Month: December 2016

Uncategorized Published - 22 December, 2016    By - Dr Clemens
Study Finds Rising Rates of Children Hospitalized for Opioid Poisonings

Beyond the rising rates of deaths related to opioid use, a new analysis of hospital records shows significantly higher rates also affecting children being hospitalized for opioid poisoning Interview with Julie R. Gaither, PhD, MPH, RN and G. Caleb Alexander, MD, MS As the deadly consequences of opioid abuse in the US remain in the […]

Read More
Uncategorized Published - 22 December, 2016    By - Dr Clemens
Activated Protein C Drives the Hyperfibrinolysis of Acute Traumatic Coagulopathy

Authors: Ross A. Davenport, Ph.D. et al   Anesthesiology 1 2017, Vol.126, 115-127. Background: Major trauma is a leading cause of morbidity and mortality worldwide with hemorrhage accounting for 40% of deaths. Acute traumatic coagulopathy exacerbates bleeding, but controversy remains over the degree to which inhibition of procoagulant pathways (anticoagulation), fibrinogen loss, and fibrinolysis drive the […]

Read More
Uncategorized Published - 22 December, 2016    By - Dr Clemens
Withholding versus Continuing Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers before Noncardiac Surgery: An Analysis of the Vascular events In noncardiac Surgery patIents

Authors: Pavel S. Roshanov, M.D., M.Sc. et al Anesthesiology 1 2017, Vol.126, 16-27 Background: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. Methods: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II receptor […]

Read More
Uncategorized Published - 21 December, 2016    By - Dr Clemens
Extubation Failure in Brain-injured Patients: Risk Factors and Development of a Prediction Score in a Preliminary Prospective Cohort Study

Authors: Thomas Godet, M.D., Ph.D. et al Anesthesiology 1 2017, Vol.126, 104-114. Background: The decision to extubate brain-injured patients with residual impaired consciousness holds a high degree of uncertainty of success. The authors developed a pragmatic clinical score predictive of extubation failure in brain-injured patients. Methods: One hundred and forty brain-injured patients were prospectively included after the first […]

Read More
Uncategorized Published - 21 December, 2016    By - Dr Clemens
Pilot Study of Propofol-induced Slow Waves as a Pharmacologic Test for Brain Dysfunction after Brain Injury

Authors: Jukka Kortelainen, M.D., Ph.D. et al Anesthesiology 1 2017, Vol.126, 94-103. Background: Slow waves (less than 1 Hz) are the most important electroencephalogram signatures of nonrapid eye movement sleep. While considered to have a substantial importance in, for example, providing conditions for single-cell rest and preventing long-term neural damage, a disturbance in this neurophysiologic phenomenon is […]

Read More
Uncategorized Published - 21 December, 2016    By - Dr Clemens
Vasopressin versusNorepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial

Authors: Ludhmila Abrahao Hajjar, M.D., Ph.D. et al      Anesthesiology 1 2017, Vol.126, 85-93. Background: Vasoplegic syndrome is a common complication after cardiac surgery and impacts negatively on patient outcomes. The objective of this study was to evaluate whether vasopressin is superior to norepinephrine in reducing postoperative complications in patients with vasoplegic syndrome. Methods: This prospective, randomized, double-blind […]

Read More
Uncategorized Published - 21 December, 2016    By - Dr Clemens
Relationship between Intraoperative Hypotension, Defined by Either Reduction from Baseline or Absolute Thresholds, and Acute Kidney and Myocardial Injury after Noncardiac Surgery: A Retrospective Cohort Analysis

Authors: Vafi Salmasi, M.D. et al       Anesthesiology 1 2017, Vol.126, 47-65  Background: How best to characterize intraoperative hypotension remains unclear. Thus, the authors assessed the relationship between myocardial and kidney injury and intraoperative absolute (mean arterial pressure [MAP]) and relative (reduction from preoperative pressure) MAP thresholds. Methods: The authors characterized hypotension by the lowest MAP below various […]

Read More
Uncategorized Published - 21 December, 2016    By - Dr Clemens
Rapid Occurrence of Chronic Kidney Disease in Patients Experiencing Reversible Acute Kidney Injury after Cardiac Surgery

Authors: David Legouis, M.D. et al     Anesthesiology 1 2017, Vol.126, 39-46. Background: There is recent evidence to show that patients suffering from acute kidney injury are at increased risk of developing chronic kidney disease despite the fact that surviving tubular epithelial cells have the capacity to fully regenerate renal tubules and restore renal function within days […]

Read More
Uncategorized Published - 20 December, 2016    By - Dr Clemens
Study Shows Opioid Undertreatment for Patients Dying of Cancer

Many patients who die of cancer receive no or delayed prescriptions for strong opioid medications, according to a study published in the journal Pain. Most patients with advanced cancer experience pain, often severe, but inadequate treatment of cancer pain continues to be a major public health problem. Efforts to improve treatment of cancer pain may […]

Read More
Uncategorized Published - 20 December, 2016    By - Dr Clemens
Hospital Readmission Rates Drop Nationally

Hospital readmission rates dropped by an average of 8% nationally from 2010 to 2015, the Centers for Medicare & Medicaid Services (CMS) announced on Thursday. The number of avoidable 30-day readmissions of Medicare patients dropped in 49 states and the District of Columbia, according to CMS. In 43 states, the readmission rates fell by more than 5%, […]

Read More