Author: Dr Clemens

Uncategorized Published - 2 July, 2015    By - Dr Clemens
Reversing Dabigatran-Induced Anticoagulation

Authors: Pollack CV Jr et al., N Engl J Med 2015 Jun 22 Idarucizumab immediately reversed dabigatran-induced increases in clotting variables without causing serious adverse events. Dabigatran is a direct thrombin inhibitor that is approved for the prevention of stroke in atrial fibrillation and for the treatment of venous thromboembolism. Bleeding is usually managed by discontinuing the drug or, […]

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Uncategorized Published - 2 July, 2015    By - Dr Clemens
Two Trials Support High-Flow Oxygen Use in Patients with Hypoxemic Respiratory Failure

Authors: Stéphan F et al., JAMA 2015 Jun 16; 313:2331 In one trial, intubation rates were similar to those of noninvasive positive pressure ventilation, and 90-day mortality was lower. Use of noninvasive positive pressure ventilation (NPPV) in patients with chronic obstructive pulmonary disease exacerbations and cardiogenic pulmonary edema is well established, but its value in treating patients […]

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Uncategorized Published - 2 July, 2015    By - Dr Clemens
Less-Than-Goal Enteral Nutrition Is OK for Critically Ill Patients

Authors: Arabi YM et al., N Engl J Med 2015 Jun 18; 372:2398 Outcomes did not differ among patients who received permissive underfeeding or full feeds. What is the right amount of nutrition for a critically ill patient? Two randomized, controlled trials demonstrated that higher-rate enteral nutrition was not necessarily better than low-rate enteral feeds (CMAJ 2004; […]

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Uncategorized Published - 2 July, 2015    By - Dr Clemens
ECMO + CPR for VFib?

Authors: Siao FY et al., Resuscitation 2015 Jul 92:70 A small Taiwanese study showed significant improvement in long-term neurological function with this intensive intervention. Survival after cardiac arrest remains low, even in patients with shockable rhythms. Extracorporeal membrane oxygenation (ECMO) may improve tissue perfusion during resuscitation, and case reports have described its use in emergency department (ED) […]

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Uncategorized Published - 1 July, 2015    By - Dr Clemens
Relying on Spirometry Alone Misses Lung Disease in Smokers

Spirometry alone isn’t sufficient to rule out lung disease in current and former smokers, according to an observational study in JAMA Internal Medicine. Some 4400 chronic (current or former) smokers with normal spirometry findings, 800 with mild COPD on spirometry, and 100 never-smokers underwent chest computed tomography, a 6-minute walk test, and symptom questionnaires. CT revealed […]

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Uncategorized Published - 1 July, 2015    By - Dr Clemens
Discharge Readiness after Tricompartment Knee Arthroplasty: Adductor Canal versus Femoral Continuous Nerve Blocks—A Dual-center, Randomized Trial

Published in Anesthesiology 6/2015 Authors: Anthony T. Machi, MD et al Background: The authors conducted a randomized, controlled, parallel-arm, superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty. Methods: Subjects undergoing tricompartment knee arthroplasty were […]

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Uncategorized Published - 1 July, 2015    By - Dr Clemens
Sufentanil Sublingual Tablet System for the Management of Postoperative Pain after Knee or Hip Arthroplasty: A Randomized, Placebo-controlled Study

Published in Anesthesiology 6/2015 Authors: Maurice Jove, MD et al Background: Complications with IV patient-controlled analgesia include programming errors, invasive access, and impairment of mobility. This study evaluated an investigational sufentanil sublingual tablet system (SSTS) for the management of pain after knee or hip arthroplasty. Methods:  This prospective, randomized, parallel-arm, double-blind study randomized postoperative patients at […]

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Uncategorized Published - 1 July, 2015    By - Dr Clemens
Malignant Hyperthermia Testing in Probands without Adverse Anesthetic Reaction

Published in Anesthesiology 6/2015 Authors: Matthew A. Timmins, B.Sc. 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 response to […]

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Uncategorized Published - 1 July, 2015    By - Dr Clemens
Association between Intraoperative Hypotension and Hypertension and 30-day Postoperative Mortality in Noncardiac Surgery

Published in Anesthesiology 6/2015 Authors: Terri G. Monk, M.D., M.S. et al Background: Although deviations in intraoperative blood pressure are assumed to be associated with postoperative mortality, critical blood pressure thresholds remain undefined. Therefore, the authors estimated the intraoperative thresholds of systolic blood pressure (SBP), mean blood pressure (MAP), and diastolic blood pressure (DBP) associated with […]

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Uncategorized Published - 30 June, 2015    By - Dr Clemens
Pre-emptive peritonsillar infiltration of magnesium sulphate and ropivacaine vs. ropivacaine or magnesium alone for relief of post-adenotonsillectomy pain in children.

Published in Int J Pediatr Otorhinolaryngol 2015 Apr;79(4):499-503 Authors; Sun J et al OBJECTIVES: The randomized, double-blinded, placebo-controlled study evaluated the administration of local infiltration of magnesium combined with ropivacaine to reduce pain scores after pediatric adenotonsillectomy. METHODS: Sixty one subjects received 5ml solution contained 0.25% ropivacaine plus 5mg/kg magnesium sulphate (Group M+R), 5ml 0.25% […]

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