23,467 results match your criteria Anaesthesia critical care & pain medicine[Journal]


[Clinical feature changes of a COVID-19 patient from mild to critical condition and cardiopulmonary pathological results].

Zhonghua Xin Xue Guan Bing Za Zhi 2020 May 26;48(0):E018. Epub 2020 May 26.

Administration Office, Shenzhen Third People's Hospitle, Shenzhen 518112, China.

To analyse the clinical history, laboratory tests and pathological data of a patient who suffered from novel coronavirus pneumonia(COVID-19) and provide reference for the clinical treatment of similar cases. Data of clinical manifestation, laboratory examination, bronchoscopy, echocardiography and cardiopulmonary pathological results were retrospectively reviewed in a case of COVID-19 with rapid exacerbation from mild to critical condition. This patient hospitalized at day 9 post 2019 novel coronavirus(2019-nCoV) infection, experienced progressive deterioration from mild to severe at day 11, severe to critical at day 18 and underwent extracorporeal membrane oxygenation(ECMO) and continuous renal replacement therapy(CRRT) as well as heart lung transplantation during day 28-45 day post infection, and died on the second day post heart and lung transplantation. Read More

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http://dx.doi.org/10.3760/cma.j.cn112148-20200304-00155DOI Listing

Coagulation in liver surgery: an observational haemostatic profile and thromboelastography study.

ANZ J Surg 2020 May 26. Epub 2020 May 26.

Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

Background: International normalized ratio (INR) is used as a marker of the haemostatic status following liver resection. However, the impact of liver resection on haemostasis is complex and beyond what can be measured by INR. This study aimed to prospectively assess haemostatic profile following liver resection and determine if INR measurement can safely guide post-operative thromboprophylaxis. Read More

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http://dx.doi.org/10.1111/ans.15912DOI Listing

COVID-19: Recommendations for regional anesthesia.

J Clin Anesth 2020 May 20;65:109885. Epub 2020 May 20.

Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ, United States of America; University of Arizona College of Medicine - Phoenix, Department of Anesthesiology, Phoenix, AZ, United States of America; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, United States of America.

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http://dx.doi.org/10.1016/j.jclinane.2020.109885DOI Listing

Tethering role of the autonomic nervous system on cardioventilatory coupling.

Respir Physiol Neurobiol 2020 May 23:103466. Epub 2020 May 23.

Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital - Polo Universitario, University of Milan, Milan, Italy.

Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and resulting cardioventilatory coupling is poorly understood even in healthy humans. We explored heart rate variability, baroreflex activity, and their interaction in an experimental protocol involving twelve mildly hypovolemic healthy subjects during spontaneous breathing and noninvasive positive-pressure ventilation. In seven subjects, an echocardiographic assessment was also performed. Read More

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http://dx.doi.org/10.1016/j.resp.2020.103466DOI Listing

Renal Doppler-Based Assessment of Regional Organ Perfusion in the Critically Ill Patient.

Shock 2020 May 21. Epub 2020 May 21.

Department of Anesthesiology. Ente Ospedaliero Ospedali Galliera, Genova, Italy, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, Genoa, Italy Cardiac Anesthesia and Intensive Care, Fondazione Cardiocentro Ticino, Lugano, Switzerland. Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy University of Pavia, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences. Anaesthesia, Intensive Care and Pain Therapy, Fondazione IRCCS Policlinico San Matteo, Italy.

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http://dx.doi.org/10.1097/SHK.0000000000001571DOI Listing

Infraglottic versus supraglottic jet-ventilation for endobronchial ultrasound-guided transbronchial needle aspiration: A randomised controlled trial.

Eur J Anaesthesiol 2020 May 20. Epub 2020 May 20.

From the Division of Cardiothoracic and Vascular Anaesthesia, Department of Anaesthesia, Critical Care and Pain Medicine, Medical University of Vienna (MA, EB TW), Faculty of Computer Science, Research Group Data Mining, University of Vienna, Vienna (RF), Department of Anaesthesia and Intensive Care Medicine (RF, NW, HK), Department of Pneumonology, Karl Landsteiner University of Health Sciences, Krems (KH, PE) and Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria (CL, TS, MAH).

Background: For endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under general anaesthesia, both rigid bronchoscopy and laryngeal masks (LMAs) with superimposed high-frequency jet ventilation can be used. Despite the fact that in Europe rigid bronchoscopy for EBUS-TBNA is still widely used, an increasing number of centres use jet ventilation via the LMA for this procedure. To our knowledge no clinical trials have ever been made to compare these two methods. Read More

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http://dx.doi.org/10.1097/EJA.0000000000001220DOI Listing

Veno-venous Extracorporeal Membrane Oxygenation for Respiratory Failure in COVID-19 Patients: Early Experience From a Major Academic Medical Center in North America.

Ann Surg 2020 May 25. Epub 2020 May 25.

Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts.

And Background Data: VV ECMO can be utilized as an advanced therapy in select patients with COVID-19 respiratory failure refractory to traditional critical care management and optimal mechanical ventilation. Anticipating a need for such therapies during the pandemic, our center created a targeted protocol for ECMO therapy in COVID-19 patients that allows us to provide this life-saving therapy to our sickest patients without overburdening already stretched resources or excessively exposing healthcare staff to infection risk.

Methods: As a major regional referral program, we used the framework of our well-established ECMO service-line to outline specific team structures, modified patient eligibility criteria, cannulation strategies, and management protocols for the COVID-19 ECMO program. Read More

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http://dx.doi.org/10.1097/SLA.0000000000004084DOI Listing

Abdominal fluid samples (negative for SARS-CoV-2) from a critically unwell patient with respiratory COVID-19.

Br J Surg 2020 May 26. Epub 2020 May 26.

Department of General, Visceral, Transplant, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.

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http://dx.doi.org/10.1002/bjs.11713DOI Listing

Evaluation of fluid responsiveness during COVID-19 pandemic: what are the remaining choices?

J Anesth 2020 May 25. Epub 2020 May 25.

Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, 01 Elsarayah Street, Elmanyal, Cairo, 11559, Egypt.

Non-protocolized fluid administration in critically ill patients, especially those with acute respiratory distress syndrome (ARDS), is associated with poor outcomes. Therefore, fluid administration in patients with Coronavirus disease (COVID-19) should be properly guided. Choice of an index to guide fluid management during a pandemic with mass patient admissions carries an additional challenge due to the relatively limited resources. Read More

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http://dx.doi.org/10.1007/s00540-020-02801-yDOI Listing

Transport of critically ill COVID-19 patients.

Intensive Care Med 2020 May 25. Epub 2020 May 25.

Anesthesia, Critical Care and Pain Management, Al Adan Hospital, Ministry of Health, Kuwait City, Kuwait.

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http://dx.doi.org/10.1007/s00134-020-06115-1DOI Listing

Focus on noninvasive respiratory support before and after mechanical ventilation in patients with acute respiratory failure.

Intensive Care Med 2020 May 25. Epub 2020 May 25.

Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. Ernest Borges Road, Parel, Mumbai, India.

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http://dx.doi.org/10.1007/s00134-020-06100-8DOI Listing

The attributable mortality of acute respiratory distress syndrome.

Intensive Care Med 2020 May 25. Epub 2020 May 25.

Department of Anesthesia, University of California San Francisco, San Francisco, CA, USA.

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http://dx.doi.org/10.1007/s00134-020-06099-yDOI Listing

Perioperative probiotic treatment decreased the incidence of postoperative cognitive impairment in elderly patients following non-cardiac surgery: A randomised double-blind and placebo-controlled trial.

Clin Nutr 2020 May 11. Epub 2020 May 11.

Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Hunan Province Key Laboratory of Brain Homeostasis, Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China; Center for Experimental Medicine, Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China. Electronic address:

Background: Given that population aging is a global health challenge, the high prevalence of postoperative neurocognitive impairment in elderly patients necessitates the development of novel simple and effective prevention methods.

Objective: To evaluate the effects of perioperative application of oral probiotic as a prophylaxis for cognitive impairment in elderly patients following non-cardiac surgery.

Methods: This randomised double-blind and placebo-controlled trial included 120 elderly patients (in a modified intention-to-treat analysis) scheduled for elective orthopaedic or colorectal surgery. Read More

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http://dx.doi.org/10.1016/j.clnu.2020.05.001DOI Listing

Study Protocol for Better Evidence for Selecting Transplant Fluids (BEST-Fluids): a pragmatic, registry-based, multi-center, double-blind, randomized controlled trial evaluating the effect of intravenous fluid therapy with Plasma-Lyte 148 versus 0.9% saline on delayed graft function in deceased donor kidney transplantation.

Trials 2020 May 25;21(1):428. Epub 2020 May 25.

Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia.

Background: Delayed graft function, the requirement for dialysis due to poor kidney function post-transplant, is a frequent complication of deceased donor kidney transplantation and is associated with inferior outcomes and higher costs. Intravenous fluids given during and after transplantation may affect the risk of poor kidney function after transplant. The most commonly used fluid, isotonic sodium chloride (0. Read More

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http://dx.doi.org/10.1186/s13063-020-04359-2DOI Listing

[Risk factors and clinical features of hospital-associated venous thromboembolism].

Zhonghua Yi Xue Za Zhi 2020 May;100(20):1539-1543

Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

To investigate the clinical features and risk factors of hospital-associated venous thromboembolism (VTE). The study enrolled acute VTE patients admitted into China-Japan Friendship Hospital from January 1, 2017 to December 31, 2017. The hospital-associated VTE (HA-VTE) group and the community-associated VTE (CA-VTE) group were classified according to whether the VTE occurred during hospitalization or within a 90-day period of admission to hospital (including inpatient with at least two days of hospital stay or a surgical procedure under general or regional anaesthesia). Read More

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http://dx.doi.org/10.3760/cma.j.cn112137-20200223-00407DOI Listing

Induction of Diffuse Axonal Brain Injury in Rats Based on Rotational Acceleration.

J Vis Exp 2020 May 9(159). Epub 2020 May 9.

Division of Anesthesia and Critical Care, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev;

Traumatic brain injury (TBI) is a major cause of death and disability. Diffuse axonal injury (DAI) is the predominant mechanism of injury in a large percentage of TBI patients requiring hospitalization. DAI involves widespread axonal damage from shaking, rotation or blast injury, leading to rapid axonal stretch injury and secondary axonal changes that are associated with a long-lasting impact on functional recovery. Read More

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http://dx.doi.org/10.3791/61198DOI Listing

Dynamic bedside assessment of the physiologic effects of prone position in acute respiratory distress syndrome patients by electrical impedance tomography.

Minerva Anestesiol 2020 May 22. Epub 2020 May 22.

Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -

Background: Prone position (PP) improves acute respiratory distress syndrome (ARDS) survival by reducing the risk of ventilation-induced lung injury. However, inter-individual variability is a hallmark of ARDS and lung protection by PP might not be optimal in all patients. In the present study, we dynamically assessed physiologic effects of PP by Electrical Impedance Tomography (EIT) and identified predictors of improved lung protection by PP in ARDS patients. Read More

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http://dx.doi.org/10.23736/S0375-9393.20.14130-0DOI Listing

Influence of mechanical ventilation and loading modifications on left ventricular global longitudinal strain in patients undergoing general anesthesia. A pilot study.

Minerva Anestesiol 2020 May 22. Epub 2020 May 22.

Department of Anesthesia and Critical Care, Hôtel Dieu, University Hospital of Nantes, Nantes, France -

Background: The modifications of left ventricular systolic function assessed with global longitudinal strain (GLS) after general anesthesia and invasive mechanical ventilation are poorly described.

Methods: This was a single-center observational study. ASA I-II patients undergoing routine surgical procedures requiring anesthesia with invasive mechanical ventilation had serial trans-thoracic speckle-tracking echocardiography: at baseline, 5 minutes after anesthesia and invasive mechanical ventilation, one minute after passive leg raising and after extubation. Read More

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http://dx.doi.org/10.23736/S0375-9393.20.14079-3DOI Listing

Intravenous fluid therapy in the perioperative and critical care setting: Executive summary of the International Fluid Academy (IFA).

Ann Intensive Care 2020 May 24;10(1):64. Epub 2020 May 24.

Department of Intensive Care Medicine, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Antwerp, Belgium.

Intravenous fluid administration should be considered as any other pharmacological prescription. There are three main indications: resuscitation, replacement, and maintenance. Moreover, the impact of fluid administration as drug diluent or to preserve catheter patency, i. Read More

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http://dx.doi.org/10.1186/s13613-020-00679-3DOI Listing

The impact of introducing nurse-led analgesia and sedation guidelines in ventilated infants following cardiac surgery.

Intensive Crit Care Nurs 2020 May 21:102879. Epub 2020 May 21.

Professor Emeritus, Royal College of Surgeons in Ireland, Dublin, Ireland.

Introduction: Enhanced clinical outcomes in the Paediatric Intensive Care Unit following standardisation of analgesia and sedation practice are reported. Little is known about the impact of standardisation of analgesia and sedation practice including incorporation of a validated distress assessment instrument on infants post cardiac surgery, a subset of whom have Trisomy 21. This study investigated whether the parallel introduction of nurse-led analgesia and sedation guidelines including regular distress assessment would impact on morphine administered to infants post cardiac surgery, and whether any differences observed would be amplified within the Trisomy 21 population. Read More

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http://dx.doi.org/10.1016/j.iccn.2020.102879DOI Listing

Preface.

Dent Clin North Am 2020 Jul;64(3):xi-xiii

Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Department of Public Health and Community Medicine, Tufts University School of Medicine, 1 Kneeland Street Boston, MA 02111, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cden.2020.04.001DOI Listing

Opioid Prescribing in Dental Practice: Managing Liability Risks.

Dent Clin North Am 2020 Jul 28;64(3):597-608. Epub 2020 Apr 28.

Department of Comprehensive Care, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA.

Dentistry should be proud of its history of providing responsible pain relief, as well as becoming more cautious in prescribing opioid medications when other safer pharmacologic options exist. Our training directs us to first eliminate the source of dental pain and prescribe analgesics only as adjunctive relief. Prescriptions must be written for a legitimate dental purpose and for a patient of record. Read More

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http://dx.doi.org/10.1016/j.cden.2020.03.003DOI Listing

Interprofessional Collaboration in the Assessment and Management of Substance Use Risk.

Dent Clin North Am 2020 Jul 21;64(3):571-583. Epub 2020 Apr 21.

Tufts University School of Dental Medicine, One Kneeland Street, Room 1163, Boston, MA 02111, USA.

Substance use disorder assessment strategies are increasingly being employed by dentistry, while adequate evaluation requires reaching out to other cotreating providers and collaborating on patient care. The field of dentistry has a range of barriers often not experienced in other professions, including limitations on e-record communication and clinical practice setting often isolated from the patient's general medical care. Barriers can be overcome if the dentist facilitates communication. Read More

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http://dx.doi.org/10.1016/j.cden.2020.02.006DOI Listing

Assessment and Management of the High-Risk Dental Patient with Active Substance Use Disorder.

Dent Clin North Am 2020 Jul 16;64(3):547-558. Epub 2020 Apr 16.

Department of Diagnostic Sciences, Center for Pain Medicine, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Every dentist cares for patients with a history of substance use disorder (SUD), regardless of a patient's socioeconomic status, education, or ethnicity. SUD is a global epidemic, with approximately 8% of the general US population meeting diagnostic criteria for a SUD and more than 20% of the global population experiencing a SUD. The importance of understanding how to identify substance use, manage patients with a SUD, and offer appropriate referral is essential for all dental professionals. Read More

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http://dx.doi.org/10.1016/j.cden.2020.02.004DOI Listing

Comorbid Conditions in Relation to Controlled Substance Abuse.

Dent Clin North Am 2020 Jul 25;64(3):535-546. Epub 2020 Apr 25.

Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Universidad Iberoamericana, Santo Domingo, Dominican Republic.

Dental patients who experience comorbid psychiatric and medical conditions present an elevated risk of medication misuse, abuse, substance use disorders, and overdose. The authors review the role of notable comorbidities in predicting the development of substance use disorder, including medical, psychiatric, and other psychosocial factors that can be assessed in general dental practice. Psychiatric disorders commonly cooccur with substance abuse, and these typically include anxiety disorders, mood disorders (major depression, bipolar), posttraumatic stress, as well as sleep and eating disorders. Read More

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http://dx.doi.org/10.1016/j.cden.2020.03.001DOI Listing

Dentistry's Role in Assessing and Managing Controlled Substance Risk: Historical Overview, Current Barriers, and Working Toward Best Practices.

Dent Clin North Am 2020 Jul 29;64(3):491-501. Epub 2020 Apr 29.

Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.

Dentistry is in a unique position among the health care professions to assess and manage the patient with controlled substance risk. The concern over opioid risk is not new, and historically dentists have had to balance the critical need for adequate pain care with the importance of recognizing the consequences of using controlled substances for their patients. Barriers for providing adequate patient assessment and management may be greater in dentistry than other health care fields, although these barriers can be recognized and overcome. Read More

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http://dx.doi.org/10.1016/j.cden.2020.02.002DOI Listing

Daring discourse: are we ready to recommend neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic? A pro-con.

Reg Anesth Pain Med 2020 May 23. Epub 2020 May 23.

Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA

The recent joint statement from the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anesthesia and Pain Therapy (ESRA) recommends neuraxial and peripheral nerve blocks for patients with coronavirus disease 2019 (COVID-2019) illness. The benefits of regional anesthetic and analgesic techniques on patient outcomes and healthcare systems are evident. Regional techniques are now additionally promoted as a mechanism to reduce aerosolizing procedures. Read More

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http://dx.doi.org/10.1136/rapm-2020-101653DOI Listing

Risk factors for postoperative delirium in patients undergoing lower extremity joint arthroplasty: a retrospective population-based cohort study.

Reg Anesth Pain Med 2020 May 23. Epub 2020 May 23.

Orthopaedics/Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

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http://dx.doi.org/10.1136/rapm-2020-101617DOI Listing

Regional anesthesia training model for resource-limited settings: a prospective single-center observational study with pre-post evaluations.

Reg Anesth Pain Med 2020 May 23. Epub 2020 May 23.

Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.

Background And Objectives: Educational initiatives are a sustainable means to address provider shortages in resource-limited settings (RLS), yet few regional anesthesia curricula for RLS have been described. We sought to design a reproducible training model for RLS called Global Regional Anesthesia Curricular Engagement (GRACE), implement GRACE at an RLS hospital in Ghana, and measure training and practice-based outcomes associated with GRACE implementation.

Methods: Fourteen of 15 physician anesthesiologists from the study location and three from an outside orthopedic specialty hospital consented to be trainees and trainers, respectively, for this prospective single-center observational study with pre-post evaluations. Read More

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http://dx.doi.org/10.1136/rapm-2020-101550DOI Listing

Associations between Infant and Parent Characteristics and Measures of Family Well-Being in Neonates with Seizures: A Cohort Study.

J Pediatr 2020 Jun;221:64-71.e4

Departments of Neurology and Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.

Objective: To characterize and determine risk factors for key dimensions of well-being at hospital discharge in families of neonates with acute symptomatic seizures.

Study Design: This prospective, observational cohort study enrolled 144 parent-infant dyads among neonates with acute symptomatic seizures from 9 pediatric hospitals in the Neonatal Seizure Registry. One parent per family completed a discharge survey, which included measures of anxiety and depression, health-related quality of life, and impact on the family. Read More

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http://dx.doi.org/10.1016/j.jpeds.2020.02.024DOI Listing

Serum GFAP and UCH-L1 for the prediction of neurological outcome in comatose cardiac arrest patients.

Resuscitation 2020 May 20. Epub 2020 May 20.

Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Lund University, Helsingborg Hospital, Lund, Sweden.

Objective: Neurological outcome prediction is crucial early after cardiac arrest. Serum biomarkers released from brain cells after hypoxic-ischemic injury may aid in outcome prediction. The only serum biomarker presently recommended in the European Resuscitation Council prognostication guidelines is neuron-specific enolase (NSE), but NSE has limitations. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2020.05.016DOI Listing

Surgical valve repair of native pulmonary valve endocarditis using Ozaki technique.

Ann Thorac Surg 2020 May 20. Epub 2020 May 20.

Department of Anaesthesia and Critical Care, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Surgery for infective endocarditis in the pulmonary position is an effective method of treatment despite a very uncommon pathology and few operations being performed. We present an adult male with right sided infective endocarditis where pulmonary valve cusps were almost completely damaged. Pulmonary valve was successfully reconstructed using glutaraldehyde treated autologous pericardium by Ozaki technique. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.03.125DOI Listing

COVID-19: Legal implications for critical care.

Anaesthesia 2020 May 23. Epub 2020 May 23.

Consultant, General Intensive Care Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.

The COVID-19 pandemic has caused an unprecedented challenge for the provision of critical care. Anticipating an unsustainable burden on the health service, the UK government introduced numerous legislative measures culminating in the Coronavirus Act, which interfere with existing legislation and rights. However, the existing standards and legal frameworks relevant to critical care clinicians are not extinguished but anticipated to adapt to a new context. Read More

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http://dx.doi.org/10.1111/anae.15147DOI Listing

Anesthetic Management and Outcomes For MRI-Guided Laser Interstitial Thermal Therapy (LITT) For Seizure Focus in Pediatrics: A Single Centre Experience With 10 Consecutive Patients.

Paediatr Anaesth 2020 May 23. Epub 2020 May 23.

Boston Children's Hospital, Anesthesiology, Critical Care and Pain Medicine, Boston, MA, USA.

MRI-guided laser interstitial thermal therapy (LITT) is a stereotactically guided percutaneous minimally invasive procedure, which delivers light energy to tissue via a fiberoptic catheter, resulting in selective thermal ablation. Its use in drug-resistant epilepsy has increased because safety and efficacy have been well-established in adult and pediatric populations . The anesthetic management of this procedure in children has not been previously reported. Read More

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http://dx.doi.org/10.1111/pan.13929DOI Listing

Global Consortium Study of Neurological Dysfunction in COVID-19 (GCS-NeuroCOVID): Study Design and Rationale.

Neurocrit Care 2020 May 22. Epub 2020 May 22.

Departments of Critical Care Medicine, Neurology, and Neurosurgery, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: As the COVID-19 pandemic developed, reports of neurological dysfunctions spanning the central and peripheral nervous systems have emerged. The spectrum of acute neurological dysfunctions may implicate direct viral invasion, para-infectious complications, neurological manifestations of systemic diseases, or co-incident neurological dysfunction in the context of high SARS-CoV-2 prevalence. A rapid and pragmatic approach to understanding the prevalence, phenotypes, pathophysiology and prognostic implications of COVID-19 neurological syndromes is urgently needed. Read More

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http://dx.doi.org/10.1007/s12028-020-00995-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243953PMC

Bioengineered airway epithelial grafts with mucociliary function based on collagen IV- and laminin-containing extracellular matrix scaffolds.

Eur Respir J 2020 May 22. Epub 2020 May 22.

Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.

Current methods to replace damaged upper airway epithelium with exogenous cells are limited. Existing strategies use grafts that lack mucociliary function, leading to infection and the retention of secretions and keratin debris. Strategies that regenerate airway epithelium with mucociliary function are clearly desirable and would enable new treatments for complex airway disease. Read More

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http://dx.doi.org/10.1183/13993003.01200-2019DOI Listing

Thick and diffuse cisternal clot independently predicts vasospasm-related morbidity and poor outcome after aneurysmal subarachnoid hemorrhage.

J Neurosurg 2020 May 22:1-9. Epub 2020 May 22.

7Department of Anesthesia and Critical Care, Hôpital de la Timone, Aix-Marseille Université, Marseille, France.

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant morbidity and mortality. The presence of thick, diffuse subarachnoid blood may portend a worse clinical course and outcome, independently of other known prognostic factors such as age, aneurysm size, and initial clinical grade.

Methods: In this post hoc analysis, patients with aSAH undergoing surgical clipping (n = 383) or endovascular coiling (n = 189) were pooled from the placebo arms of the Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage (CONSCIOUS)-2 and CONSCIOUS-3 randomized, double-blind, placebo-controlled phase 3 studies, respectively. Read More

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http://dx.doi.org/10.3171/2020.3.JNS193400DOI Listing

Use of Erector Spinae Plane Block in Thoracic Surgery Leads to Rapid Recovery from Anesthesia.

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Background: Ultrasound guidance has resulted in a continuous evolution in techniques for pain control for video assisted thoracoscopic surgery (VATS). The objective of this study was to compare Erector Spinae Plane blocks (ESP) with intercostal blocks (ICB) as part of multi-modal analgesia in quality of postoperative pain control and preservation of pulmonary function after VATS.

Methods: A consecutive cohort of patients undergoing elective VATS were enrolled in the study and divided into the ESP and ICB block groups. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.03.117DOI Listing

Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic.

Ann Oncol 2020 May 16. Epub 2020 May 16.

Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK; National Cancer Registration and Analysis Service, Public Health England, Wellington House, London, UK; Department of Clinical Genetics, Royal Marsden NHS Foundation Trust, London, UK. Electronic address:

Background: Cancer diagnostics and surgery have been disrupted by the response of healthcare services to the COVID-19 pandemic. Progression of cancers during delay will impact on patient long-term survival.

Methods: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. Read More

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http://dx.doi.org/10.1016/j.annonc.2020.05.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237184PMC

Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization.

Gastroenterology 2020 May 19. Epub 2020 May 19.

Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China; State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China. Electronic address:

Backgroud & Aims: Although SARS-CoV-2 infects gastrointestinal tissues, little is known about the roles of gut commensal microbes in susceptibility to and severity of infection. We investigated changes in fecal microbiomes of patients with SARS-CoV-2 infection during hospitalization and associations with severity and fecal shedding of virus.

Methods: We performed shotgun metagenomic sequencing analyses of fecal samples from 15 patients with COVID-19 in Hong Kong, from February 5 through March 17, 2020. Read More

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http://dx.doi.org/10.1053/j.gastro.2020.05.048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237927PMC

Sevoflurane Consumption During Inhalational Induction in Children: A Randomized Comparison of Minute Ventilation-Based Techniques With Standard Fixed Fresh Gas Flow Technique.

AANA J 2020 Jun;88(3):177-182

is an anesthesiologist in the Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India.

This study was done to ascertain the optimum fresh gas flow (FGF) offering the best balance between rapid induction and minimal waste in pediatric patients. Forty-five children (weighing 10-20 kg) undergoing elective procedures under general anesthesia were randomly assigned into 3 groups: 0.5 minute ventilation (MV), MV, and S (FGF = 6 L/min). Read More

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Limitations of regional ventilation inhomogeneity indices in children with cystic fibrosis.

Pediatr Pulmonol 2020 May 22. Epub 2020 May 22.

Respiratory, Critical Care and Anaesthesia Section, UCL Great Ormond Street Institute of Child Health, London, UK.

Background: S is a Multiple Breath Washout (MBW) index that measures convection-dependent ventilation inhomogeneity (CDI) arising within conductive airways, but the calculation method is unreliable in subjects with advanced cystic fibrosis (CF) lung disease. A new CDI index, S *, has been proposed for use in adults with CF and moderate to severe ventilation inhomogeneity. We aimed to evaluate the most appropriate CDI index in children and adolescents with CF and various degrees of inhomogeneity, and from that the most appropriate diffusion-convection-interaction index (S or S *). Read More

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http://dx.doi.org/10.1002/ppul.24863DOI Listing

Smoking and risk of surgical bleeding: nationwide analysis of 5,452,411 surgical cases.

Transfusion 2020 May 22. Epub 2020 May 22.

Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: Although smoking is associated with several postoperative complications, a possible association with surgical bleeding remains unclear. We examined if smoking is associated with a higher risk of surgical bleeding.

Study Design And Methods: We included patients from the American College of Surgeons National Surgical Quality Improvement Program 2007-2016 from 680 hospitals across the United States. Read More

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http://dx.doi.org/10.1111/trf.15852DOI Listing

A proposed lung ultrasound and phenotypic algorithm for the care of COVID-19 patients with acute respiratory failure.

Can J Anaesth 2020 May 21. Epub 2020 May 21.

Department of Surgery, Sherbrooke University, Sherbrooke, QC, Canada.

Pulmonary complications are the most common clinical manifestations of coronavirus disease (COVID-19). From recent clinical observation, two phenotypes have emerged: a low elastance or L-type and a high elastance or H-type. Clinical presentation, pathophysiology, pulmonary mechanics, radiological and ultrasound findings of these two phenotypes are different. Read More

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http://dx.doi.org/10.1007/s12630-020-01704-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241588PMC

The EPICENTRE (ESPNIC Covid pEdiatric Neonatal Registry) initiative: background and protocol for the international SARS-CoV-2 infections registry.

Eur J Pediatr 2020 May 22. Epub 2020 May 22.

Neonatal Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia.

The outbreak of SARS-CoV-2 is the worst healthcare emergency of this century, and its impact on pediatrics and neonatology is still largely unknown. The European Society for Pediatric and Neonatal Intensive Care (ESPNIC) launched the EPICENTRE (ESPNIC Covid pEdiatric Neonatal Registry) international, multicenter, and multidisciplinary initiative to study the epidemiology, clinical course, and outcomes of pediatric and neonatal SARS-CoV-2 infections. EPICENTRE background and aims are presented together with protocol details. Read More

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http://dx.doi.org/10.1007/s00431-020-03690-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242019PMC

Personal Protective Equipment N95 Facemask Shortage Quick Fix: The Modified Airway From VEntilatoR Circuit (MAVerIC).

Cureus 2020 May 1;12(5):e7914. Epub 2020 May 1.

Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, USA.

We are in a crisis where healthcare providers on the frontlines are running out of the appropriate personal protective equipment including N95 masks and power air-purifying respirators. Here, we propose a makeshift filter mask that we call the Modified Airway from VEntilatoR Circuit (MAVerIC) that can be assembled within seconds using widely available supplies routinely utilized by anesthesia providers in the operating room to provide practitioners on the frontlines with the high standard of protection of a N95 mask during the coronavirus disease 2019 (COVID-19) pandemic, and can be easily quantitatively "fit tested" to ensure no significant leak to optimize safety and efficacy. Read More

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http://dx.doi.org/10.7759/cureus.7914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237167PMC

Dopaminergic D1 receptors in the nucleus basalis modulate recovery from propofol anesthesia in rats.

Iran J Basic Med Sci 2020 Mar;23(3):298-302

Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Dalian road 149, Zunyi 563000, Guizhou, China.

Objectives: Melatonin, an important hormone secreted by the epiphysis, is a powerful anti-oxidant with a high potential to neutralize medical toxins. The goal of this study was to demonstrate the beneficial effect of melatonin on epididymal sperm and reproductive parameters in mice treated with acetylsalicylic acid (ASA).

Materials And Methods: Thirty-nine SD rats were randomly split into D1 receptor agonist (chloro-APB), D1 receptor antagonist (SCH23390), and saline groups after preparing NB microinjection model. Read More

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http://dx.doi.org/10.22038/IJBMS.2019.37716.8962DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229503PMC

The Use of Topical Nitroglycerin to Facilitate Radial Arterial Catheter Insertion in Children: A Randomized Controlled Trial.

J Cardiothorac Vasc Anesth 2020 Apr 29. Epub 2020 Apr 29.

Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.

Objectives: To determine whether the use of topical nitroglycerin patch increases radial artery diameter and facilitate cannulation in children.

Design: Randomized controlled trial.

Setting: Cairo University Hospital. Read More

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http://dx.doi.org/10.1053/j.jvca.2020.04.035DOI Listing

Anesthetic concerns for pediatric patients in the era of COVID-19.

Paediatr Anaesth 2020 May 21. Epub 2020 May 21.

Department of Anesthesiology & Critical Care Medicine, University of New Mexico Schoolof Medicine, Albuquerque, New Mexico, USA.

Aftera novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was reported in China in December 2019, the disease quicklyreached pandemic level. On January 30, 2020, the World Health Organization (WHO) declared that the SARS-CoV-2 outbreak constituted a Public Health Emergency of International Concern. The caseload has increased exponentially, with WHO reporting 182,000 global cases by 17 March 2020, and over 2. Read More

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http://dx.doi.org/10.1111/pan.13924DOI Listing

Specific adsorption of tetracycline from milk by using biocompatible magnetic molecular imprinting material and evaluation by ECD.

Food Chem 2020 May 5;326:126969. Epub 2020 May 5.

Tang Center for Herbal Medicine Research and Department of Anesthesia & Critical Care, University of Chicago, Chicago, IL 60637, USA.

Biocompatible magnetic molecularly imprinted polymers (BMMIPs) were prepared with Zein for the first time, and were used to enrich tetracycline compounds selectively. Innovative combination of BMMIPs and electrochemistry to obtain lower detection line to satisfy industrial detection demands. Using Zein as the crosslinking agent, the polymers were synthesized on the surface of FeO particles. Read More

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http://dx.doi.org/10.1016/j.foodchem.2020.126969DOI Listing