Exposure of the grafting site during off-pump coronary bypass surgery (OPCAB) requires displacement of the heart, resulting in a decreased cardiac index (CI) and mixed venous oxygen saturation 1 2 Although these haemodynamic consequences are usually transient and well tolerated,3 4 haemodynamic collapse unresponsive to corrective measures does occur, requiring emergent cardiopulmonary bypass that is [...]
The B-type natriuretic peptides; B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, are increasing being used as biomarkers for the diagnosis, management and prognostication of cardiac failure, but their application in the peri-operative period is unclear. This review examines the current understanding of the role of B-type natriuretic peptides in both the operative and non-operative [...]
Clonidine is an α2 adrenoreceptor and imidazoline receptor agonist which has analgesic, sedative, and minimum alveolar anesthetic concentration-sparing effects. It has been used orally, IV, and epidurally. In spinal surgery, there is a reluctance to use local anesthetic-based epidural analgesia postoperatively because of fears of masking important signs of nerve root or spinal cord injury. [...]
The term “awareness” during anesthesia, as used in the anesthesia literature, implies that during a period of intended general anesthesia, the brain is aroused by stimuli that are stored in memory for future explicit recall. Patients who experience awareness will recall such experiences during a state of inadequate anesthesia. Awareness is an uncommon phenomenon, occurring [...]
With the recent proliferation of ultrasound (US)-guided techniques for performing regional anaesthetic procedures such as peripheral nerve blocks, there has been much debate on the relative merits of US technology in comparison with the earlier methods of nerve localization. The use of a peripheral nerve stimulator (PNS) has been the ‘gold standard’ for performing peripheral [...]
The American Society of Anesthesiologists (ASA) Task Force on Anesthetic Care for Magnetic Resonance Imaging (MRI) has issued a practice advisory in this area and published it in the March issue of Anesthesiology. Anesthetic care for MRI encompasses provision of moderate and deep sedation, monitored anesthesia care, general anesthesia, and ventilatory and critical care support.
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Anaesth Intensive Care 2009; 37: 14-9: A large VT and high Paw during one-lung ventilation were associated with an increased risk of post-pneumonectomy ALI/ARDS in primary lung cancer patients. N Engl J Med 2009; 360: 20-31: In an ICU population in which the mortality rate associated with standard care was 27.5% at day 28, the [...]
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Tamar F. Barlam, M.D.; Dennis L. Kasper, M.D. AccessMedicine from McGraw-Hill. 2008; ©2008 The McGraw-Hill Companies – Posted 01/12/2009 Ventilator-associated pneumonia (VAP) is a major nosocomial infection that results in significant morbidity, mortality, and health care costs. Most strategies to reduce VAP attempt to decrease rates of colonization of the aerodigestive tract and aspiration of [...]
Paul M. Fenton, FFARCSI, DTM & H Transfusion Alter Transfusion Med. 2008;10(2):82-89. ©2008 Blackwell Publishing – Posted 12/02/2008 Death from acute blood loss is a common event in many parts of the world. Most of the half-million-plus maternal deaths worldwide are due to postpartum hemorrhage. While a state of general nonreportage exists in under-resourced countries, [...]
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Sharmeen Lotia, MBBS, MRCP, FRCA; Mark C. Bellamy, MBBS, MA, FRCA Cont Edu Anaesth Crit Care & Pain. 2008;8(5):151-156. ©2008 Oxford University Press – Posted 10/07/2008 The prevalence of morbid obesity is increasing in the UK. Recent UK government statistics suggest that 20% of adults are obese and 1% morbidly obese. Anaesthesia and surgery may [...]
In cancer patients, allogeneic blood transfusion is associated with poorer prognosis, but the independent effect of the transfusion is controversial. Moreover, mediating mechanisms underlying the alleged cancer-promoting effects of blood transfusion are unknown, including the involvement of donors’ leukocytes, erythrocytes, and soluble factors. Blood Transfusion Promotes Cancer Progression: A Critical Role for Aged Erythrocytes
The authors calculated the effect size for treatments recommended for the pediatric population in the new Guidelines for the Management of Postoperative Nausea and Vomiting that should be implemented with the help of a new risk scale developed for children. Calculation of Prophylaxis Effectiveness and Expected Incidence of Vomiting under Treatment Using Bayesian Meta-analysis
MedWire News: Hyperglycemia is common in children undergoing urgent or emergent craniotomy for traumatic brain injury (TBI), increasing their risk for poor outcomes, say US researchers.
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I disturbi respiratori del sonno rappresentano una percentuale non trascurabile delle patologie dell’apparato respiratorio. A causa della sempre maggiore attenzione verso questa particolare classe di patologie, la loro incidenza negli ultimi anni ha registrato un netto aumento. Il motivo per il quale per molto tempo questi disturbi sono stati sottovalutati probabilmente risiede nel fatto che [...]
The largest ever prospective study [1,2] into the major complications [3] of epidurals and spinal anaesthetics published in the British Journal of Anaesthesia concludes that previous studies have over-estimated the risks of severe complications of these procedures. The study concludes that the estimated risk of permanent harm following a spinal anaesthetic or epidural is lower [...]
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