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Authors: Ezekiel J. Emanuel, MD, PhD et al JAMA. Published online January 29, 2018. Everyone wants the best physician. Patients want their physician to know medical information by heart, to possess diagnostic acumen, and to be well-versed in the latest tests and treatments. Finding the best physicians often involves looking for resumes with stellar attributes, such as having […]
Read MoreAuthors: R. Makaryusvet et al British Journal of Anesthesia February 2018 Volume 120, Issue 2, Pages 376–383 Abstract Perioperative fluid management impacts outcomes and plays a pivotal role in enhanced recovery pathways (ERPs). There have been major advances in understanding the effects of fluid therapy and administration during the perioperative period. Improving fluid management during this […]
Read MoreAuthors: Sachin Kheterpal, M.D., M.B.A. et al Anesthesiology 2 2018, Vol.128, 272-282. Background: The authors hypothesized that a multiparameter intraoperative decision support system with real-time visualizations may improve processes of care and outcomes. Methods: Electronic health record data were retrospectively compared over a 6-yr period across three groups: experimental cases, in which the decision support […]
Read MoreAuthors: Laurent G. Glance, M.D. et al Anesthesiology 2 2018, Vol.128, 244-246. doi:10.1097/ALN.0000000000002021 “If risk prediction tools are to be used in clinical care, it is essential that they be vetted with the same care as any new drug or medical device.” LAST year Amazon captured 40% of online sales partly as a result of accurate […]
Read MoreAuthors: Nienke M. G. Rorije, M.D. et al Anesthesiology 2 2018, Vol.128, 352-360. Background: Sodium-induced microcirculatory changes, endothelial surface layer alterations in particular, may play an important role in sodium-mediated blood pressure elevation. However, effects of acute and chronic sodium loading on the endothelial surface layer and microcirculation in humans have not been established. The objective of […]
Read MoreAuthor: Jayshil J. Patel, MD1 JAMA. 2018;319(4):341-342. Gwynne’s Grammar1 is my favorite writing guide. In it, he advocates for precision in the use of language, which is the machine for thinking and necessary for clear judgment and good decisions. Gwynne creates a nine-step argument for the importance of words, even suggesting: “If enough societies in the world crumble as […]
Read MoreBrief training in breathing exercises before upper abdominal surgery significantly reduces postoperative pulmonary complications, a study in The BMJ finds. Over 400 adults scheduled for surgery (e.g., colectomy, nephrectomy) were randomized to a breathing exercise intervention or a control group. All patients received, within 6 weeks before surgery, an information booklet that prescribed postoperative breathing exercises. Intervention […]
Read MoreAuthors: Michelle Trieu, B.Sc. et al Anesthesiology 2 2018, Vol.128, 361-374. Background: Microcirculatory dysfunction is associated with multiple organ failure and unfavorable patient outcome. We investigated whether therapeutically targeting the endothelial angiopoietin/Tie2 system preserves microvascular integrity during hemorrhagic shock. Methods: Rats were treated with the angiopoietin-1 mimetic vasculotide and subjected to hemorrhagic shock and fluid resuscitation. Microcirculatory perfusion […]
Read MoreAuthors: Per Ederoth, M.D., Ph.D. et al Anesthesiology published on January 24, 2018. Background: Acute kidney injury is a common complication after cardiac surgery, leading to increased morbidity and mortality. One suggested cause for acute kidney injury is extracorporeal circulation–induced ischemia–reperfusion injury. In animal studies, cyclosporine has been shown to reduce ischemia–reperfusion injury in the kidneys. […]
Read MoreAuthors: Lijian Pei, M.D. et al Anesthesiology published on January 24, 2018. Background: The effect of ambient temperature, with and without active warming, on intraoperative core temperature remains poorly characterized. The authors determined the effect of ambient temperature on core temperature changes with and without forced-air warming. Methods: In this unblinded three-by-two factorial trial, 292 adults were randomized […]
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