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Uncategorized Published - 16 November, 2016    By - Dr Clemens
Opioid Use in Pediatric Patients – Time to Reassess

Authors: Joseph P. Cravero, M.D., FAAP et al ASA Monitor 11 2016, Vol.80, 28-30. Opioids represent one of the time-honored tools for pediatric anesthesiologists in treating the most significant pain and suffering that confront our patients. While we continue to seek adequate pain treatment and avoid the consequences of inadequately treated pain, the reality of the ongoing […]

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Uncategorized Published - 16 November, 2016    By - Dr Clemens
Anesthetic-Related Neurotoxicity – Current State of the Art

Authors: Caleb H. Ing, M.D., M.S. et al ASA Monitor 11 2016, Vol.80, 16-18. The possibility of anesthetic neurotoxicity was first suggested more than 15 years ago with findings of apoptosis in the brains of rodents after ethanol exposure during critical periods of neurodevelopment. A similar neuroapoptotic effect was soon identified in anesthetic agents and linked to […]

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Uncategorized Published - 15 November, 2016    By - Dr Clemens
Selecting the Level of Positive End-expiratory Pressure for One-lung Ventilation: “By Formula” or “By Feel”?

Author: John Pfitzner, M.B.B.S., F.R.C.A. Anesthesiology 12 2016, Vol.125, 1254-1255. Blank et al  confirm that one-lung ventilation (OLV) is not without risk, but I have grave doubts about whether it is reasonable to conclude that “advances in our understanding of protective ventilation during OLV are likely to derive from well-designed randomized trials controlling for variables of inherent pathophysiologic […]

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Uncategorized Published - 15 November, 2016    By - Dr Clemens
High versus Low Technology in Assessment of Endotracheal Tube Position

Author: Hans-Joachim Priebe, M.D. Anesthesiology 12 2016, Vol.125, 1246-1247. I read with great interest the publication by Ramsingh et al. which elegantly shows that point-of-care ultrasound examination is considerably more accurate than chest auscultation in discriminating between endotracheal and endobronchial intubation. However, several factors limit the practicality of this technique in routine clinical practice. It requires unrestricted access […]

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Uncategorized Published - 15 November, 2016    By - Dr Clemens
Detection of Inadvertent Endobronchial Intubation

Authors: Mohammad El-Orbany, M.D. Anesthesiology 12 2016, Vol.125, 1248 I read with interest the article by Ramsingh et al regarding point-of-care ultrasound verification of endotracheal tube (ETT) insertion depth. Numerous tests had been previously utilized to prevent and/or detect inadvertent endobronchial (main stem) intubation. Each one of these tests has its own advantages and limitations. Undoubtedly, the use […]

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Uncategorized Published - 15 November, 2016    By - Dr Clemens
Portal Catheter Fracture in a Pediatric Patient

Authors: Antoinette Van Meter, M.D. et al    Anesthesiology 12 2016, Vol.125, 1220. IMPLANTED vascular access devices enable patients to receive long-term therapy, including chemotherapy, parenteral nutrition, and blood transfusions. While portal cathethers (PACs) rarely fracture (incidence, 0.4 to 1.8%), the most common location of fractures is at the space between the clavicle and the first […]

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Uncategorized Published - 15 November, 2016    By - Dr Clemens
Assessing the Effect of Exogenous Albumin on the Incidence of Postoperative Acute Kidney Injury in Patients Undergoing Off-pump Coronary Artery Bypass Surgery

Authors: Wei Zhang, M.D. et al Anesthesiology 12 2016, Vol.125, 1251-1252. In a prospective, randomized, and placebo-controlled trial, Lee et al.1 recently showed that administration of 20% exogenous albumin immediately before surgery increases urine output during surgery and reduces the risk of acute kidney injury (AKI) after off-pump coronary artery bypass surgery in patients with a preoperative serum […]

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Uncategorized Published - 14 November, 2016    By - Dr Clemens
New Setting of Neurally Adjusted Ventilatory Assist during Noninvasive Ventilation through a Helmet

Authors: Gianmaria Cammarota, M.D., Ph.D. et al    Anesthesiology 12 2016, Vol.125, 1181-1189 Background: Compared to pneumatically controlled pressure support (PSP), neurally adjusted ventilatory assist (NAVA) was proved to improve patient–ventilator interactions, while not affecting comfort, diaphragm electrical activity (EAdi), and arterial blood gases (ABGs). This study compares neurally controlled pressure support (PSN) with PSP and NAVA, delivered […]

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Uncategorized Published - 14 November, 2016    By - Dr Clemens
Median Effective Dose of Intranasal Dexmedetomidine for Rescue Sedation in Pediatric Patients Undergoing Magnetic Resonance Imaging

Authors: Wenhua Zhang, M.D. et al Anesthesiology 12 2016, Vol.125, 1130-1135. Background: The median effective dose (ED50) of intranasal dexmedetomidine after failed chloral hydrate sedation has not been described for children. This study aims to determine the ED50 of intranasal dexmedetomidine for rescue sedation in children aged 1 to 36 months, who were inadequately sedated by chloral hydrate […]

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Uncategorized Published - 14 November, 2016    By - Dr Clemens
Perioperative Aspirin for Prevention of Venous Thromboembolism: The PeriOperative ISchemia Evaluation-2 Trial and a Pooled Analysis of the Randomized Trials

Authors: John W. Eikelboom, M.B.B.S. et al Anesthesiology 12 2016, Vol.125, 1121-1129 Background: The PeriOperative ISchemia Evaluation-2 (POISE-2) trial compared aspirin with placebo after noncardiac surgery. Methods: The authors randomly assigned 10,010 patients undergoing noncardiac surgery to receive 200 mg aspirin or placebo 2 to 4 h before surgery and then 100 mg aspirin daily or placebo daily for up to 30 days after […]

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