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Author: Саrdiac Anesthesiologist Prolonged mechanical ventilation after Cardiac Surgery (CS) is associated with longer hospitalization, higher morbidity, mortality, and increased costs. Prolonged intubation is associated with both ventilator-associated pneumonia and significant dysphagia. Early extubation, within 6 hours of ICU arrival, can be achieved with time-directed extubation protocols and low-dose opioid anesthesia. This is safe (even in patients at high risk) and associated with […]
Read MoreAUTHORS: Aykanat, Verna M. FANZCA, MBBS, BMedSci (Hons) et al Anesthesia & Analgesia: December 2021 BACKGROUND: Prevention of hypotension during the intra- and postoperative period is an important goal. Peripheral administration of low-concentration norepinephrine may be a safe and effective strategy to reduce the risk of hypotension. METHODS: We conducted a 2-center, randomized pilot feasibility trial, […]
Read MoreAUTHORS: Mazzeffi, Michael MD, MPH, MSc et al Anesthesia & Analgesia: December 13, 2021 BACKGROUND: Coagulopathic bleeding is common during adult extracorporeal membrane oxygenation (ECMO), and acquired von Willebrand syndrome is a contributing factor. We compared ECMO patient blood samples that were treated in vitro with recombinant von Willebrand Factor concentrate and plasma-derived von Willebrand Factor […]
Read MoreAUTHORS: Du, Austin L. BS et al Anesthesia & Analgesia: January 2022 BACKGROUND: The rise in obesity in the United States, along with improvements in antiviral therapies, has led to an increase in the number of obese patients receiving liver transplants. Currently, obesity is a relative contraindication for liver transplant, although exact body mass index (BMI) […]
Read MoreAuthor: Саrdiac Anesthesiologist – 4M ago – Postoperative hypothermia is the failure to return to or maintain normothermia (>36°C) 2 to 5 hours after an intensive care unit (ICU) admission associated with Cardiac Surgery (CS). Hypothermia is associated with increased bleeding, infection, a prolonged hospital stay, and death. Large registry observational studies suggest if hypothermia is of short […]
Read MoreAuthor: Саrdiac Anesthesiologist To help reduce surgical site infections, cardiac surgery (CS) programs should include a care bundle that includes topical intranasal therapies, depilation protocols, and appropriate timing and stewardship of perioperative prophylactic antibiotics, combined with smoking cessation, adequate glycemic control, and promotion of postoperative normothermia during recovery. Moderate-quality meta-analysis have concluded that care bundles of […]
Read MoreAUTHORS: Otsuki, Sachiko MD, PhD et al Anesthesia & Analgesia: December 28, 2021 BACKGROUND: Malignant hyperthermia (MH) is an inherited muscle disorder induced by volatile anesthetics and depolarizing muscle relaxants. While the incidence of MH is high in young, there are few reports on the clinical features of pediatric MH. In this study, we selected pediatric […]
Read MoreAUTHORS: Khan, Fauzia A. MBBS, FRCA et al Anesthesia & Analgesia: December 28, 2021 BACKGROUND: Pakistan is a lower middle–income country located in South Asia with a population of nearly 208 million. Sindh is its second largest province. The aim of this survey was to identify the current setup of pediatric services, staffing, equipment, and training […]
Read MoreAUTHORS: O’Bryan, Liam J. MD et al Anesthesia & Analgesia: January 2022 – Volume 134 – Issue 1 – p 69-81 BACKGROUND: The perioperative inflammatory response may be implicated in adverse outcomes including neurocognitive dysfunction and cancer recurrence after oncological surgery. The immunomodulatory role of anesthetic agents has been demonstrated in vitro; however, its clinical relevance […]
Read MoreAUTHORS: Kouz, Karim MD et al Anesthesia & Analgesia: December 10, 2021 BACKGROUND: Cardiac output is an important hemodynamic variable and determines oxygen delivery. In contrast to blood pressure, cardiac output is rarely measured even in high-risk surgical patients, suggesting that clinicians consider blood pressure to be a reasonable indicator of systemic blood flow. However, the […]
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