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Authors: Sinziana Avramescu, MD, PhD, et al Anesthesiology published on 11 2015. Background: Critically ill patients with severe inflammation often exhibit heightened sensitivity to general anesthetics; however, the underlying mechanisms remain poorly understood. Inflammation increases the number of γ-aminobutyric acid type A (GABAA) receptors expressed on the surface of neurons, which supports the hypothesis that inflammation increases up-regulation […]
Read MoreAuthors: Daniel J. Johnson, B.S. el at Anesthesiology published on 11 2015. Background: It is well recognized that increased transfusion volumes are associated with increased morbidity and mortality, but dose–response relations between high- and very-high-dose transfusion and clinical outcomes have not been described previously. In this study, the authors assessed (1) the dose–response relation over a wide […]
Read MoreAuthors: Karim S. Ladha, MD M.Sc et al Anesthesiology published on 11 2015. Background: Opioids play a crucial role in providing analgesia throughout the perioperative period; however, patients may become persistent users of these medications months after surgery. Epidurals have been posited to prevent the development of persistent pain, but there are little data on the effect […]
Read MoreAuthors: Lisbeth Evered, B.Sc, M.Biostat, PhD et al Anesthesiology published on 11 2015. Background: Postoperative cognitive dysfunction (POCD) affects 16 to 21% of the elderly 3 months after anesthesia and surgery and is associated with adverse outcomes. The exact cause of POCD remains unknown. The authors hypothesized that elderly individuals with Alzheimer disease (AD) neuropathology, identified by cerebrospinal […]
Read MoreAuthors: Christoffer C. Jorgensen MD, et al Anesthesiology 12 2015, Vol.123, 1281-1291. doi:10.1097/ALN.0000000000000632 Background: Psychiatric disorder (PsD) is rarely considered when evaluating perioperative risk factors. Studies on PsD are often limited by use of administrative coding, incomplete follow-up, and lack of preoperative data on psychopharmacological treatment. Methods: A multicenter study with prospective registration on preoperative comorbidity, complete 90-day follow-up, […]
Read MoreAuthors: Gabriela K. Fragiadakis B.A. et al Anesthesiology 12 2015, Vol.123, 1241-1255. doi:10.1097/ALN.0000000000000887 Background: Recovery after surgery is highly variable. Risk-stratifying patients based on their predicted recovery profile will afford individualized perioperative management strategies. Recently, application of mass cytometry in patients undergoing hip arthroplasty revealed strong immune correlates of surgical recovery in blood samples collected shortly after surgery. However, the […]
Read MoreAuthor: Larry M. Silver MD ASA Monitor 11 2015, Vol.79, 40-42. Larry M. Silver, M.D. is Private Practice Anesthesiologist, Coastal Anesthesia Medical Associates; Medical Product Developer for Tahoe Institute of Rural Health Research, San Luis Obispo, California. Acute care cognitive aids (ACCAs) are tools used by clinicians to deliver emergent treatment to patients with acute medical […]
Read MoreAuthors: George Diaiani, MD, FRCA, FRCPC, et al Anesthesiology published on 11 2015. Background: Postoperative delirium (POD) is a serious complication after cardiac surgery. Use of dexmedetomidine to prevent delirium is controversial. The authors hypothesized that dexmedetomidine sedation after cardiac surgery would reduce the incidence of POD. Methods: After institutional ethics review board approval, and informed consent, a single-blinded, […]
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Read MoreAuthor: Emily Richardson, MD ASA Monitor 11 2015, Vol.79, 36-38. Emily Richardson, M.D. is Chief Quality Officer, Encompass Medical Partners, Fort Collins, Colorado. Collection of data is all well and good, but improvement in patient outcomes requires the ability to turn information into action. The AQI Practice Quality Improvement Committee (PQIC) will collect and present examples […]
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