20,282 results match your criteria Anaesthesia critical care & pain medicine[Journal]


Comparison of circular and sagittal reinforced rod options on the sagittal balance restoration in adolescents undergoing pedicle screw instrumentation for idiopathic scoliosis.

World Neurosurg 2019 Apr 14. Epub 2019 Apr 14.

Department of Paediatric Orthopaedic Surgery, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, FI-20521 Turku.

Objective: Pedicle screw instrumentation is widely used for spinal deformity correction and fusion in adolescents for idiopathic scoliosis. The goal is to achieve and sustain good alignment in all three plains. We compared two different cobalt-chromium (CoCr) rod designs with different stiffness, in regard to the coronal and sagittal balance restoration in adolescents operated for idiopathic scoliosis. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193102
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http://dx.doi.org/10.1016/j.wneu.2019.04.028DOI Listing
April 2019
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Early results of a modified biological valved conduit for the Bentall procedure.

J Card Surg 2019 Apr 17. Epub 2019 Apr 17.

Department of Surgery, Division of Cardiac Surgery, The McGill University Health Center, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.

Introduction: Few bioprosthetic valved conduits for aortic root surgery are commercially available. Long-term Warfarin therapy (mechanical), potential root calcification (xeno- or homograft valves), and the need for additional ascending aorta grafts are concerns associated with currently used valved conduits. A simplified, self-assembled bioroot conduit comprising currently available materials that facilitates future intervention and exhibits advantages of a bioprosthesis was used. Read More

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http://dx.doi.org/10.1111/jocs.14046DOI Listing

Consensus Recommendations for the Conduct, Training, Implementation, and Research of Perioperative Handoffs.

Anesth Analg 2019 May;128(5):e71-e78

Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania Department of Anesthesiology & Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas Department of Anesthesiology, Cooper Medical School of Rowan University, Camden, New Jersey Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Dallas, Texas Department of Anesthesiology, Vanderbilt Medical Center, Nashville, Tennessee Department of Anesthesiology, Duke University & Veterans Affairs Medical Center, Durham, North Carolina Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Dallas, Texas Department of Anesthesiology, NorthShore University HealthSystem, Dallas, Texas, Department of Anesthesiology and Critical Care, University of Chicago, Chicago, Illinois Department of Anesthesiology, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Dallas, Texas Department of Anesthesiology, Cooper Medical School of Rowan University, Camden, New Jersey Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

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http://dx.doi.org/10.1213/ANE.0000000000004118DOI Listing

Update in Neurocritical Care: a summary of the 2018 Paris international conference of the French Society of Intensive Care.

Ann Intensive Care 2019 Apr 16;9(1):47. Epub 2019 Apr 16.

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.

The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current standards for the clinical assessment of altered consciousness states (including coma and delirium) and peripheral nervous system in critically ill patients, monitoring of brain function (specifically, electro-encephalography) and best practices for sedation-analgesia-delirium management. An update on the treatment of specific severe brain pathologies-including ischaemic/haemorrhagic stroke, cerebral venous thrombosis, hypoxic-ischaemic brain injury, immune-mediated and infectious encephalitis and refractory status epilepticus-was also provided. Read More

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http://dx.doi.org/10.1186/s13613-019-0523-xDOI Listing

Determinants of left ventricular ejection fraction and a novel method to improve its assessment of myocardial contractility.

Ann Intensive Care 2019 Apr 16;9(1):48. Epub 2019 Apr 16.

Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA.

Background: The aim of this study was to quantify the impact of different cardiovascular factors on left ventricular ejection fraction (LVEF) and test a novel LVEF calculation considering these factors.

Results: 10 pigs were studied. The experimental protocol consisted of sequentially changing afterload, preload and contractility. Read More

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http://dx.doi.org/10.1186/s13613-019-0526-7DOI Listing

Predicting Renal Recovery After Dialysis-Requiring Acute Kidney Injury.

Kidney Int Rep 2019 Apr 28;4(4):571-581. Epub 2019 Jan 28.

Division of Nephrology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.

Introduction: After dialysis-requiring acute kidney injury (AKI-D), recovery of sufficient kidney function to discontinue dialysis is an important clinical and patient-oriented outcome. Predicting the probability of recovery in individual patients is a common dilemma.

Methods: This cohort study examined all adult members of Kaiser Permanente Northern California who experienced AKI-D between January 2009 and September 2015 and had predicted inpatient mortality of <20%. Read More

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http://dx.doi.org/10.1016/j.ekir.2019.01.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451155PMC

Comparing the Efficacy of Two Drugs Senalin and Bisacodyl in Treatment of Constipation in Intensive Care Units' Patients.

Adv Biomed Res 2019 27;8:17. Epub 2019 Feb 27.

Department of Anesthesia and Critical Care, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Constipation is an intestinal syndrome that can be created alone or in the context of another disease in patients admitted to intensive care units (ICUs). Given the role of sennosides in increasing the transfer rate of materials from the large intestine, we aimed to compare the effect of senalin with bisacodyl on the treatment of constipation in patients admitted to ICUs.

Materials And Methods: In this randomized, double-blind study, 70 patients admitted to the ICU were divided into two groups. Read More

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http://dx.doi.org/10.4103/abr.abr_165_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425743PMC
February 2019

Pro: Patient and allograft survival remain the best metric to gauge successful liver transplantation.

Clin Liver Dis (Hoboken) 2018 Mar 6;11(3):59-61. Epub 2018 Apr 6.

Department of Surgery, Section of Transplantation The University of Chicago Medical Center Chicago IL.

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http://dx.doi.org/10.1002/cld.697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6385945PMC

Characteristics of Nonpulmonary Organ Dysfunction at Onset of ARDS Based on the Berlin Definition.

Respir Care 2019 Apr 16. Epub 2019 Apr 16.

Department of Pulmonary and Critical Care Medicine, University of California, San Francisco at San Francisco General Hospital, San Francisco, California.

Background: The Berlin definition of ARDS does not account for nonpulmonary organ failure, which is a major determinant of outcome. We examined whether an increasing severity of hypoxemia across the Berlin definition classifications also corresponded with evidence of multiple organ dysfunction on the day of ARDS onset. We also examined the representation of major etiologies for ARDS across the Berlin definition classifications. Read More

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http://dx.doi.org/10.4187/respcare.06165DOI Listing

Heterogeneity of regional inflection points from pressure-volume curves assessed by electrical impedance tomography.

Crit Care 2019 Apr 16;23(1):119. Epub 2019 Apr 16.

Department of Morphology, Surgery and Experimental Medicine, Intensive Care Unit, University of Ferrara, Azienda Ospedaliera - Universitaria Sant'Anna Hospital, Via Aldo Moro, Ferrara, Italy.

Background: The pressure-volume (P-V) curve has been suggested as a bedside tool to set mechanical ventilation; however, it reflects a global behavior of the lung without giving information on the regional mechanical properties. Regional P-V (PVr) curves derived from electrical impedance tomography (EIT) could provide valuable clinical information at bedside, being able to explore the regional mechanics of the lung. In the present study, we hypothesized that regional P-V curves would provide different information from those obtained from global P-V curves, both in terms of upper and lower inflection points. Read More

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http://dx.doi.org/10.1186/s13054-019-2417-6DOI Listing

Associations of variants In the hexokinase 1 and interleukin 18 receptor regions with oxyhemoglobin saturation during sleep.

PLoS Genet 2019 Apr 16;15(4):e1007739. Epub 2019 Apr 16.

Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States of America.

Sleep disordered breathing (SDB)-related overnight hypoxemia is associated with cardiometabolic disease and other comorbidities. Understanding the genetic bases for variations in nocturnal hypoxemia may help understand mechanisms influencing oxygenation and SDB-related mortality. We conducted genome-wide association tests across 10 cohorts and 4 populations to identify genetic variants associated with three correlated measures of overnight oxyhemoglobin saturation: average and minimum oxyhemoglobin saturation during sleep and the percent of sleep with oxyhemoglobin saturation under 90%. Read More

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http://dx.doi.org/10.1371/journal.pgen.1007739DOI Listing

Correction to: Univariate comparison of performance of different cerebrovascular reactivity indices for outcome association in adult TBI: a CENTER-TBI study.

Acta Neurochir (Wien) 2019 Apr 15. Epub 2019 Apr 15.

Brain Physics Laboratory, Division of Neurosurgery, Dept of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.

Incorrect family name of Nino Stocchetti. Read More

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http://dx.doi.org/10.1007/s00701-019-03896-3DOI Listing

Correction to: A decade of progress in critical care echocardiography: a narrative review.

Intensive Care Med 2019 Apr 15. Epub 2019 Apr 15.

Consultant in Cardiothoracic Critical Care, St Georges Hospital, St Georges University of London, London, UK.

The original version of this article unfortunately contained a mistake. Read More

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http://dx.doi.org/10.1007/s00134-019-05616-yDOI Listing

Haemophagocytic syndrome due to Ebstein-Barr virus.

Authors:
Anuj Sarma

Indian J Anaesth 2019 Mar;63(3):248-250

Department of Anaesthesia and Critical Care, Down Town Hospital, Gauhati, Assam, India.

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http://dx.doi.org/10.4103/ija.IJA_763_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423934PMC

Ultrasound-guided modified serratus anterior plane block for perioperative analgesia in breast oncoplastic surgery: A case series.

Indian J Anaesth 2019 Mar;63(3):231-234

Department of Anaesthesia and Critical Care, Tata Medical Center, 14, MAR (EW), Newtown, Kolkata, West Bengal, India.

Ultrasound-guided serratus anterior plane (SAP) block has been described to provide complete anaesthesia and analgesia to the lateral thoracic wall. Its use has been recently reported in breast reconstruction surgeries. We present a series of 11 patients where ultrasound-guided SAP block was used as part of multimodal analgesia in breast reconstruction surgery using latissimus dorsi (LD) myocutaneous flap after mastectomies. Read More

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http://dx.doi.org/10.4103/ija.IJA_752_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423945PMC

Efficacy of local wound infiltration analgesia with ropivacaine and dexmedetomidine in tubercular spine surgery - A pilot randomised double-blind controlled trial.

Indian J Anaesth 2019 Mar;63(3):182-187

Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.

Background And Aims: Regional analgesic techniques are difficult to use in tubercular spine patients due to distorted spinal anatomy and presence of infection. This study was conducted with the aim to evaluate analgesic efficacy of local wound infiltration before wound closure in tubercular spine patients.

Methods: This pilot randomised double-blind controlled study was conducted in 32 American Society of Anesthesiologists I-III patients, age ≥15 years, undergoing elective surgery for spinal tuberculosis. Read More

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http://dx.doi.org/10.4103/ija.IJA_780_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423940PMC

Acute Tubular Injury is Associated With Severe Traumatic Brain Injury: in Vitro Study on Human Tubular Epithelial Cells.

Sci Rep 2019 Apr 15;9(1):6090. Epub 2019 Apr 15.

Department of Anesthesia and Intensive Care, University of Turin, Città della Salute e della Scienza - Molinette University Hospital, Turin, Italy.

Acute kidney injury following traumatic brain injury is associated with poor outcome. We investigated in vitro the effects of plasma of brain injured patients with acute tubular kidney injury on kidney tubular epithelial cell function. we performed a prospective observational clinical study in ICU in a trauma centre of the University hospital in Italy including twenty-three ICU patients with traumatic brain injury consecutively enrolled. Read More

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http://dx.doi.org/10.1038/s41598-019-42147-4DOI Listing

Evaluation of intravenous lidocaine in head and neck cancer surgery: study protocol for a randomized controlled trial.

Trials 2019 Apr 15;20(1):220. Epub 2019 Apr 15.

Department of Anesthesiology and Critical Care, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.

Background: Pain after major head and neck cancer surgery is underestimated and has both nociceptive and neuropathic characteristics. Extended resection, flap coverage, nerve lesions, inflammation, and high-dose opioid administration can also lead to hyperalgesia and chronic postoperative pain. Opioids are frequently associated with adverse events such as dizziness, drowsiness, nausea and vomiting, or constipation disturbing postoperative recovery and extending the length of hospital stay. Read More

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http://dx.doi.org/10.1186/s13063-019-3303-xDOI Listing

Cardiovascular determinants of resuscitation from sepsis and septic shock.

Crit Care 2019 Apr 15;23(1):118. Epub 2019 Apr 15.

Department of Critical Care Medicine, University of Pittsburgh, 1215.4 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.

Background: We hypothesized that the cardiovascular responses to Surviving Sepsis Guidelines (SSG)-defined resuscitation are predictable based on the cardiovascular state.

Methods: Fifty-five septic patients treated by SSG were studied before and after volume expansion (VE), and if needed norepinephrine (NE) and dobutamine. We measured mean arterial pressure (MAP), cardiac index (CI), and right atrial pressure (Pra) and calculated pulse pressure and stroke volume variation (PPV and SVV), dynamic arterial elastance (Ea), arterial elastance (Ea) and left ventricular (LV) end-systolic elastance (Ees), Ees/Ea (VAC), LV ejection efficiency (LVeff), mean systemic pressure analogue (Pmsa), venous return pressure gradient (Pvr), and cardiac performance (Eh), using standard formulae. Read More

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https://ccforum.biomedcentral.com/articles/10.1186/s13054-01
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http://dx.doi.org/10.1186/s13054-019-2414-9DOI Listing
April 2019
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Validity of mini-fluid challenge for predicting fluid responsiveness following liver transplantation.

BMC Anesthesiol 2019 Apr 13;19(1):56. Epub 2019 Apr 13.

Medical ICU, Bicêtre Hospital, Paris-South University, Paris, France.

Background: Mini-fluid challenge is a well tested and effective tool to predict fluid responsiveness under various clinical conditions. However, mini-fluid challenge has never been tested in patients with end-stage liver disease. This study investigated whether infusion of 150 ml albumin 5% can predict fluid responsiveness in cirrhotic patients following liver transplant. Read More

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http://dx.doi.org/10.1186/s12871-019-0728-4DOI Listing

Global Brain Drain: How Can the Maslow Theory of Motivation Improve Our Understanding of Physician Migration?

Int J Environ Res Public Health 2019 Apr 2;16(7). Epub 2019 Apr 2.

Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.

The migration of physicians from low-resource to high-resource settings is a prevalent global phenomenon that is insufficiently understood. Most low-income countries are severely understaffed with physicians, and the emigration of the already limited number of physicians to other countries can significantly reduce access to healthcare in the source country. Despite a growing interest in global capacity building in these countries by academic and non-governmental organizations in high-income countries, efforts to stem physician migration have been mostly unsuccessful. Read More

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https://www.mdpi.com/1660-4601/16/7/1182
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http://dx.doi.org/10.3390/ijerph16071182DOI Listing
April 2019
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Problem-Based Learning Discussion on Neuraxial Anesthesia in Parturients With Repaired Tetralogy of Fallot.

MedEdPORTAL 2016 Nov 3;12:10491. Epub 2016 Nov 3.

Assistant Professor, Department of Anesthesiology, Wayne State University School of Medicine.

Introduction: Approximately 1% of all children born in the United States suffer from congenital heart disease, and 25% of those affected are born with critical congenital heart disease requiring surgical intervention. Advances in cardiac surgery have allowed an increasing number of patients with complex congenital heart disease to live into adulthood. It is important that anesthesiologists understand the particularities of providing safe clinical care for these patients in different situations. Read More

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http://dx.doi.org/10.15766/mep_2374-8265.10491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440416PMC
November 2016

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity: A randomised controlled trial.

Eur J Anaesthesiol 2019 Apr 9. Epub 2019 Apr 9.

From the Department of Anesthesiology & Critical Care, Brabois University Hospital, University de Lorraine, CHRU Nancy (TF-B, DS, LH, CM), the Clinical Research Support Facility PARC, Brabois University Hospital (CB), the Multidisciplinary Unit of Bariatric Surgery, UMCO, Brabois University Hospital, University de Lorraine, CHRU Nancy (CN-C, LB), University de Lorraine, INSERM U954, Faculty of Medicine, Nancy, France (LB), and Department of Anesthesiology, Université Libre de Bruxelles, CHU Brugmann, Bruxelles, Belgium (DS).

Background: There is a controversy in the literature whether deep compared with moderate neuromuscular block (NMB) improves surgical conditions for laparoscopic surgery.

Objectives: The primary outcome measure was to examine whether switching from moderate to deep NMB improves surgical conditions for laparoscopic surgery in the obese; secondary outcome measures were changes in intra-abdominal pressure, time required to perform the gastrojejunal anastomosis and peri-operative surgical complications.

Design: A single-centre, randomised controlled study. Read More

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http://dx.doi.org/10.1097/EJA.0000000000000996DOI Listing

Preventing Mental Health Symptoms in Post ICU Patients and Their Family Members.

Crit Care Med 2019 May;47(5):e429-e430

Fellow Neuroanesthesia & Critical Care, Liverpool, United Kingdom, and Department of Anesthesia & Intensive Care, All India Institute of Medical Sciences, Bhubaneswar, India Department of Psychiatry, Black County Partnership NHS Foundation Trust, Wolverhampton, United Kingdom.

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http://Insights.ovid.com/crossref?an=00003246-201905000-0002
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http://dx.doi.org/10.1097/CCM.0000000000003651DOI Listing
May 2019
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The authors reply.

Crit Care Med 2019 May;47(5):e429

Department of Surgery and the Program in Trauma, University of Maryland School of Medicine, Baltimore, MD Department of Critical Care Medicine, Cooper University Health System, Camden, NJ Pittsburgh Critical Care Associates, Pittsburgh, PA Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN Neuroscience Institute, The Queen's Medical Center, Honolulu, HI Department of Surgery, University of Florida, Gainesville, FL Department of Anesthesia & Critical Care, University of Chicago, Chicago, IL Department of Medicine, Emory University, Atlanta, GA Department of Emergency Medicine, Washington University School of Medicine in Saint Louis, St. Louis, MO.

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http://dx.doi.org/10.1097/CCM.0000000000003691DOI Listing

Outcomes and Safety Among Patients With Obstructive Sleep Apnea Undergoing Cancer Surgery Procedures in a Freestanding Ambulatory Surgical Facility.

Anesth Analg 2019 Apr 8. Epub 2019 Apr 8.

From the *Department of Anesthesiology and Critical Care, Josie Robertson Surgery Center †Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.

Background: Patients with obstructive sleep apnea (OSA) may be at increased risk for serious perioperative complications. The suitability of ambulatory surgery for patients with OSA remains controversial, and several national guidelines call for more evidence that assesses clinically significant outcomes. In this study, we investigate the association between OSA status (STOP-BANG risk, or previously diagnosed) and short-term outcomes and safety for patients undergoing cancer surgery at a freestanding ambulatory surgery facility. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004111DOI Listing

In Response.

Authors:
Emery N Brown

Anesth Analg 2019 Apr 8. Epub 2019 Apr 8.

Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, Department of Brain and Cognitive Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts, Institute for Data Systems and Society, Massachusetts Institute of Technology, Cambridge, Massachusetts,

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http://dx.doi.org/10.1213/ANE.0000000000004168DOI Listing

The patient with substance use disorder.

Curr Opin Anaesthesiol 2019 Apr 9. Epub 2019 Apr 9.

Department of Anesthesia and Critical Care, Division of Pain Management, University of Chicago Medical Center, Illinois, USA.

Purpose Of Review: The purpose of this review is to describe the anesthesiologist's perioperative challenges when caring for the patient with substance use disorder and, in particular, opioid use disorder.

Recent Findings: With the introduction of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, psychiatric literature recently changed the criteria for defining substance use disorder. In patients with known opioid use disorder, who are undergoing elective surgery and also on maintenance therapy, use of multimodal analgesia is essential to treat postoperative pain. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000738DOI Listing

Understanding Lactatemia in Human Sepsis: Potential Impact for Early Management.

Am J Respir Crit Care Med 2019 Apr 15. Epub 2019 Apr 15.

Regions Hospital, St. Paul, Minnesota, United States.

Rationale: Hyperlactatemia in sepsis may derive from a prevalent impairment of oxygen supply/demand and/or oxygen utilization. Discriminating between these two mechanisms may be relevant for the early fluid resuscitation strategy.

Objectives: Understanding the relationship between central venous oxygen saturation (ScvO2), lactate and base excess to better determine the origin of lactate. Read More

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http://dx.doi.org/10.1164/rccm.201812-2342OCDOI Listing

Inappropriate opioid prescription after surgery.

Lancet 2019 Apr;393(10180):1547-1557

Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; Department of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.

Worldwide, the use of prescription opioid analgesics more than doubled between 2001 and 2013, with several countries, including the USA, Canada, and Australia, experiencing epidemics of opioid misuse and abuse over this period. In this context, excessive prescribing of opioids for pain treatment after surgery has been recognised as an important concern for public health and a potential contributor to patterns of opioid misuse and related harm. In the second paper in this Series we review the evolution of prescription opioid use for pain treatment after surgery in the USA, Canada, and other countries. Read More

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http://dx.doi.org/10.1016/S0140-6736(19)30428-3DOI Listing

Effects of low-dose intraoperative fentanyl on postoperative respiratory complication rate: a pre-specified, retrospective analysis.

Br J Anaesth 2019 Apr 11. Epub 2019 Apr 11.

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

Background: Fentanyl is one of the most frequently administered intraoperative drugs and may increase the risk of postoperative respiratory complications (PRCs).

Methods: We performed a pre-specified analysis of 145 735 adult non-cardiac surgical cases under general anaesthesia. Using multivariable logistic regression, we evaluated the association of intraoperative fentanyl dose and PRCs within 3 days after surgery (defined as reintubation, respiratory failure, pneumonia, pulmonary oedema, or atelectasis). Read More

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http://dx.doi.org/10.1016/j.bja.2019.03.017DOI Listing

Sepsis Management with a Blood Purification Membrane: European Experience.

Blood Purif 2019 12;47 Suppl 3:1-9. Epub 2019 Apr 12.

Baxter, Baxter Deutschland GmbH, Unterschleissheim, Germany.

Background: Septic shock is a leading cause of acute kidney injury (AKI). Endotoxins and cytokine levels are associated with the occurrence and severity of AKI, and different blood purification devices are available to remove them from circulation. One such device, oXiris, is a hollow-fibre purification filter that clears both endotoxins and cytokines. Read More

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http://dx.doi.org/10.1159/000499355DOI Listing

oXiris® Use in Septic Shock: Experience of Two French Centres.

Blood Purif 2019 12;47 Suppl 3:1-7. Epub 2019 Apr 12.

Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.

Background: Sepsis is a dysregulated host response to an infection and can result in organ dysfunctions and death. Extracorporeal blood purification techniques aim to improve the prognosis of these patients by modulating the unbalanced immune response. This study reports our experience with the use of the oXiris® membrane for septic shock patients requiring continuous renal replacement therapy (CRRT). Read More

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http://dx.doi.org/10.1159/000499510DOI Listing

Lentiviral haemopoietic stem/progenitor cell gene therapy for treatment of Wiskott-Aldrich syndrome: interim results of a non-randomised, open-label, phase 1/2 clinical study.

Lancet Haematol 2019 Apr 10. Epub 2019 Apr 10.

San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy; Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address:

Background: Wiskott-Aldrich syndrome is a rare, life-threatening, X-linked primary immunodeficiency characterised by microthrombocytopenia, infections, eczema, autoimmunity, and malignant disease. Lentiviral vector-mediated haemopoietic stem/progenitor cell (HSPC) gene therapy is a potentially curative treatment that represents an alternative to allogeneic HSPC transplantation. Here, we report safety and efficacy data from an interim analysis of patients with severe Wiskott-Aldrich syndrome who received lentiviral vector-derived gene therapy. Read More

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http://dx.doi.org/10.1016/S2352-3026(19)30021-3DOI Listing

A checklist for intrahospital transport of critically ill patients improves compliance with transportation safety guidelines.

Aust Crit Care 2019 Apr 10. Epub 2019 Apr 10.

Department of Anaesthesia and Pain Management and Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre for Integrated Critical Care, University of Melbourne, Parkville, Victoria, Australia.

Objectives: Critically ill patients are often transferred from the intensive care unit (ICU) to other locations around the hospital during which adverse events, some life threatening, are common. An intercollegiate guideline covering the transport of critically ill patients exists in Australasia; however, compliance with this guideline has previously been shown to be poor, and its role in improving safety in transportation of patients in the ICU is unknown. We performed a pre-post interventional study in a tertiary metropolitan ICU, assessing the impact of the introduction of a transport checklist on guideline compliance. Read More

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http://dx.doi.org/10.1016/j.aucc.2019.02.004DOI Listing

Operator-Directed Procedural Sedation in the Congenital Cardiac Catheterization Laboratory.

JACC Cardiovasc Interv 2019 Apr 5. Epub 2019 Apr 5.

Division of Cardiology, The Children's Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Objectives: The purpose of this study was to evaluate the association between the method of procedural sedation and outcomes for congenital cardiac catheterization procedures.

Background: The safety of operator-directed sedation (ODS) in the pediatric/congenital cardiac catheterization laboratory has been questioned. To our knowledge, the relative safety of ODS versus general anesthesia (GA) in these cases has not to date been critically evaluated. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S19368798193031
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http://dx.doi.org/10.1016/j.jcin.2019.01.224DOI Listing
April 2019
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Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU.

J Am Geriatr Soc 2019 Apr 12. Epub 2019 Apr 12.

Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale, Paris, France.

Objectives: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs).

Design: Prospective cohort study.

Setting: A total of 306 ICUs from 24 European countries. Read More

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http://dx.doi.org/10.1111/jgs.15888DOI Listing

Alleviation of trigeminal neuropathic pain by electroacupuncture: the role of hyperpolarization-activated cyclic nucleotide-gated channel protein expression in the Gasserian ganglion.

Acupunct Med 2019 Apr 12:964528419841614. Epub 2019 Apr 12.

2 MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Introduction: The aim of this study was to examine the effect of electroacupuncture (EA) on trigeminal neuropathic pain in rats and explore the potential mechanism underlying the putative therapeutic effect of EA.

Methods: Trigeminal neuropathic pain behavior was induced in rats by unilateral chronic constriction injury of the distal infraorbital nerve (dIoN-CCI). EA was administered at ST2 ( Sibai) and Jiachengjiang. Read More

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http://dx.doi.org/10.1177/0964528419841614DOI Listing

Procalcitonin-Guided Treatment on Duration of Antibiotic Therapy and Cost in Septic Patients (PRODA): a Multi-Center Randomized Controlled Trial.

J Korean Med Sci 2019 Apr 15;34(14):e110. Epub 2019 Apr 15.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: The objective of this study was to establish the efficacy and safety of procalcitonin (PCT)-guided antibiotic discontinuation in critically ill patients with sepsis in a country with a high prevalence of antimicrobial resistance and a national health insurance system.

Methods: In a multi-center randomized controlled trial, patients were randomly assigned to a PCT group (stopping antibiotics based on a predefined cut-off range of PCT) or a control group. The primary end-point was antibiotic duration. Read More

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https://jkms.org/DOIx.php?id=10.3346/jkms.2019.34.e110
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http://dx.doi.org/10.3346/jkms.2019.34.e110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460106PMC
April 2019
2 Reads

Perioperative Pain Management in the Critically Ill Patient.

Curr Pain Headache Rep 2019 Apr 11;23(5):34. Epub 2019 Apr 11.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.

Purpose Of Review: The assessment and management of perioperative pain in an intensive care setting is complex and challenging, requiring several patient-specific considerations. Administering analgesia is difficult due to interacting effects of pre-existing conditions, interventions, and deviation from standard levels of expressiveness of pain. A significant part of this complexity also arises from the reduced capacity of critically ill patients to fully communicate the severity and nature of their pain. Read More

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http://link.springer.com/10.1007/s11916-019-0771-3
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http://dx.doi.org/10.1007/s11916-019-0771-3DOI Listing
April 2019
5 Reads

A collaborative educational intervention on procedural sedation and analgesia across the Pacific.

Acute Med Surg 2019 Apr 27;6(2):109-116. Epub 2018 Dec 27.

Department of Emergency Medicine University of New Mexico Albuquerque New Mexico.

Aim: Worldwide, health-care providers carry out procedural sedation and analgesia (PSA) in the emergency department. However, training opportunities are limited in many Asian countries, including Japan. We formed an educational group consisting of board-certified emergency physicians in the USA and Japanese physicians and developed a PSA training module. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1002/ams2.384
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http://dx.doi.org/10.1002/ams2.384DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442536PMC
April 2019
1 Read

Red American ginseng enhances the effect of fluorouracil on human colon cancer cells via both paraptosis and apoptosis pathways.

J Appl Biomed 2018 Nov 31;16(4):311-319. Epub 2018 May 31.

Tang Center for Herbal Medicine Research, University of Chicago, Chicago, IL 60637, USA.

Introduction: As a commonly used chemotherapeutic agent, fluorouracil (5-FU) has serious dose-limiting side effects. In this study, we evaluated the synergy between red American ginseng (RAG) and 5-FU on human colorectal cancer cells, and explored the potential mechanisms.

Methods: Ginsenoside contents of white American ginseng (WAG) and RAG were determined by HPLC. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456072PMC
November 2018

Glutathione prevents chronic oscillating glucose intake-induced β-cell dedifferentiation and failure.

Cell Death Dis 2019 Apr 11;10(4):321. Epub 2019 Apr 11.

Cardiac Regeneration Research Institute, Wenzhou Medical University, Wenzhou, China.

Modern lifestyles have altered diet and metabolic homeostasis, with increased sugar intake, glycemic index, and prediabetes. A strong positive correlation between sugar consumption and diabetic incidence is revealed, but the underlying mechanisms remain obscure. Here we show that oral intake of long-term oscillating glucose (LOsG) (4 times/day) for 38 days, which produces physiological glycemic variability in rats, can lead to β-cells gaining metabolic memory in reactive oxygen species (ROS) stress. Read More

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http://dx.doi.org/10.1038/s41419-019-1552-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459929PMC

Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protocol for a randomized controlled trial.

Trials 2019 Apr 11;20(1):213. Epub 2019 Apr 11.

Department of Anaesthesiology and Intensive Care, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.

Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Read More

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http://dx.doi.org/10.1186/s13063-019-3208-8DOI Listing
April 2019
1 Read

Impact of body mass index on utilization of selected hospital resources for four common surgical procedures.

ANZ J Surg 2019 Apr 11. Epub 2019 Apr 11.

Centre for Health Research Illawarra Shoalhaven Population, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.

Background: Evidence about the impact of obesity on surgical resource consumption in the Australian setting is equivocal. Our objectives were to quantify the prevalence of obesity in four frequently performed surgical procedures and explore the association between body mass index (BMI) and hospital resource utilization including procedural duration, length of stay (LOS) and costs.

Methods: A retrospective cohort study of patients undergoing four surgical procedures at a tertiary referral centre in New South Wales, between 1 January 2016 and 31 December 2016, was conducted. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/ans.15085
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http://dx.doi.org/10.1111/ans.15085DOI Listing
April 2019
10 Reads

oXirisNet Registry: A Prospective, National Registry on the oXiris Membrane.

Blood Purif 2019 04 11;47 Suppl 3:1-8. Epub 2019 Apr 11.

Department of Health Sciences, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.

Worldwide, the widespread use of extracorporeal blood purification therapies (EBPTs) is progressively increasing in everyday clinical practice, particularly in critical care settings. The efficacy of EBPTs on removal of inflammatory mediators is already well established in the literature. Nonetheless, clinical research is particularly cumbersome in this setting, and many clinical trials aiming at exploring the effect of EBPTs on outcomes have failed in demonstrating consistent results regarding 28-day- or hospital-mortality rates. Read More

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https://www.karger.com/Article/FullText/499356
Publisher Site
http://dx.doi.org/10.1159/000499356DOI Listing
April 2019
2 Reads

Distraction-Free Induction Zone: A Quality Improvement Initiative at a Large Academic Children's Hospital to Improve the Quality and Safety of Anesthetic Care for Our Patients.

Anesth Analg 2018 Oct 23. Epub 2018 Oct 23.

From the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.

Background: Noise in the operating room may cause distractions during critical periods and impair reliable communication between staff. Even momentary inefficiency while administering anesthesia can lead to errors and serious consequences for the patient. Distractions to an anesthesia provider during critical periods such as induction and emergence are a patient safety issue. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003879DOI Listing
October 2018

Ingestion of Dental Prosthesis of A Patient with an LMA Under General Anesthesia: A case report.

Arch Anesthesiol 2019 ;2(1):25-27

Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center.

60-year-old male presented for outpatient cystoscopy under General Anesthesia with a Laryngeal Mask Airway (LMA). The patient denied dental prosthesis during assessment. In recovery, a family member noticed a missing dental bridge which prompted a workup that revealed the ingested dental bridge in the stomach. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453139PMC
January 2019
1 Read

Credibility Evidence for Computational Patient Models Used in the Development of Physiological Closed-Loop Controlled Devices for Critical Care Medicine.

Front Physiol 2019 26;10:220. Epub 2019 Mar 26.

Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States.

Physiological closed-loop controlled medical devices automatically adjust therapy delivered to a patient to adjust a measured physiological variable. In critical care scenarios, these types of devices could automate, for example, fluid resuscitation, drug delivery, mechanical ventilation, and/or anesthesia and sedation. Evidence from simulations using computational models of physiological systems can play a crucial role in the development of physiological closed-loop controlled devices; but the utility of this evidence will depend on the credibility of the computational model used. Read More

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http://dx.doi.org/10.3389/fphys.2019.00220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445134PMC

A Fixed-Dose Combination, QXOH/Levobupivacaine, Produces Long-Acting Local Anesthesia in Rats Without Additional Toxicity.

Front Pharmacol 2019 26;10:243. Epub 2019 Mar 26.

Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.

QXOH, a QX314 derivative with longer duration and lesser local toxicity, is a novel local anesthetic in preclinical drug development. Previous studies demonstrated that bupivacaine can prolong the effects of QX314. So, we attempted to combine QXOH with levobupivacaine to shorten the onset time and lengthen the duration. Read More

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http://dx.doi.org/10.3389/fphar.2019.00243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443723PMC