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, […]
Read MoreAuthors: 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 […]
Read MoreAuthors: 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; […]
Read MoreAuthors: 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) […]
Read MoreSpirometry 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 […]
Read MorePublished 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 […]
Read MorePublished 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 […]
Read MorePublished 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 […]
Read MorePublished 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 […]
Read MorePublished 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% […]
Read More