Author: Dr Clemens

Uncategorized Published - 29 December, 2017    By - Dr Clemens
You Don’t Need to Do a Prolonged Fast Before Surgery

The recommendation is outdated, but many hospitals still mistakenly encourage it. Why? By Marina Kamenev Patients can have light meals six hours before their procedures—but instructions often still call for fasting. In 1946, obstetrician and cardiologist Curtis Lester Mendelson discovered a disturbing phenomenon: He found that some women who had anesthesia in labor were vomiting and […]

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Uncategorized Published - 29 December, 2017    By - Dr Clemens
Cricoid Pressure: Effective Measure or Ritual?

Author: Hans-Joachim Priebe, M.D. Anesthesiology 1 2018, Vol.128, 233-234. To the Editor: I read with great interest the review on cricoid pressure (CP) by Salem et al.1  The authors assure the reader that they have “used discretion in deciding which articles to finally include, favoring peer-reviewed articles from highly ranked journals written in English.” However, a couple of […]

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Uncategorized Published - 29 December, 2017    By - Dr Clemens
Should the Dominant or Nondominant Hand Be Used for Applying Cricoid Pressure?

Authors: Jonathan V. Roth, M.D. Anesthesiology 1 2018, Vol.128, 233. To the Editor: In their excellent review, Salem et al.1  suggest that the dominant hand should be used to apply cricoid pressure (CP) because even though either hand can achieve adequate CP, the applied force may become inadequate if it needs to be sustained with the nondominant hand.2  I […]

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Uncategorized Published - 28 December, 2017    By - Dr Clemens
Age Matters: The Older the Physician, the Fewer the Patient Complaints

It turns out the age of a physician does influence the likelihood patients will have a complaint. However, the older the doctor, the fewer patient complaints, according to a study published in JAMA Ophthalmology. Researchers from Vanderbilt University School of Medicine in Nashville, Tennessee, wanted to see if physician age was associated with an increased […]

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Uncategorized Published - 28 December, 2017    By - Dr Clemens
Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: A Discussion of the Level of Evidence

Authors: Arthur James, M.D. et al Anesthesiology 1 2018, Vol.128, 228. To the Editor: We read with great interest Hajjar et al.’s article1  that was published in the January 2017 issue of Anesthesiology. Norepinephrine, the most commonly recommended vasopressor agent for vasoplegic shock states, can cause unfortunate side effects; therefore, researchers strive to find a therapeutic alternative. Several […]

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Uncategorized Published - 28 December, 2017    By - Dr Clemens
Use of Vasopressin in Vasoplegic Syndrome with Reduced Ejection Fraction: Asking for Trouble

Author: Ajay Kumar Jha, M.D., D.M. Anesthesiology 1 2018, Vol.128, 227. To the Editor: I read the article by Hajjar et al. with great enthusiasm.1  First, I would like to congratulate the authors for their ambitious study and reasonable conclusions. They concluded that vasopressin improved clinical outcomes better than norepinephrine in vasoplegic shock after cardiac surgery. I would […]

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Uncategorized Published - 28 December, 2017    By - Dr Clemens
Preoperative Prediction of Chronic Postsurgical Pain after Thoracotomy: Need for Adequately Sized Population-based Samples

Authors: Antonio Montes, M.D., Ph.D. et al Anesthesiology 1 2018, Vol.128, 224. To the Editor: The article by Bayman et al.,1  evaluating predictors of chronic pain 6 months after thoracic surgery, provides important evidence of the high incidence and severity of chronic postsurgical pain (CPSP) after both thoracotomy and video-assisted thoracic surgery. However, we are surprised the authors […]

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Uncategorized Published - 28 December, 2017    By - Dr Clemens
Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery

Authors: Alexandre Joosten, M.D. et al Anesthesiology 1 2018, Vol.128, 55-66. Background: The type of fluid and volume regimen given intraoperatively both can impact patient outcome after major surgery. This two-arm, parallel, randomized controlled, double-blind, bi-center superiority study tested the hypothesis that when using closed-loop assisted goal-directed fluid therapy, balanced colloids are associated with fewer postoperative complications […]

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Uncategorized Published - 27 December, 2017    By - Dr Clemens
Effects of Changes in Arterial Carbon Dioxide and Oxygen Partial Pressures on Cerebral Oximeter Performance

Authors: Andrew Schober, M.D., Ph.D. et al Anesthesiology 1 2018, Vol.128, 97-108 Background: Cerebral oximetry (cerebral oxygen saturation; ScO2) is used to noninvasively monitor cerebral oxygenation. ScO2 readings are based on the fraction of reduced and oxidized hemoglobin as an indirect estimate of brain tissue oxygenation and assume a static ratio of arterial to venous intracranial blood. Conditions […]

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Uncategorized Published - 27 December, 2017    By - Dr Clemens
An International, Multicenter, Observational Study of Cerebral Oxygenation during Infant and Neonatal Anesthesia

Authors: Vanessa A. Olbrecht, M.D., M.B.A. et al Anesthesiology 1 2018, Vol.128, 85-96. Background: General anesthesia during infancy is associated with neurocognitive abnormalities. Potential mechanisms include anesthetic neurotoxicity, surgical disease, and cerebral hypoxia–ischemia. This study aimed to determine the incidence of low cerebral oxygenation and associated factors during general anesthesia in infants. Methods: This multicenter study enrolled 453 […]

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