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European Journal of Anaesthesiology: April 2016 – Volume 33 – Issue 4 – p 275–282 AUTHORS: Lee, Su Hyun et al BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a risk factor that increases the incidence of postoperative cardiopulmonary morbidity and mortality after lung resection. Dexmedetomidine, a selective α2-adrenoreceptor agonist, has been reported previously to attenuate intrapulmonary […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 626–633 AUTHORS: Applegate, Richard L. II MD et al BACKGROUND: The use of intraoperative pulse oximetry (SpO2) enhances hypoxia detection and is associated with fewer perioperative hypoxic events. However, SpO2 may be reported as 98% when arterial partial pressure of oxygen (PaO2) is […]
Read MoreAuthors: Pavel S. Roshanov, M.D., M.Sc. et al Anesthesiology published on October 23, 2016. Background: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. Methods: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II […]
Read MoreAuthors: Patrick J. McCormick, M.D. et al Anesthesiology published on October 23, 2016. Background: We tested the hypothesis that an electronic alert for a “double low” of mean arterial pressure less than 75 mmHg and a bispectral index less than 45 reduces the primary outcome of 90-day mortality. Methods: Adults having noncardiac surgery were randomized to receive either […]
Read MoreIn a soul-searching Emery A. Rovenstine Memorial Lecture on Monday, David Chestnut, M.D., examined the key attributes of professionalism and his own journey on the road to professionalism in anesthesiology. “Each of us helps shape the culture of professionalism in our practice environment. Professionalism is not something that we learn once. None of us is […]
Read MoreDavid J. Bjorkman, MD, MSPH (HSA), SM (Epid.) Reviewing Kumar NL et al., Gastrointest Endosc 2016 Sep 29; Earlier endoscopy — performed within 12 versus 24 hours of bleeding presentation — was associated with worse outcomes in low-risk patients. Most guidelines recommend that patients with nonvariceal upper gastrointestinal bleeding (UGIB) undergo endoscopy within 24 hours of presentation. But […]
Read MoreEdited by Susan Sadoughi, MD, and André Sofair, MD, MPH Elective sigmoidectomy is associated with improved quality of life for patients with recurrent and persistent symptoms after a diverticulitis episode, suggests an open-label trial in the Lancet Gastroenterology & Hepatology. Roughly 100 Dutch patients who’d had an episode of left-sided diverticulitis followed by either ongoing abdominal complaints lasting […]
Read MoreAuthors: Colin F. Royse, M.B.B.S., M.D., F.A.N.Z.C.A. et al Anesthesiology published on October 23, 2016 Background: Inflammation after cardiopulmonary bypass may contribute to postoperative delirium and cognitive dysfunction. The authors evaluated the effect of high-dose methylprednisolone to suppress inflammation on the incidence of delirium and postoperative quality of recovery after cardiac surgery. Methods: Five hundred fifty-five adults from […]
Read MoreAuthors: Lesley K. Rao, M.D. et al Anesthesiology published on October 23, 2016. Background: At therapeutic concentrations, cytochrome P4502B6 (CYP2B6) is the major P450 isoform catalyzing hepatic ketamine N-demethylation to norketamine in vitro. The CYP2B6 gene is highly polymorphic. The most common variant allele, CYP2B6*6, is associated with diminished hepatic CYP2B6 expression and catalytic activity compared with wild-type CYP2B6*1/*1. CYP2B6.6, […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 731–738 AUTHORS: Sigakis, Matthew J. G. MD et al BACKGROUND: Discharge diagnoses are used to track national trends and patterns of maternal morbidity. There are few data regarding the validity of the International Classification of Diseases (ICD) codes used for this purpose. The goal […]
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