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Free Anaesthesia Papers

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83 papers 100 to 500 followers Only Free Anaesthesia Papers
https://www.readbyqxmd.com/read/26660675/pharmacological-adjuncts-to-stop-bleeding-options-and-effectiveness
#1
M Panteli, I Pountos, P V Giannoudis
Severe trauma and massive haemorrhage represent the leading cause of death and disability in patients under the age of 45 years in the developed world. Even though much advancement has been made in our understanding of the pathophysiology and management of trauma, outcomes from massive haemorrhage remain poor. This can be partially explained by the development of coagulopathy, acidosis and hypothermia, a pathological process collectively known as the "lethal triad" of trauma. A number of pharmacological adjuncts have been utilised to stop bleeding, with a wide variation in the safety and efficacy profiles...
June 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#2
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
November 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27806241/case-23-2016-a-man-with-somnolence-after-orthopedic-surgery
#3
LETTER
Alden W Dudley
No abstract text is available yet for this article.
November 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27774838/tranexamic-acid-in-patients-undergoing-coronary-artery-surgery
#4
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
Background Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. Methods In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here...
October 23, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27592289/echocardiography-as-a-guide-for-fluid-management
#5
REVIEW
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27440628/preoperative-heart-rate-and-myocardial-injury-after-non-cardiac-surgery-results-of-a-predefined-secondary-analysis-of-the-vision-study
#6
T E F Abbott, G L Ackland, R A Archbold, A Wragg, E Kam, T Ahmad, A W Khan, E Niebrzegowska, R N Rodseth, P J Devereaux, R M Pearse
BACKGROUND: Increased baseline heart rate is associated with cardiovascular risk and all-cause mortality in the general population. We hypothesized that elevated preoperative heart rate increases the risk of myocardial injury after non-cardiac surgery (MINS). METHODS: We performed a secondary analysis of a prospective international cohort study of patients aged ≥45 yr undergoing non-cardiac surgery. Preoperative heart rate was defined as the last measurement before induction of anaesthesia...
August 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27659469/contrast-induced-acute-kidney-injury
#7
REVIEW
Peter A McCullough, James P Choi, Georges A Feghali, Jeffrey M Schussler, Robert M Stoler, Ravi C Vallabahn, Ankit Mehta
Coronary angiography and percutaneous intervention rely on the use of iodinated intravascular contrast for vessel and chamber imaging. Despite advancements in imaging and interventional techniques, iodinated contrast continues to pose a risk of contrast-induced acute kidney injury (CI-AKI) for a subgroup of patients at risk for this complication. There has been a consistent and graded signal of risk for associated outcomes including need for renal replacement therapy, rehospitalization, and death, according to the incidence and severity of CI-AKI...
September 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27566811/management-of-bleeding-in-vascular-surgery
#8
REVIEW
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27058509/the-half-life-of-infusion-fluids-an-educational-review
#9
Robert G Hahn, Gordon Lyons
An understanding of the half-life (T1/2) of infused fluids can help prevent iatrogenic problems such as volume overload and postoperative interstitial oedema. Simulations show that a prolongation of the T1/2 for crystalloid fluid increases the plasma volume and promotes accumulation of fluid in the interstitial fluid space. The T1/2 for crystalloids is usually 20 to 40 min in conscious humans but might extend to 80 min or longer in the presence of preoperative stress, dehydration, blood loss of <1 l or pregnancy...
July 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27233380/prevention-of-contrast-associated-acute-kidney-injury-what-should-we-do
#10
EDITORIAL
Steven D Weisbord, Paul M Palevsky
No abstract text is available yet for this article.
October 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26945358/impact-of-albumin-on-coagulation-competence-and-hemorrhage-during-major-surgery-a-randomized-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Kirsten C Rasmussen, Michael Højskov, Pär I Johansson, Irina Kridina, Thomas Kistorp, Lisbeth Salling, Henning B Nielsen, Birgitte Ruhnau, Tom Pedersen, Niels H Secher
For patients exposed to a massive blood loss during surgery, maintained coagulation competence is important. It is less obvious whether coagulation competence influences bleeding during elective surgery where patients are exposed to infusion of a crystalloid or a colloid. This randomized controlled trial evaluates whether administration of 5% human albumin (HA) or lactated Ringer solution (LR) affects coagulation competence and in turn blood loss during cystectomy due to bladder cancer. Forty patients undergoing radical cystectomy were included to receive either 5% HA (n = 20) or LR (n = 20)...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26976277/crystalloid-fluid-therapy
#12
REVIEW
Sumeet Reddy, Laurence Weinberg, Paul Young
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
March 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27087980/fluid-therapy-in-the-perioperative-setting-a-clinical-review
#13
REVIEW
Anders Winther Voldby, Birgitte Brandstrup
BACKGROUND: Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to provide evidence-based recommendations for clinical practice. RESULTS: Preoperative oral or intravenous administration of carbohydrate containing fluids has been shown to improve postoperative well-being and muscular strength and to reduce insulin resistance...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27017184/-quality-of-recovery-from-anesthesia-in-patients-undergoing-orthopedic-surgery-of-the-lower-limbs
#14
Eduardo Toshiyuki Moro, Manoel Arthur Nóbrega da Silva, Marcelo Gouvêa Couri, Danielle da Silva Issa, Julia Morais Barbieri
BACKGROUND AND OBJECTIVES: For patients undergoing regional anesthesia for orthopedic surgery, a common situation in our work environment, the quality of recovery may be influenced in different ways, which justifies studies to identify possible predictive factors of dissatisfaction. The aim of this study was to assess the opinion of patients on recovery from anesthesia for lower limb orthopedic surgeries. We also identified potential predictive factors for poor quality of recovery. METHODS: We evaluated patients undergoing lower limb orthopedic surgeries and able to participate in the study...
November 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26896899/0-9-saline-or-balanced-crystalloid-fluids-for-critically-ill-patients-split-decision
#15
EDITORIAL
Brandon Galm, Sean M Bagshaw
No abstract text is available yet for this article.
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26370823/impact-of-intravenous-fluid-composition-on-outcomes-in-patients-with-systemic-inflammatory-response-syndrome
#16
Andrew D Shaw, Carol R Schermer, Dileep N Lobo, Sibyl H Munson, Victor Khangulov, David K Hayashida, John A Kellum
INTRODUCTION: Intravenous (IV) fluids may be associated with complications not often attributed to fluid type. Fluids with high chloride concentrations such as 0.9 % saline have been associated with adverse outcomes in surgery and critical care. Understanding the association between fluid type and outcomes in general hospitalized patients may inform selection of fluid type in clinical practice. We sought to determine if the type of IV fluid administered to patients with systemic inflammatory response syndrome (SIRS) is associated with outcome...
September 12, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26620144/peri-operative-cardiac-protection-for-non-cardiac-surgery
#17
REVIEW
S S C Wong, M G Irwin
Cardiovascular complications are an important cause of morbidity and mortality after non-cardiac surgery. Pre-operative identification of high-risk individuals and appropriate peri-operative management can reduce cardiovascular risk. It is important to continue chronic beta-blocker and statin therapy. Statins are relatively safe and peri-operative initiation may be beneficial in high-risk patients and those scheduled for vascular surgery. The pre-operative introduction of beta-blockers reduces myocardial injury but increases rates of stroke and mortality, possibly due to hypotension...
January 2016: Anaesthesia
https://www.readbyqxmd.com/read/26620146/peri-operative-pulmonary-dysfunction-and-protection
#18
REVIEW
K Marseu, P Slinger
Pulmonary complications are a major cause of peri-operative morbidity and mortality, but have been researched less thoroughly than cardiac complications. It is important to try and predict which patients are at risk of peri-operative pulmonary complications and to intervene to reduce this risk. Anaesthetists are in a unique position to do this during the whole peri-operative period. Pre-operative training, smoking cessation and lung ventilation with tidal volumes of 6-8 ml.kg(-1) and low positive end-expiratory pressure probably reduce postoperative pulmonary complications...
January 2016: Anaesthesia
https://www.readbyqxmd.com/read/26620147/peri-operative-renal-dysfunction-prevention-and-management
#19
REVIEW
D Golden, J Corbett, L G Forni
Postoperative increases in serum creatinine concentration, by amounts historically viewed as trivial, are associated with increased morbidity and mortality. Acute kidney injury is common, affecting one in five patients admitted with acute medical disease and up to four in five patients admitted to intensive care, of whom one in two have had operations. This review is focused principally on the identification of patients at risk of acute kidney injury and the prevention of injury. In the main, there are no interventions that directly treat the damaged kidney...
January 2016: Anaesthesia
https://www.readbyqxmd.com/read/26620145/peri-operative-fluid-management-to-enhance-recovery
#20
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
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