Author: Dr Clemens

Uncategorized Published - 23 February, 2023    By - Dr Clemens
Performance of Noninvasive Airway Occlusion Maneuvers to Assess Lung Stress and Diaphragm Effort in Mechanically Ventilated Critically Ill Patients

Authors: Heder J. de Vries, M.D. et al  Anesthesiology March 2023, Vol. 138, 274–288. Background Monitoring and controlling lung stress and diaphragm effort has been hypothesized to limit lung injury and diaphragm injury. The occluded inspiratory airway pressure (Pocc) and the airway occlusion pressure at 100 ms (P0.1) have been used as noninvasive methods to assess […]

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Uncategorized Published - 23 February, 2023    By - Dr Clemens
Is time running out for small ASCs?

Author: Patsy Newitt  Becker’s ASC Review Although the ASC industry remains fragmented, some leaders are worried about the viability of independent ASCs amid an increasingly consolidated healthcare landscape. “I am focused on the consolidation of health systems, capital equity firms, private practices and third-party payers purchasing practices and ASCs,” Matt Kraemer, administrator of Northern Arizona […]

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Uncategorized Published - 23 February, 2023    By - Dr Clemens
Hospital-, Anesthesiologist-, Surgeon-, and Patient-Level Variations in Neuraxial Anesthesia Use for Lower Limb Revascularization Surgery

AUTHORS: Roberts, Derek J. MD, PhD, FRCSC et al  Anesthesia & Analgesia 135(6):p 1282-1292, December 2022. BACKGROUND: Although neuraxial anesthesia may promote improved outcomes for patients undergoing lower limb revascularization surgery, its use is decreasing over time. Our objective was to estimate variation in neuraxial (versus general) anesthesia use for lower limb revascularization at the hospital, […]

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Uncategorized Published - 23 February, 2023    By - Dr Clemens
Decreased Electroencephalographic Alpha Power During Anesthesia Induction Is Associated With EEG Discontinuity in Human Infants

AUTHORS: Chao, Jerry Y. MD, MS et al  Anesthesia & Analgesia 135(6):p 1207-1216, December 2022. | BACKGROUND: Electroencephalogram (EEG) discontinuity can occur at high concentrations of anesthetic drugs, reflecting suppression of electrocortical activity. This EEG pattern has been reported in children and reflects a deep state of anesthesia. Isoelectric events on the EEG, a more extreme degree […]

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Uncategorized Published - 23 February, 2023    By - Dr Clemens
Are Viscoelastic Tests Clinically Useful to Identify Platelet-Dependent Bleeding in High-Risk Cardiac Surgery Patients?

AUTHORS: Baryshnikova, Ekaterina PhD et al  Anesthesia & Analgesia 135(6):p 1198-1206, December 2022. BACKGROUND: Postoperative use of platelet function testing to rule out microvascular bleeding due to platelet dysfunction after cardiac surgery still lacks strong reference data and reliable cutoff values, yielding a clinically adequate sensitivity and specificity. The present study aims to investigate the performance […]

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Uncategorized Published - 22 February, 2023    By - Dr Clemens
Hypobaric Unilateral Spinal Anesthesia Versus General Anesthesia for Hip Fracture Surgery in the Elderly

AUTHORS: Simonin, Marine MD et al  Anesthesia & Analgesia 135(6):p 1262-1270, December 2022. BACKGROUND: Hypotension during surgery is frequent in the elderly population and is associated with acute kidney and myocardial injury, which are, themselves, associated with increased 30-day mortality. The present study compared the hemodynamic effects of hypobaric unilateral spinal anesthesia (HUSA) to general anesthesia […]

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Uncategorized Published - 22 February, 2023    By - Dr Clemens
Completion of an Enhanced Recovery Program in a Pediatric Ambulatory Surgery Center

AUTHORS: Martin, Lynn D. MD, MBA et al  Anesthesia & Analgesia 135(6):p 1271-1281, December 2022. BACKGROUND: Enhanced Recovery After Surgery (ERAS) was first established in 2001 focusing on recovery from complex surgical procedures in adults and recently expanded to ambulatory surgery. The evidence for ERAS in children is limited. In 2018, recognized experts began developing needed […]

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Uncategorized Published - 22 February, 2023    By - Dr Clemens
Early Vasopressor Utilization Strategies and Outcomes in Critically Ill Patients With Severe Traumatic Brain Injury

AUTHORS: Toro, Camilo BA et al  Anesthesia & Analgesia 135(6):p 1245-1252, December 2022.  BACKGROUND: Early hypotension after severe traumatic brain injury (sTBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors, commonly norepinephrine and phenylephrine, to support blood pressure after TBI. However, guidelines do not specify vasopressor […]

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Uncategorized Published - 22 February, 2023    By - Dr Clemens
Predictors and Hospital Outcomes in Pregnant Patients Undergoing Extracorporeal Membrane Oxygenation

AUTHORS: van den Bosch, Oscar F. C. MD et al  Anesthesia & Analgesia 135(6):p 1172-1179, December 2022. Abstract BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients with severe cardiorespiratory collapse. Although prior large database reviews of ECMO use in the peripartum population exist, they do not stratify by ECMO indication nor do they include […]

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Uncategorized Published - 22 February, 2023    By - Dr Clemens
Ultrasound-guided genicular nerves block vs. local infiltration analgesia for total knee arthroplasty

DG Journal Club Authors: T Cuñat, J Mejía, I Tatjer, O Comino Anaesthesia. 2022 Nov 9 Genicular nerves block is a promising technique to treat acute postoperative pain in total knee arthroplasty. Similar to surgeon-administered local infiltration analgesia, it targets sensory branches from the knee capsule, but through a selective ultrasound-guided injection that reduces local […]

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