settings, with a focus on perioperative considerations. Although there are many ways to define hemostasis, one clinical definition would be control of bleeding without the occurrence of pathologic thrombotic events (i...
February 1, 2010: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28493642/adverse-events-with-ketamine-versus-ketofol-for-procedural-sedation-on-adults-a-double-blinded-randomized-controlled-trial
#11
Fabien Lemoel, Julie Contenti, Didier Giolito, Mathieu Boiffier, Jocelyn Rapp, Jacques Istria, Marc Fournier, François-Xavier Ageron, Jacques Levraut
OBJECTIVES: The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol"). METHODS: We performed a multicentric, randomized, double-blinded trial in which adult patients received emergency procedural sedations with ketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Other outcomes were frequency of interventions required by these recovery reactions, rates of respiratory or hemodynamic events, emesis, and satisfaction of patients as well as providers...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28487139/a-multicenter-randomized-trial-of-ramped-position-versus-sniffing-position-during-endotracheal-intubation-of-critically-ill-adults
#12
Matthew W Semler, David R Janz, Derek W Russell, Jonathan D Casey, Robert J Lentz, Aline N Zouk, Bennett P deBoisblanc, Jairo I Santanilla, Yasin A Khan, Aaron M Joffe, William S Stigler, Todd W Rice
BACKGROUND: Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. METHODS: Multicenter, randomized trial comparing ramped position (head of the bed elevated to 25 degrees) to sniffing position (torso supine, neck flexed, head extended) among 260 adults undergoing endotracheal intubation by Pulmonary and Critical Care Medicine fellows in four intensive care units between July 22, 2015 and July 19, 2016...
May 6, 2017: Chest
https://www.readbyqxmd.com/read/28302612/difficult-lumbar-puncture-pitfalls-and-tips-from-the-trenches
#13
REVIEW
P A Hudgins, A J Fountain, P R Chapman, L M Shah
Lumbar puncture has, for many years, been the responsibility of the internal medicine physician or the neurologist. As more patients have undergone spine surgery and with the current increase in body mass index of the general population, the radiologist has been consulted with increasing frequency to perform lumbar puncture with fluoroscopic guidance. Radiology, in fact, is now the dominant overall provider of lumbar puncture procedures. The procedure is more difficult when the needle length increases, and if fluoroscopy is used, landmarks are more difficult to visualize with increasing subcutaneous fat...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28412161/the-effect-of-the-apneic-period-on-the-respiratory-physiology-of-patients-undergoing-intubation-in-the-emergency-department
#14
Jason R West, Anthony Scoccimarro, Cody Kramer, Nicholas D Caputo
OBJECTIVES: We sought to examine the physiological impact the apneic period has on the respiratory physiology of patients undergoing intubation in the emergency department and whether DAO, the delivery of 15L oxygen by nasal cannula during apnea, can affect the development of respiratory acidosis. METHODS: This was a prospective observational cohort study conducted at an urban academic level 1 trauma center. A convenience sample of 100 patients was taken. Timed data collection forms were completed during the periintubation period...
April 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26705351/difficult-airway-society-2015-guidelines-for-the-management-of-unanticipated-difficult-intubation-in-adults-not-just-another-algorithm
#15
C A Hagberg, R T Connis
No abstract text is available yet for this article.
February 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/23302983/review-article-extubation-of-the-difficult-airway-and-extubation-failure
#16
REVIEW
Laura F Cavallone, Andrea Vannucci
Respiratory complications after tracheal extubation are associated with significant morbidity and mortality, suggesting that process improvements in this clinical area are needed. The decreased rate of respiratory adverse events occurring during tracheal intubation since the implementation of guidelines for difficult airway management supports the value of education and guidelines in advancing clinical practice. Accurate use of terms in defining concepts and describing distinct clinical conditions is paramount to facilitating understanding and fostering education in the treatment of tracheal extubation-related complications...
February 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/23364566/practice-guidelines-for-management-of-the-difficult-airway-an-updated-report-by-the-american-society-of-anesthesiologists-task-force-on-management-of-the-difficult-airway
#17
Jeffrey L Apfelbaum, Carin A Hagberg, Robert A Caplan, Casey D Blitt, Richard T Connis, David G Nickinovich, Carin A Hagberg, Robert A Caplan, Jonathan L Benumof, Frederic A Berry, Casey D Blitt, Robert H Bode, Frederick W Cheney, Richard T Connis, Orin F Guidry, David G Nickinovich, Andranik Ovassapian
No abstract text is available yet for this article.
February 2013: Anesthesiology
https://www.readbyqxmd.com/read/26449292/obstetric-anaesthetists-association-and-difficult-airway-society-guidelines-for-the-management-of-difficult-and-failed-tracheal-intubation-in-obstetrics
#18
M C Mushambi, S M Kinsella, M Popat, H Swales, K K Ramaswamy, A L Winton, A C Quinn
The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered...
November 2015: Anaesthesia
https://www.readbyqxmd.com/read/22321104/difficult-airway-society-guidelines-for-the-management-of-tracheal-extubation
#19
M Popat, V Mitchell, R Dravid, A Patel, C Swampillai, A Higgs
Tracheal extubation is a high-risk phase of anaesthesia. The majority of problems that occur during extubation and emergence are of a minor nature, but a small and significant number may result in injury or death. The need for a strategy incorporating extubation is mentioned in several international airway management guidelines, but the subject is not discussed in detail, and the emphasis has been on extubation of the patient with a difficult airway. The Difficult Airway Society has developed guidelines for the safe management of tracheal extubation in adult peri-operative practice...
March 2012: Anaesthesia
https://www.readbyqxmd.com/read/25998999/is-there-a-gold-standard-for-management-of-the-difficult-airway
#20
REVIEW
Carlos A Artime, Carin A Hagberg
Numerous practice guidelines have been developed to assist clinicians in the management of the difficult airway. The nature of difficult airway management, however, does not provide a practical way of comparing different guidelines or algorithms; no evidence supports one set of guidelines over another. Nevertheless they play an important role in patient safety as dissemination of such guidelines encourages airway practitioners to consider their strategies and formulate specific plans for the management of a predicted or unexpected difficult airway...
June 2015: Anesthesiology Clinics
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