Month: February 2018

Uncategorized Published - 22 February, 2018    By - Dr Clemens
Statin Therapy before Cardiac Surgery: Neutral or Detrimental Effects?

Authors: Alessandro Putzu, M.D. et al Anesthesiology 3 2018, Vol.128, 685-686. To the Editor: We read the interesting large retrospective study by Komatsu et al. on preoperative chronic statin use in patients undergoing coronary artery bypass grafting, valve surgery, or combined procedures.1  Chronic statin therapy was associated with no significant difference in prolonged mechanical ventilation, pneumonia, in-hospital mortality, […]

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Uncategorized Published - 22 February, 2018    By - Dr Clemens
Volume Responsiveness Alone Is Not an Indication for Volume Administration!

Authors: Joshua A. Bloomstone, M.D., C.S.S.G.B., C.L.S. et al Anesthesiology 3 2018, Vol.128, 681-682. To the Editor: It is with intrigue that we read Gómez-Izquierdo et al.’s paper demonstrating the lack of effectiveness of goal-directed fluid therapy (GDFT) in reducing ileus after elective laparoscopic colorectal surgery.1  We congratulate the authors for a well-done study and Anesthesiology for publishing an […]

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Uncategorized Published - 22 February, 2018    By - Dr Clemens
Impact of Weaning from Mechanical Ventilation: The Importance of Pleural Effusions and Their Effect on Pulmonary Vascular Resistance

Authors: Eric Jacobsohn, M.B.Ch.B., M.H.P.E., F.R.C.P.C. et al Anesthesiology 3 2018, Vol.128, 677-678. To the Editor: The recent multicenter prospective observational study by Dres et al.1  examining the impact of pleural effusions on liberation from mechanical ventilation showed that 13% of their patients had a pleural effusion at the time of ventilator weaning, but that there was no […]

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Uncategorized Published - 22 February, 2018    By - Dr Clemens
Does the Brachial Artery Lack Effective Collaterals?

Authors: T. Andrew Bowdle, M.D., Ph.D., F.A.S.E. et al Anesthesiology 3 2018, Vol.128, 674-675. To the Editor: We read with interest the recent article by Singh et al.1  We place many brachial artery catheters in our practice and find them useful. It would be interesting to know whether ultrasound guidance was used for some or all of the […]

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Uncategorized Published - 22 February, 2018    By - Dr Clemens
House Committee Advances ASA-Supported Medical Liability Bill

On Wednesday, February 14, the House Energy and Commerce Committee advanced an ASA-supported medical liability reform bill intended to protect medical professionals providing care during natural disasters.  H.R. 1876, the Good Samaritan Health Professionals Act, will shield health care professionals from liability when they volunteer their services during a federally-declared disaster. The bill earned Republican […]

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Uncategorized Published - 22 February, 2018    By - Dr Clemens
Monitoring for Opioid-Induced Respiratory Depression

Authors: Rajnish K. Gupta, MD, and David A. Edwards, MD, PhD. In 2006 and 2011, the Anesthesia Patient Safety Foundation (APSF) convened multidisciplinary conferences to address the serious patient safety issue of Opioid-Induced Ventilatory Impairment (OIVI).1Given the significance of the problem, and that no best monitor exists for detection of OIVI associated-adverse events, the consensus […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective Observational Study of Ambulation after Regional Anesthesia and Analgesia Interventions

Authors: Julia Ma, B.Sc., M.P.H. et al Anesthesiology 3 2018, Vol.128, 598-608. Background: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Sevoflurane Blocks the Induction of Long-term Potentiation When Present during, but Not When Present Only before, the High-frequency Stimulation

Authors: Jinyang Liu, M.S. et al Anesthesiology 3 2018, Vol.128, 555-563. Background: This study tests the hypothesis that sevoflurane blocks long-term potentiation only if it is present during the high-frequency stimulation that induces long-term potentiation. Methods: Long-term potentiation, an electrophysiologic correlate of memory, was induced by high-frequency stimulation and measured as a persistent increase in the field excitatory […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation

Authors: Savino Spadaro, M.D., Ph.D. et al Anesthesiology 3 2018, Vol.128, 531-538. Background: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion

Authors: Aaron Louie, B.S. et al Anesthesiology 3 2018, Vol.128, 520-530. Background: Pulse oximeter performance is degraded by motion artifacts and low perfusion. Manufacturers developed algorithms to improve instrument performance during these challenges. There have been no independent comparisons of these devices. Methods: We evaluated the performance of four pulse oximeters (Masimo Radical-7, USA; Nihon Kohden OxyPal Neo, […]

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