Author: Dr Clemens

Uncategorized Published - 24 June, 2015    By - Dr Clemens
Compliance with Surgical Care Improvement Project for Body Temperature Management (SCIP Inf-10) Is Associated with Improved Clinical Outcomes

Published in Anesthesiology 7 2015, Vol.123, 116-125. Authors: Andrew V. Scott BS et al Background: In an effort to measure and improve the quality of perioperative care, the Surgical Care Improvement Project (SCIP) was introduced in 2003. The SCIP guidelines are evidence-based process measures designed to reduce preventable morbidity, but it remains to be determined whether SCIP-measure […]

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Uncategorized Published - 24 June, 2015    By - Dr Clemens
A Randomized, Double-blinded Trial of a “Rule of Threes” Algorithm versus Continuous Infusion of Oxytocin during Elective Cesarean Delivery

Published in Anesthesiology 7 2015, Vol.123, 92-100 Authors: Vesela P. Kovacheva, MD, PhD et al Background: The administration of uterotonic agents during cesarean delivery is highly variable. The authors hypothesized a “rule of threes” algorithm, featuring oxytocin 3 IU, timed uterine tone evaluations, and a systematic approach to alternative uterotonic agents, would reduce the oxytocin dose required […]

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Uncategorized Published - 24 June, 2015    By - Dr Clemens
Intraoperative Mean Arterial Pressure Variability and 30-day Mortality in Patients Having Noncardiac Surgery

Published in Anesthesiology 7 2015, Vol.123, 79-91. Authors: Edward J. Mascha PhD et al Background: Little is known about the relationship between intraoperative blood pressure variability and mortality after noncardiac surgery. Therefore, the authors tested the hypothesis that blood pressure variability, independent from absolute blood pressure, is associated with increased 30-day mortality. Methods: Baseline and intraoperative variables plus […]

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Uncategorized Published - 24 June, 2015    By - Dr Clemens
A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery

Published in Anesthesiology 7 2015, Vol.123, 126-135. Authors: John R. Feiner, MD et al Background: Transfusion-related acute lung injury incidence remains the leading cause of posttransfusion mortality. The etiology may be related to leukocyte antibodies or biologically active compounds in transfused plasma, injuring susceptible recipient’s lungs. The authors have hypothesized that transfusion could have less severe effects […]

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Uncategorized Published - 23 June, 2015    By - Dr Clemens
Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study—Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

Published in Anesthesiology 7 2015, Vol.123, 38-54 Authors: Andrew J. Davidson, MD et al Background: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general […]

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Uncategorized Published - 23 June, 2015    By - Dr Clemens
Decision Aid for Cigarette Smokers Scheduled for Elective Surgery

Published in Anesthesiology 7 2015, Vol.123, 18-28 Authors: David O. Warner, MD et al Background: Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. Methods: In formative work, a […]

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Uncategorized Published - 23 June, 2015    By - Dr Clemens
Hyperinsulinemic Normoglycemia Does Not Meaningfully Improve Myocardial Performance during Cardiac Surgery: A Randomized Trial

Published in Anesthesiology 6/2015 Authors: Andra E. Duncan, MD Background: Glucose–insulin–potassium (GIK) administration during cardiac surgery inconsistently improves myocardial function, perhaps because hyperglycemia negates the beneficial effects of GIK. The hyperinsulinemic normoglycemic clamp (HNC) technique may better enhance the myocardial benefits of GIK. The authors extended previous GIK investigations by (1) targeting normoglycemia while administering a GIK […]

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Uncategorized Published - 23 June, 2015    By - Dr Clemens
Association between Withholding Angiotensin Receptor Blockers in the Early Postoperative Period and 30-day Mortality: A Cohort Study of the Veterans Affairs Healthcare System

Published in Anesthesiology 5 2015 Authors: Susan M. Lee MD FRCPC et al Background: Despite widespread use, there is limited information to guide perioperative management of angiotensin receptor blockers (ARBs). Methods: In this retrospective cohort study, the authors evaluated the patterns of postoperative ARB use in veterans regularly prescribed ARBs admitted for noncardiac surgery at the Veterans Affairs […]

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Uncategorized Published - 23 June, 2015    By - Dr Clemens
Shift From IV to Oral Sedation for Pain Procedures?

The transition from extensive use of intravenous (IV) sedation for interventional pain procedures to almost exclusive use of oral anxiolysis at an outpatient pain center led to significant improvements in patient satisfaction and recovery times, a new study shows. But not all practitioners are on board with such a policy, citing potential safety issues. “The […]

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Uncategorized Published - 22 June, 2015    By - Dr Clemens
Preanesthesia Sedative Unnecessary, RCT Data Suggest

It may be time to rethink the widespread practice of routinely giving a sedative before anesthesia to patients undergoing elective surgery, suggest findings of the randomized multicenter PremedX trial. Results published in the March 3 issue of JAMA show that compared with no premedication or a placebo, lorazepam premedication failed to improve patients’ overall satisfaction with the perioperative […]

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