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Uncategorized Published - 17 November, 2016    By - Dr Clemens
Oxygen in Critically Ill Patients: Too Much of a Good Thing Might Do Harm

Authors: Ferguson ND., JAMA 2016 Oct 18; 316:1553 Outcomes were worse with a conventional high-oxygenation goal than with a conservative moderate-oxygenation goal. Increasingly, excess oxygen administration is recognized as a risk factor for adverse outcomes when used perioperatively (NEJM JW Infect Dis Nov 2009 and JAMA 2009; 302:1543) or after myocardial infarction (NEJM JW Hosp Med Aug 2015 and Circulation2015; 131:2143). But […]

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Uncategorized Published - 17 November, 2016    By - Dr Clemens
Protective Ventilation during Anesthesia: Is It Meaningful?

Authors: Göran Hedenstierna, M.D., Ph.D. et al Anesthesiology 12/ 2016, Vol.125, 1079-1082. SEVERAL clinical trials on protective ventilation during anesthesia and postoperative pulmonary complications have been performed during the past years and assumed to be suitable as guidelines for clinical treatment.1–8  Comprehensive reviews and meta-analysis have also been performed.9,10  Why then do these studies differ in their recommendations? […]

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Uncategorized Published - 17 November, 2016    By - Dr Clemens
Lung Metabolic Activation as an Early Biomarker of Acute Respiratory Distress Syndrome and Local Gene Expression Heterogeneity

Authors: Tyler J. Wellman, Ph.D. et al Commentary: Early Regional Inflammation: The Seeds of Lung Injury Anesthesiology 11 2016, Vol.125, 992-1004. Background: Acute respiratory distress syndrome (ARDS) is an inflammatory condition comprising diffuse lung edema and alveolar damage. ARDS frequently results from regional injury mechanisms. However, it is unknown whether detectable inflammation precedes lung edema and opacification and […]

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Uncategorized Published - 17 November, 2016    By - Dr Clemens
Complications of One-lung Ventilation: Is It the Blood Flow or the Ventilation?

Author: Jonathan V. Roth, M.D. Anesthesiology 12 2016, Vol.125, 1253-1254. The results of the study of management of one-lung ventilation by Blank et al. suggest that adequate positive end-expiratory pressure (PEEP) is an important factor in reducing pulmonary complications. Blank et al.1  provide an excellent discussion of the mechanical mechanisms and implications. I suggest an alternative or additional possible explanation […]

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Uncategorized Published - 16 November, 2016    By - Dr Clemens
Distinct Cortical Signatures Associated with Sedation and Respiratory Rate Depression by Morphine in a Pediatric Population

Authors: Gaspard Montandon, Ph.D. et al Anesthesiology 11 2016, Vol.125, 889-903. Background: Opioid analgesia is an essential component of perioperative care, but effective analgesia can be limited by excessive sedation and respiratory depression. The cortical signatures associated with sedation by opioids and the relationship between changes in cortical activity and respiratory function are not well understood. The […]

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