Month: November 2017

Uncategorized Published - 21 November, 2017    By - Dr Clemens
Low End-Tidal Carbon Dioxide at the Onset of Emergent Trauma Surgery Is Associated With Nonsurvival: A Case Series

AUTHORS: Dudaryk, Roman MD et al Anesthesia & Analgesia: October 2017 – Volume 125 – Issue 4 – p 1261–1266 BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation after cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in […]

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Uncategorized Published - 21 November, 2017    By - Dr Clemens
Apneic Oxygenation Prevents Desaturation During Intubation

Authors: Binks MJ et al., Am J Emerg Med 2017 Jun 24; Two meta-analyses used different methods but have similar findings. Apneic oxygenation is the delivery of high-flow oxygen by nasal cannula during endotracheal intubation. Two separate meta-analyses provide pooled results from trials of apneic oxygenation. The first meta-analysis included 8 studies and 1953 patients in critical care […]

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Uncategorized Published - 20 November, 2017    By - Dr Clemens
The Effect of Glycopyrrolate on the Incidence of Hypotension and Vasopressor Requirement During Spinal Anesthesia for Cesarean Delivery: A Meta-analysis

AUTHORS: Patel, Selina D. BMedSci, MBBS, FRCA et al Anesthesia & Analgesia: July 2017 BACKGROUND: The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery. METHODS: A literature search was performed to identify randomized controlled trials investigating the effect of glycopyrrolate on spinal-induced hypotension during cesarean delivery. […]

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Uncategorized Published - 20 November, 2017    By - Dr Clemens
Abnormal Calcium Levels During Trauma Resuscitation Are Associated With Increased Mortality, Increased Blood Product Use, and Greater Hospital Resource Consumption: A Pilot Investigation

AUTHORS: MacKay, Emily J. DO et al Anesthesia & Analgesia: September 2017 – Volume 125 – Issue 3 – p 895–901 BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in […]

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Uncategorized Published - 20 November, 2017    By - Dr Clemens
Implementation of a Standardized Transfusion Protocol for Cardiac Patients Treated With Venoarterial Extracorporeal Membrane Oxygenation Is Associated With Decreased Blood Component Utilization and May Improve Clinical Outcome

AUTHORS: Cahill, Christine M. MS et al Anesthesia & Analgesia:  July 2017 BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. […]

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Uncategorized Published - 20 November, 2017    By - Dr Clemens
Patient Survey of Referral From One Surgeon to Another to Reduce Maximum Waiting Time for Elective Surgery and Hours of Overutilized Operating Room Time

AUTHORS: Logvinov, Ilana I. RN, MSN, CCRP et al Anesthesia & Analgesia: July 2017 BACKGROUND: Studies of shared (patient-provider) decision making for elective surgical care have examined both the decision whether to have surgery and patients’ understanding of treatment options. We consider shared decision making applied to case scheduling, since implementation would reduce labor costs. METHODS: […]

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Uncategorized Published - 20 November, 2017    By - Dr Clemens
IV Dexamethasone Does Not Affect Psoas Nerve Block Duration

Although previous surrogate outcomes have suggested that IV dexamethasone can prolong the duration of peripheral nerve blockade, new research indicates otherwise. When sensory blockade was measured by an objective pinprick assessment, neither a 4- nor 8-mg dose of systemic dexamethasone given at the time of peripheral nerve blockade had an effect on block duration. “Based […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
High Wastage of Infused Medications Found, But Fix Not Difficult

If the experience of researchers at Duke University Medical Center is indicative of the nation as a whole, then infused medications are being wasted throughout the perioperative process. This is the product of preparing and priming standard infusions regardless of patient and procedural characteristics. The good news is that such practices seem to be easily […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
Pain Control After Liver Transplant Inadequate for Most Patients

Better pain management protocols are needed for patients who undergo orthotopic liver transplantation, according to research presented here at the 2017 Annual Meeting of the Canadian Anesthesiologists Society (CAS). “Liver transplantation is very painful surgery,” said Hussein Sadkhan, MD, London Health Sciences Center/Western University, London, Ontario. “We conducted a retrospective study to assess pain control […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
General Anesthesia No Safer Than Sedation for TAVR

Although general anesthesia is preferred by many anesthesiologists because of a perceived superior safety profile, a study has found that it is no safer than sedation in patients undergoing transcatheter aortic valve replacement (TAVR). The retrospective trial concluded that compared with sedation, TAVR patients who receive general anesthesia do not have smaller volume requirements, fewer […]

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