Author: Dr Clemens

Uncategorized Published - 29 August, 2018    By - Dr Clemens
Respiratory Muscle Effort during Expiration in Successful and Failed Weaning from Mechanical Ventilation

Authors: Jonne Doorduin, Ph.D. et al  Anesthesiology 9 2018, Vol.129, 490-501. What We Already Know about This Topic: Inspiratory muscle weakness delays weaning from mechanical ventilation, but the contributions of expiratory muscles activity are less well understood. What This Article Tells Us That Is New: Twenty adult patients receiving mechanical ventilation (more than 72 h) performed […]

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Uncategorized Published - 29 August, 2018    By - Dr Clemens
Cognitive Decline after Delirium in Patients Undergoing Cardiac Surgery

Authors: Charles H. Brown, IV, M.D., M.H.S. et al  Anesthesiology 9 2018, Vol.129, 406-416. What We Already Know about This Topic: Cardiac surgery is associated with cognitive decline and postoperative delirium The relationship between postoperative delirium and cognitive decline after cardiac surgery is unclear What This Article Tells Us That Is New: The development of postoperative […]

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Uncategorized Published - 28 August, 2018    By - Dr Clemens
Dexmedetomidine Prevents Excessive γ-Aminobutyric Acid Type A Receptor Function after Anesthesia

Authors: Dian-Shi Wang, M.D., Ph.D. et al  Anesthesiology 9 2018, Vol.129, 477-489. What We Already Know about This Topic: Dexmedetomidine is effective in reducing delirium in the postoperative period and in the intensive care unit in patients and prevents memory deficits in experimental animals subjected to anesthesia. The mechanism by which dexmedetomidine preserves cognition is not […]

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Uncategorized Published - 28 August, 2018    By - Dr Clemens
Maternal Body Mass Index and Use of Labor Neuraxial Analgesia: A Population-based Retrospective Cohort Study

Authors: Alexander J. Butwick, M.B.B.S., F.R.C.A., M.S. et al  Anesthesiology 9 2018, Vol.129, 448-458. What We Already Know about This Topic: Neuraxial labor analgesia for parturients is often recommended to avoid airway instrumentation in case of urgent surgical delivery The extent to which neuraxial use varies by maternal body mass index using modern, national data remains […]

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Uncategorized Published - 28 August, 2018    By - Dr Clemens
Defining an Intraoperative Hypotension Threshold in Association with Stroke in Cardiac Surgery

Authors: Louise Y. Sun, M.D., S.M. et al  Anesthesiology 9 2018, Vol.129, 440-447. What We Already Know about This Topic: Ischemic stroke after cardiac surgery is a devastating complication affecting approximately 2% of patients The relationship between hypotension occurring before, during, and after cardiopulmonary bypass and stroke remains unclear What This Article Tells Us That Is […]

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Uncategorized Published - 28 August, 2018    By - Dr Clemens
Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis

Authors: Kristen K. MacKenzie, M.D. et al  Anesthesiology 9 2018, Vol.129, 417-427. What We Already Know about This Topic: Up to 20% of patients undergoing major surgery experience postoperative delirium or cognitive dysfunction Intraoperative management strategies to reduce the risk of postoperative delirium remain unclear What This Article Tells Us That Is New: The heterogeneity of […]

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Uncategorized Published - 28 August, 2018    By - Dr Clemens
Baseline Cerebral Metabolic Rate Is a Critical Determinant of the Cerebral Vasodilating Potency of Volatile Anesthetic Agents

Author: John C. Drummond, M.D., F.R.C.P.C. Anesthesiology 7 2018, Vol.129, 187-189. Abstract A Comparison of the Direct Cerebral Vasodilating Potencies of Halothane and Isoflurane in the New Zealand White Rabbit. By Drummond JC, Todd MM, Scheller MS, and Shapiro HM. Anesthesiology 1986; 65:462–7. Reprinted with permission. Halothane is commonly viewed as a more potent cerebral vasodilator than […]

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Uncategorized Published - 27 August, 2018    By - Dr Clemens
FDA Approves Liposomal Bupivacaine for Interscalene Brachial Plexus Block

On Friday the FDA approved a supplemental new drug application (sNDA) for the administration of liposomal bupivacaine (Exparel, Pacira) via interscalene brachial plexus block for postoperative regional analgesia. Liposomal bupivacaine now becomes the first long-acting, single-dose nerve block available for upper extremity surgeries, such as total shoulder arthroplasty. The approval comes despite an earlier, marginally […]

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Uncategorized Published - 27 August, 2018    By - Dr Clemens
Do Hospitals Performing Frequent Neuraxial Anesthesia for Hip and Knee Replacements Have Better Outcomes?

Authors: Stavros G. Memtsoudis, M.D., Ph.D., F.C.C.P. et al  Anesthesiology 9 2018, Vol.129, 428-439. What We Already Know about This Topic: Neuraxial anesthesia is being used more frequently for elective hip and knee replacements It is unclear whether increasing rates of hospital-level use of neuraxial anesthesia are associated with beneficial medical or economic outcomes What This […]

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Uncategorized Published - 27 August, 2018    By - Dr Clemens
Critical Role of the Surgeon–Anesthesiologist Relationship for Patient Safety

Author: Jeffrey B. Cooper, Ph.D. Anesthesiology 9 2018, Vol.129, 402-405. Abstract Teamwork is now recognized as important for safe, high-quality perioperative care. The relationship in each surgeon–anesthesiologist dyad is perhaps the most critical element of overall team performance. A well-functioning relationship is conducive to safe, effective care. A dysfunctional relationship can promote unsafe conditions and contribute […]

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