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Anesthesiology 10 2015, Vol.123, 775-785 Authors: Mark D. Willingham, MD MCSI et al Background: An intraoperative concurrence of mean arterial pressure less than 75 mmHg, minimum alveolar concentration less than 0.8, and bispectral index less than 45 has been termed a “triple low” state. An association between triple low and postoperative mortality has been reported but was not […]
Read MoreAnesthesiology 9 2015 Authors: Xin Luo PhD et al Background: The optimal oxygen administration strategy during resuscitation from hemorrhagic shock (HS) is still controversial. Improving oxygenation and mitigating oxidative stress simultaneously seem to be contradictory goals. To maximize oxygen delivery while minimizing oxidative damage, the authors proposed the notion of gradually increased oxygen administration (GIOA), which entails making […]
Read MoreAnesthesiology 9 2015 Authors: Maxim A. Terkhov MS et al Background: Estimating surgical risk is critical for perioperative decision making and risk stratification. Current risk-adjustment measures do not integrate dynamic clinical parameters along with baseline patient characteristics, which may allow a more accurate prediction of surgical risk. The goal of this study was to determine whether the […]
Read MoreAnesthesiology 9 2015 Authors: G. Alec Rooke, MD, PhD et al Background: Management of cardiovascular implantable electronic devices (CIEDs), including pacemakers and implantable cardioverter defibrillators, for surgical procedures is challenging due to the increasing number of patients with CIEDs and limited availability of trained providers. At the authors’ institution, a small group of anesthesiologists were trained to […]
Read MoreAuthors: Mascha EJ et al., Anesthesiology 2015 Jul 123:79 Intraoperative hypotension was much more important than intraoperative hypertension or BP variability. Adverse effects of severe hypotension during surgery are quite clear. But what about intraoperative hypertension or marked variability of blood pressure (BP) during surgery? Two studies shed light on this question. A study from six U.S. […]
Read MoreAuthors: Chang JE et al., Anaesthesia 2015 Aug 70:933 During oral flexible fiberoptic intubation, the jaw-thrust maneuver was more effective when patients were in a semi-erect position than a supine position. An unobstructed path through the airway makes fiberoptic intubation easier to perform. Patient positioning, airway adjuncts, and jaw or tongue manipulation have all been used to improve […]
Read MoreAuthors: Andersen LW et al., JAMA 2015 Aug 25; 314:802 Among children with nonshockable rhythms, longer time to epinephrine administration was associated with lower likelihood of return of spontaneous circulation, survival at 24 hours, and survival to discharge with favorable neurologic outcome. Using data from the national Get With the Guidelines–Resuscitation registry from 2000 to 2014, investigators […]
Read MoreAnesthesiology 9 2015, Vol.123, 618-627 Authors: Massimo Cressoni MD et al Background: During mechanical ventilation, stress and strain may be locally multiplied in an inhomogeneous lung. The authors investigated whether, in healthy lungs, during high pressure/volume ventilation, injury begins at the interface of naturally inhomogeneous structures as visceral pleura, bronchi, vessels, and alveoli. The authors wished also to […]
Read MoreAnesthesiology 9 2015, Vol.123, 548-556 Authors: Matthew A. Timmins, B.Sc, et al Background: Malignant hyperthermia (MH) is triggered by reactions to anesthetics. Reports link nonanesthetic-induced MH-like reactions to a variety of disorders. The objective of the authors was to retrospectively investigate the reasons for referrals for MH testing in nonanesthetic cases and assess their phenotype. In addition, the […]
Read MoreAuthors: Douketis JD et al., N Engl J Med 2015 Aug 27; 373:823 Perioperative “bridging” anticoagulation in warfarin-treated AF patients didn’t prevent thromboembolism but did cause excess major bleeding. In the U.S., many warfarin-treated patients with atrial fibrillation (AF) who undergo elective surgery receive perioperative bridging anticoagulation, despite a paucity of evidence supporting this practice. In this […]
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