Month: February 2015

Uncategorized Published - 5 February, 2015    By - Dr Clemens
Goals Set for Medicare to Pay Providers Based on Quality Rather Than Volume

By the end of 2016, 30% of the payments that Medicare makes to physicians and hospitals should be based on the value, rather than the quantity, of the services provided, and by the end of 2018, the proportion should increase to 50%, the Department of Health and Human Services announced. Currently, value-based payments — made […]

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Uncategorized Published - 5 February, 2015    By - Dr Clemens
Possible Pathogenic Mechanism of Propofol Infusion Syndrome Involves Coenzyme Q

Authors: Arnaud Vincent Vanlander, M.D. et al Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 343-352. doi:10.1097/ALN.0000000000000484 Background: Propofol is a short-acting intravenous anesthetic agent. In rare conditions, a life-threatening complication known as propofol infusion syndrome can occur. The pathophysiologic mechanism is still unknown. Some studies suggested that propofol acts as uncoupling […]

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Uncategorized Published - 5 February, 2015    By - Dr Clemens
Factors Associated with Improved Survival after Resection of Pancreatic Adenocarcinoma: A Multivariable Model

Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 317-324. doi:10.1097/ALN.0000000000000489 Authors: Tyler R. Call, M.D et al Background: Several retrospective studies suggest that perioperative care and anesthetic management for cancer resection may influence cancer recurrence or patient survival. Various intraoperative techniques such as paravertebral blocks, decreased opioid use, immunomodulation, and perioperative antiinflammatory […]

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Uncategorized Published - 5 February, 2015    By - Dr Clemens
Neurophysiological Correlates of Sevoflurane-induced Unconsciousness

Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 307-316. doi:10.1097/ALN.0000000000000482 Authors: Stefanie Blain-Moraes, Ph.D. et al Background: Recent studies of anesthetic-induced unconsciousness in humans have focused predominantly on the intravenous drug propofol and have identified anterior dominance of alpha rhythms and frontal phase–amplitude coupling patterns as neurophysiological markers. However, it is unclear […]

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Uncategorized Published - 5 February, 2015    By - Dr Clemens
Sodium Bicarbonate and Renal Function after Cardiac Surgery: A Prospectively Planned Individual Patient Meta-analysis

Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 294-306. doi:10.1097/ALN.0000000000000547 Authors: Michael Bailey, Ph.D. et al Background: The effect of urinary alkalinization in cardiac surgery patients at risk of acute kidney injury (AKI) is controversial and trial findings conflicting. Accordingly, the authors performed a prospectively planned individual patient data meta-analysis of the […]

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Uncategorized Published - 4 February, 2015    By - Dr Clemens
Obama Budget Gets Mixed Reviews from Providers, Advocates

The budget proposal calls for a permanent repeal of Medicare’s widely reviled sustainable growth rate funding formula for physicians, but also calls for about $400 billion in cuts, mostly to Medicare and Medicaid, over the next decade. The reaction from healthcare providers to the Obama Administration’s $4 trillion 2016 budget proposal has been mixed, but […]

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Uncategorized Published - 4 February, 2015    By - Dr Clemens
Intraoperative Core Temperature Patterns, Transfusion Requirement, and Hospital Duration in Patients Warmed with Forced Air

Authors: Zhuo Sun, M.D et al Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 276-285. doi:10.1097/ALN.0000000000000551 Background: Core temperature patterns in patients warmed with forced air remain poorly characterized. Also unknown is the extent to which transient and mild intraoperative hypothermia contributes to adverse outcomes in broad populations. Methods: We evaluated esophageal (core) […]

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Uncategorized Published - 4 February, 2015    By - Dr Clemens
Bleeding and the New Anticoagulants: Strategies and Concerns

Publshed in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 236-237. doi:10.1097/ALN.0000000000000541 Authors: Charles Marc Samama, M.D., Ph.D., F.C.C.P.; Jerrold H. Levy, M.D., F.A.H.A., F.C.C.M. THE non–vitamin K antagonist K oral anticoagulants (NOACs) represent a major step forward as compared with low-molecular-weight heparins and vitamin K antagonists. Four active molecules are now available on the […]

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Uncategorized Published - 4 February, 2015    By - Dr Clemens
Sodium Bicarbonate for Kidney Protection in Cardiac Surgery: Demise of Yet Another Magic Bullet?

Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 233-235. doi:10.1097/ALN.0000000000000548 Authors: Duminda N. Wijeysundera, M.D., Ph.D.; Chirag R. Parikh, M.D., Ph.D. ACUTE kidney injury following cardiac surgery is associated with significant morbidity and mortality.  This important postoperative complication, termed cardiac surgery–associated acute kidney injury (CS-AKI), is multifactorial in etiology, with postulated causes including […]

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Uncategorized Published - 4 February, 2015    By - Dr Clemens
Perioperative Temperature Management: Time for a New Standard of Care?

Author: Harriet W. Hopf, M.D. Published in The Journal of the American Society of Anesthesiologists 2 2015, Vol.122, 229-230. doi:10.1097/ALN.0000000000000552 When I started anesthesia residency in 1988, patients undergoing major surgery routinely arrived in the postanesthesia care unit (PACU) with a core temperature of 34.5° to 35°C. We did not fully understand how anesthesia causes hypothermia; […]

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