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Uncategorized Published - 23 September, 2015    By - Dr Clemens
The Jaw Thrust Finds a Purpose During Flexible Fiberoptic Intubation

Authors: Chang JE et al., Anaesthesia 2015 Aug 70:933 During oral flexible fiberoptic intubation, the jaw-thrust maneuver was more effective when patients were in a semi-erect position than a supine position. An unobstructed path through the airway makes fiberoptic intubation easier to perform. Patient positioning, airway adjuncts, and jaw or tongue manipulation have all been used to improve […]

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Uncategorized Published - 23 September, 2015    By - Dr Clemens
Delay to Epinephrine Linked with Worse Outcomes in Children with In-Hospital Cardiac Arrest

Authors: Andersen LW et al., JAMA 2015 Aug 25; 314:802 Among children with nonshockable rhythms, longer time to epinephrine administration was associated with lower likelihood of return of spontaneous circulation, survival at 24 hours, and survival to discharge with favorable neurologic outcome. Using data from the national Get With the Guidelines–Resuscitation registry from 2000 to 2014, investigators […]

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Uncategorized Published - 22 September, 2015    By - Dr Clemens
Lung Inhomogeneities and Time Course of Ventilator-induced Mechanical Injuries

Anesthesiology 9 2015, Vol.123, 618-627 Authors: Massimo Cressoni MD et al Background: During mechanical ventilation, stress and strain may be locally multiplied in an inhomogeneous lung. The authors investigated whether, in healthy lungs, during high pressure/volume ventilation, injury begins at the interface of naturally inhomogeneous structures as visceral pleura, bronchi, vessels, and alveoli. The authors wished also to […]

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Uncategorized Published - 22 September, 2015    By - Dr Clemens
Malignant Hyperthermia Testing in Probands without Adverse Anesthetic Reaction

Anesthesiology 9 2015, Vol.123, 548-556 Authors: Matthew A. Timmins, B.Sc, et al Background: Malignant hyperthermia (MH) is triggered by reactions to anesthetics. Reports link nonanesthetic-induced MH-like reactions to a variety of disorders. The objective of the authors was to retrospectively investigate the reasons for referrals for MH testing in nonanesthetic cases and assess their phenotype. In addition, the […]

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Uncategorized Published - 22 September, 2015    By - Dr Clemens
Perioperative Anticoagulation in Atrial Fibrillation: A Bridge to Nowhere

Authors: Douketis JD et al., N Engl J Med 2015 Aug 27; 373:823 Perioperative “bridging” anticoagulation in warfarin-treated AF patients didn’t prevent thromboembolism but did cause excess major bleeding. In the U.S., many warfarin-treated patients with atrial fibrillation (AF) who undergo elective surgery receive perioperative bridging anticoagulation, despite a paucity of evidence supporting this practice. In this […]

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Uncategorized Published - 22 September, 2015    By - Dr Clemens
Xenon Does Not Increase Heart Rate–corrected Cardiac QT Interval in Volunteers and in Patients Free of Cardiovascular Disease

Anesthesiology 9 2015, Vol.123, 542-547 Authors: Martin Neukirchen NM et al Background: Impaired cardiac repolarization, indicated by prolonged QT interval, may cause critical ventricular arrhythmias. Many anesthetics increase the QT interval by blockade of rapidly acting potassium rectifier channels. Although xenon does not affect these channels in isolated cardiomyocytes, the authors hypothesized that xenon increases the QT […]

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Uncategorized Published - 22 September, 2015    By - Dr Clemens
A Randomized Crossover Study Comparing a Novel Needle Guidance Technology for Simulated Internal Jugular Vein Cannulation

Anesthesiology 9 2015, Vol.123, 535-541 Authors: David B. Auyong MD et al Background: Despite ultrasound guidance for central line placement, complications persist, as exact needle location is often difficult to confirm with standard two-dimension ultrasound. A novel real-time needle guidance technology has recently become available (eZono, Germany) that tracks the needle during insertion. This randomized, blinded, crossover study examined […]

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Uncategorized Published - 22 September, 2015    By - Dr Clemens
Modified Valsalva Maneuver for Supraventricular Tachycardia

Authors: Appelboam A et al., Lancet 2015 Aug 24; A simple modification in the Valsalva maneuver dramatically increased its effectiveness. The Valsalva maneuver is recommended first-line treatment for stable patients with supraventricular tachycardia, although it is successful in only a minority of patients. These authors tested whether a modified Valsalva maneuver can improve cardioversion rates. In a […]

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Uncategorized Published - 21 September, 2015    By - Dr Clemens
Astrocytes Protect against Isoflurane Neurotoxicity by Buffering pro-brain–derived Neurotrophic Factor

Anesthesiology 10 2015, Vol.123, 810-819 Authors: Creed M. Stary, MD, PhD et al Background: Isoflurane induces cell death in neurons undergoing synaptogenesis via increased production of pro-brain–derived neurotrophic factor (proBDNF) and activation of postsynaptic p75 neurotrophin receptor (p75NTR). Astrocytes express p75NTR, but their role in neuronal p75NTR-mediated cell death remains unclear. The authors investigated whether astrocytes have the capacity […]

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Uncategorized Published - 21 September, 2015    By - Dr Clemens
Ability of the Nociception Level, a Multiparameter Composite of Autonomic Signals, to Detect Noxious Stimuli during Propofol–Remifentanil Anesthesia

Anesthesiology 9 2015, Vol.123, 524-534 Authors: Chris H. Martini MD et al ; Background: A novel multidimensional index of nociception, the nociception level (NoL) index, derived from the nonlinear composite of heart rate (HR), HR variability, amplitude of the photoplethysmogram, skin conductance, fluctuations in skin conductance, and their time derivatives, was used to assess nociception during anesthesia. Methods: Seventy-two […]

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