Author: Dr Clemens

Uncategorized Published - 8 July, 2016    By - Dr Clemens
Rapid Infusion of Hydroxyethyl Starch 70/0.5 but not Acetate Ringer’s Solution Decreases the Plasma Concentration of Propofol during Target-controlled Infusion

Authors:  Sayako Itakura, M.D. et al Anesthesiology 8 2016, Vol.125, 304-312. Background: Rapid fluid infusion resulting in increased hepatic blood flow may decrease the propofol plasma concentration (Cp) because propofol is a high hepatic extraction drug. The authors investigated the effects of rapid colloid and crystalloid infusions on the propofol Cp during target-controlled infusion. Methods: Thirty-six patients were […]

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Uncategorized Published - 8 July, 2016    By - Dr Clemens
Emergency Cricothyrotomy Performed by Surgical Airway–naive Medical Personnel: A Randomized Crossover Study in Cadavers Comparing Three Commonly Used Techniques

Authors: Frédéric Heymans, M.D. et al Anesthesiology 8 2016, Vol.125, 295-303 Background: When conventional approaches to obtain effective ventilation and return of effective spontaneous breathing fail, surgical airway is the last rescue option. Most physicians have a limited lifetime experience with cricothyrotomy, and it is unclear what method should be taught for this lifesaving procedure. The aim […]

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Uncategorized Published - 8 July, 2016    By - Dr Clemens
Preoperative Evaluation Clinic Visit Is Associated with Decreased Risk of In-hospital Postoperative Mortality

Authors: Jeanna D. Blitz, M.D. et al Anesthesiology 8 2016, Vol.125, 280-294. Background: As specialists in perioperative medicine, anesthesiologists are well equipped to design and oversee the preoperative patient preparation process; however, the impact of an anesthesiologist-led preoperative evaluation clinic (PEC) on clinical outcomes has yet to be fully elucidated. The authors compared the incidence of in-hospital […]

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Uncategorized Published - 7 July, 2016    By - Dr Clemens
Surgical Cricothyrotomy, Rather than Percutaneous Cricothyrotomy, in “Cannot Intubate, Cannot Oxygenate” Situation

Author: Takashi Asai, M.D., Ph.D. Anesthesiology 8 2016, Vol.125, 269-271. CRICOTHYROTOMY (except for surgical tracheostomy) is regarded as the last resort in a situation of “cannot intubate, cannot oxygenate” after induction of general anesthesia,1–3  and thus, we should always be prepared to perform this task reliably in such a dire situation. Cricothyrotomy can be performed either surgically […]

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Uncategorized Published - 7 July, 2016    By - Dr Clemens
A Population-based Study Evaluating the Association between Surgery in Early Life and Child Development at Primary School Entry

Authors: James D. O’Leary, M.D. et al Anesthetic Neurotoxicity Meets Big Data: Reasons to Be Cheerful? Anesthesiology 8 2016, Vol.125, 272-279 Background: It is unclear whether exposure to surgery in early life has long-term adverse effects on child development. The authors aimed to investigate whether surgery in early childhood is associated with adverse effects on child development […]

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Uncategorized Published - 7 July, 2016    By - Dr Clemens
Perioperative Diastolic Dysfunction in Patients Undergoing Noncardiac Surgery Is an Independent Risk Factor for Cardiovascular Events: A Systematic Review and Meta-analysis

Authors: Ashraf Fayad, M.D., M.Sc., F.R.C.P.C., F.A.C.C., F.A.S.E. et al Anesthesiology 7 2016, Vol.125, 72-91. Background: The prognostic value of perioperative diastolic dysfunction (PDD) in patients undergoing noncardiac surgery remains uncertain, and the current guidelines do not recognize PDD as a perioperative risk factor. This systematic review aimed to investigate whether existing evidence supports PDD as an […]

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Uncategorized Published - 7 July, 2016    By - Dr Clemens
Preliminary Intraoperative Validation of the Nociception Level Index: A Noninvasive Nociception Monitor

Authors: Ruth Edry, M.D. et al Anesthesiology 7 2016, Vol.125, 193-203. Background: The nociception level (NoL) index is an index of nociception based on nonlinear combination of heart rate, heart rate variability, photoplethysmograph wave amplitude, skin conductance, skin conductance fluctuations, and their time derivatives. The authors evaluated the abilities of the NoL index and other measures of […]

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Uncategorized Published - 6 July, 2016    By - Dr Clemens
Guidelines for Imaging and Transfusion in Trauma

Authors: Glen J et al., BMJ 2016 Jun 22; 353:i3051 Early, whole-body computed tomography is emphasized; crystalloid is discouraged. Sponsoring Organization: U.K.’s National Institute for Health and Care Excellence (NICE) Target Population: Emergency physicians, surgeons, and other clinicians who care for patients with trauma Background and Objective An expert panel commissioned by the U.K.’s National Health Service reported recommendations […]

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Uncategorized Published - 6 July, 2016    By - Dr Clemens
Whole Body CT for Severe Trauma Might Not Offer Survival Advantage

Authors: Wurmb TE and Bernhard M., Lancet 2016 Jun 28; There were no major outcome differences between patients randomized to immediate, whole-body computed tomography and those who underwent targeted imaging. Retrospective studies in European cohorts have raised the possibility that immediate, whole-body computed tomography (CT) can decrease mortality for patients with severe trauma (NEJM JW Emerg Med […]

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Uncategorized Published - 6 July, 2016    By - Dr Clemens
Determining the Likelihood of Appendicitis: Clinical Scoring Systems vs. Gestalt

Authors: Golden SK et al., Emerg Med J 2016 Jul 33:458 Neither clinical scoring systems nor physician gestalt, alone or in combination, adequately risk stratified patients with appendicitis. Several scoring systems have been developed to risk stratify patients with suspected appendicitis. To determine how they compare with physician’s estimates of risk, researchers conducted a prospective observational study […]

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