AUTHORS: Sun R et al BMJ Open 9 (4), e025850 (Apr 2019) INTRODUCTION: Delirium is very common in patients admitted to intensive care unit (ICU), and may worsen survival in these patients. Several meta-analyses have evaluated the antidelirium effects of dexmedetomidine in ICU patients, but their findings were inconsistent. Recently, several large multicentre randomised clinical […]
Characterizing the Structural Integrity of Endotracheal Tube Taping Techniques
AUTHORS: Matchett, Gerald MD et al Anesthesia & Analgesia: May 2019 BACKGROUND: Endotracheal tubes (ETTs) are commonly secured with tape to prevent undesirable tube migration. Many methods of taping have been described, although little has been published comparing various methods of taping to one another. In this study, we evaluated several methods for securing ETTs with tape. […]
Body Position Alters Mechanical Power and Respiratory Mechanics During Thoracic Surgery
AUTHORS: Chiumello, Davide MD et al Anesthesia & Analgesia: May 2019 BACKGROUND: During thoracic surgery, patients are usually positioned in lateral decubitus and only the dependent lung ventilated. The ventilated lung is thus exposed to the weight of the contralateral hemithorax and restriction of the dependent chest wall. We hypothesized that mechanical power would increase during one-lung […]
End-Expiratory Occlusion Test to Predict Fluid Responsiveness Is Not Suitable for Laparotomic Surgery
AUTHORS: Weil, Gregoire MD et al Anesthesia & Analgesia: May 2019 BACKGROUND: The end-expiratory occlusion test predicts fluid responsiveness in ventilated intensive care patients; however, its utility in the operating room is questioned. We assessed end-expiratory occlusion test in laparotomic surgery for predicting volume expansion. METHODS: Forty-six patients were included in this study: stage 1 (n = 26) […]
Retrospective Analysis of the Safety and Efficacy of Sugammadex Versus Neostigmine for the Reversal of Neuromuscular Blockade in Children
AUTHORS: Gaver, Renee S. MD et al Anesthesia & Analgesia: May 2019 BACKGROUND: Sugammadex, with its novel mechanism of action of encapsulation and noncompetitive binding of aminosteroid neuromuscular-blocking agents (rocuronium and vecuronium), may offer distinct advantage to pediatric patients where residual neuromuscular blockade may be poorly tolerated. Data describing its use in the pediatric population are limited, […]
Epidemiology of Hospital-Onset Versus Community-Onset Sepsis in U.S. Hospitals and Association With Mortality: A Retrospective Analysis Using Electronic Clinical Data
Authors: Rhee, Chanu MD, MPH et al Critical Care Medicine: September 2019 – Volume 47 – Issue 9 – p 1169-1176 Objectives: Prior studies have reported that hospital-onset sepsis is associated with higher mortality rates than community-onset sepsis. Most studies, however, have used inconsistent case-finding methods and applied limited risk-adjustment for potential confounders. We used consistent sepsis criteria and detailed electronic clinical data […]
Drug Overdose Death Rates in Cities Surpass Those in Rural Areas
By Kelly Young Rates of drug overdose deaths in cities have overtaken those in rural areas, according to new data from the CDC’s National Center for Health Statistics. From 2007 through 2015, rural areas led urban areas in overdose deaths. But then in 2016 and 2017, the age-adjusted drug rate of drug overdose deaths was […]
Preoperative predictors of poor acute postoperative pain control
AUTHORS: Yang M et al BMJ Open 9 (4), e025091 (Apr 2019) OBJECTIVES: Inadequate postoperative pain control is common and is associated with poor clinical outcomes. This study aimed to identify preoperative predictors of poor postoperative pain control in adults undergoing inpatient surgery. RESULTS: Thirty-three studies representing 53 362 patients were included in this review. Significant […]
Presence of Pediatric Pulmonary Hypertension Requires Vigilance
Author: Michael Vlessides Anesthesiology News A significant contributor to morbidity and mortality, pulmonary hypertension is associated with diverse cardiac, pulmonary and systemic diseases among neonates, infants and older children. Yet some experts say the significant risk presented by these patients can be mitigated by adaptability and vigilance on the part of the anesthesiologists who treat […]
Medicare public option could put 55% of rural hospitals at high risk of closure, analysis finds
Author: Kelly Gooch A Medicare public option, meaning adding a government-sponsored health insurance option into the marketplace, could have a significant effect on rural hospital closures across the country, according to a new analysis. The Navigant Consulting analysis, supported by the Partnership for America’s Healthcare Future, found that a public option could put up to 55 percent […]