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Uncategorized Published - 2 December, 2019    By - Dr Clemens
Performing A “Deep” Extubation

Author: Rishi  RK.MD A “deep” extubation refers to removing an endotracheal tube (ETT) or laryngeal mask airway (LMA) while the patient is still under anesthesia and his/her airway reflexes (ie, gag) have not returned. Although there are no absolute indications for deep extubation, it’s often performed in pediatric anesthesia as well as adult neurosurgery and […]

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Uncategorized Published - 2 December, 2019    By - Dr Clemens
Intensive Treatment of Hyperglycemia Does Not Improve Stroke Outcomes

Authors: Johnston KC et al.  JAMA 2019 Jul 23 A randomized trial finds no benefit with intensive glucose control. About 40% of patients with acute ischemic stroke have hyperglycemia. Previous studies have linked hyperglycemia with worse outcomes, including increased infarct growth and higher rates of hemorrhagic transformation. Whether aggressive treatment of hyperglycemia improves outcomes following ischemic […]

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Uncategorized Published - 29 November, 2019    By - Dr Clemens
Comparative efficacy of epidural clonidine versus epidural fentanyl for treating breakthrough pain during labor

Author Allison Lee et al International Journal of Obstetric Anesthesia Highlights •Avoiding neuraxial opioids for labor analgesia may be warranted in some patients. •Epidural clonidine was not superior to fentanyl for breakthrough labor pain. •Epidural clonidine and fentanyl both showed efficacy for breakthrough labor pain. •Incidence of hypotension, sedation and fetal bradycardia did not significantly […]

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Uncategorized Published - 29 November, 2019    By - Dr Clemens
Fresh Frozen Plasma versus Crystalloid Priming of Cardiopulmonary Bypass Circuit in Pediatric Surgery

Author: Audrey Dieu, M.D. et al    Anesthesiology October 2019. Editor’s Perspective: What We Already Know about This Topic: Fresh frozen plasma is often used to prime the cardiopulmonary bypass circuit for pediatric cardiac surgical patients to help offset dilutional coagulopathy that might result in increased perioperative bleeding and allogeneic blood transfusion Prior randomized trials […]

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Uncategorized Published - 29 November, 2019    By - Dr Clemens
Time for consensus on rapid sequence intubation?

Authors: M. Charlesworth et al  Anaesthesia Oct 2019 This month in Anaesthesia, Zdravkovic et al. report an international survey of 10,003 anaesthetists and 16 airway experts on preferences for clinical practices associated with rapid sequence intubation (RSI) 1. For a hypothetical patient with intestinal obstruction requiring RSI, the head‐up or ‐down position was preferable, as was nasogastric […]

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