12,114 results match your criteria Current Anaesthesia & Critical Care[Journal]


Different temperature thresholds for antipyretic intervention in critically ill children with fever due to infection: the FEVER feasibility RCT.

Health Technol Assess 2019 Feb;23(5):1-148

Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, UK.

Background: Fever accelerates host immune system control of pathogens but at a high metabolic cost. The optimal approach to fever management and the optimal temperature thresholds used for treatment in critically ill children are unknown.

Objectives: To determine the feasibility of conducting a definitive randomised controlled trial (RCT) to evaluate the clinical effectiveness and cost-effectiveness of different temperature thresholds for antipyretic management. Read More

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http://dx.doi.org/10.3310/hta23050DOI Listing
February 2019

Regional Anesthesia in the Combat Setting: Are ACGME Requirements Enough?

Mil Med 2019 Feb 22. Epub 2019 Feb 22.

Defense and Veterans Center for Integrative Pain Management, Department of Military and Emergency Medicine, Uniformed Services University, 11300 Rockville Pike, Suite 709, Rockville, MD.

Introduction: Updated Joint Trauma System Clinical Practice Guidelines (CPG) indicate regional anesthesia and pain management (RAAPM) are important for combat casualty care. However, it is unclear whether military anesthesiology residents are receiving adequate RAAPM training to meet the CPGs. The goal of this study was to conduct a preliminary evaluation of resident-completed combat-relevant regional anesthesia procedures. Read More

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http://dx.doi.org/10.1093/milmed/usz007DOI Listing
February 2019

Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction.

Ther Adv Urol 2019 Jan-Dec;11:1756287219828971. Epub 2019 Feb 14.

University of Thessaly, Faculty of Medicine, Department of Urology, Feidiou 6-8, 41221, Larissa, Greece.

Transurethral resection of the prostate (TURP) is considered the 'gold standard' for the surgical management of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). However, during recent years TURP has been challenged by several minimally invasive therapies (MITs). The reasons for the development of these MITs are the need for anesthesia and the rather unchanged morbidity of TURP, including ejaculation disorders. Read More

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http://dx.doi.org/10.1177/1756287219828971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376539PMC
February 2019

Blood flow maintenance by cardiac massage during cardiopulmonary resuscitation: Classical theories, newer hypotheses, and clinical utility of mechanical devices.

J Intensive Care Soc 2019 Feb 18;20(1):2-10. Epub 2018 Jun 18.

Department of Anaesthesia and Intensive Care, Santa Maria Annunziata Hospital, Florence, Italy.

The mechanisms by which closed chest cardiac massage produces and maintains blood flow during cardiopulmonary resuscitation are still debated. To date, two main theories exist: the "cardiac pump", which assumes that blood flow is driven by direct cardiac compression and the "chest pump", which hypothesizes that blood flow is caused by changes in intrathoracic pressure. Newer hypotheses including the "atrial pump", the "lung pump", and the "respiratory pump" were also proposed. Read More

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http://dx.doi.org/10.1177/1751143718778486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376580PMC
February 2019

Treatment of Cervical Dysplasia by Clinicians Who Perform Colposcopy in German-speaking Countries - a Questionnaire-based Study.

Geburtshilfe Frauenheilkd 2019 Feb 18;79(2):189-197. Epub 2019 Feb 18.

Klinik für Frauenheilkunde und Geburtshilfe, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Herne, Germany.

In connection with the reorganisation of cervical carcinoma screening, the importance of colposcopy as an integral part of the planned series of clarification testing will greatly increase. Quality standards for performing the colposcopic examination should therefore be defined in detail. A precondition for this is surveying the current standard in clinical practice. Read More

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http://dx.doi.org/10.1055/a-0828-7831DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379162PMC
February 2019

Differential Inhibition of Neuronal Sodium Channel Subtypes by the General Anesthetic Isoflurane.

J Pharmacol Exp Ther 2019 Feb 21. Epub 2019 Feb 21.

Weill Cornell Medical College

Volatile anesthetics depress neurotransmitter release in a brain region- and neurotransmitter-selective manner by unclear mechanisms. Voltage-gated sodium channels (Na), which are coupled to synaptic vesicle exocytosis, are inhibited by volatile anesthetics through reduction of peak current and modulation of gating. Subtype-selective effects of anesthetics on Na might contribute to observed neurotransmitter-selective anesthetic effects on release. Read More

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http://dx.doi.org/10.1124/jpet.118.254938DOI Listing
February 2019

Cathodic-leading pulses are more effective than anodic-leading pulses in intracortical microstimulation of the auditory cortex.

J Neural Eng 2019 Feb 21. Epub 2019 Feb 21.

Institute of AudioNeuroTechnology & Experimental Otology, Hannover Medical School, Hannover, GERMANY.

Objective: Intracortical microstimulation (ICMS) is widely used in neuroscientific research. Earlier work from our lab showed the possibility to combine ICMS with neuronal recordings on the same shank of multi-electrode arrays and consequently inside the same cortical column in vivo. The standard stimulus pulse shape for ICMS is a symmetric, biphasic current pulse. Read More

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http://dx.doi.org/10.1088/1741-2552/ab0944DOI Listing
February 2019

[Novel minimally invasive treatment options for male lower urinary tract symptom].

Urologe A 2019 Feb 21. Epub 2019 Feb 21.

Klinik für Urologie, Universitätsklinikum Freiburg, Freiburg, Deutschland.

Novel minimally invasive treatment options strive for innovative approaches that are equally efficient to standard procedures with a superior safety profile. A true minimally invasive technique can be performed in an ambulatory setting under local anaesthesia and no need for postinterventional catheterization so that quick and problem-free return to everyday life is possible. Sexual dysfunction is a great concern of sexually active patients facing surgery. Read More

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http://dx.doi.org/10.1007/s00120-019-0876-7DOI Listing
February 2019

Central neurological complications following obstetric neuraxial blockade.

Curr Opin Anaesthesiol 2019 Feb 14. Epub 2019 Feb 14.

Department of Anaesthesia, Queen's Hospital, Romford.

Purpose Of Review: Central neuraxial blockade is increasingly the anaesthetic management of choice for parturients, including in higher risk pregnancies. Although they are usually effective and safe, there are potentially devastating neurological complications that may present either overtly or insidiously. A thorough understanding of the variety of potential neurological complications is essential to adequately consent patients in addition to diagnosing and managing complications following neuraxial anaesthesia. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000714DOI Listing
February 2019

Physiology and Predictors of Impaired Gas Exchange in Infants with Bronchopulmonary Dysplasia.

Am J Respir Crit Care Med 2019 Feb 21. Epub 2019 Feb 21.

University of Western Australia, Human Sciences, Perth, Western Australia, Australia.

Rationale A sensitive outcome measure for infants with bronchopulmonary dysplasia would facilitate clinical benchmarking, enhance epidemiological understanding, evaluation of clinical interventions, and outcome prediction. Objectives Non-invasive assessment of pulmonary gas exchange in preterm infants with and without bronchopulmonary dysplasia to grade disease severity and identify determinants of impaired gas exchange. Methods Prospective observational study in very preterm infants. Read More

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http://dx.doi.org/10.1164/rccm.201810-2037OCDOI Listing
February 2019

Motoneuron firing properties are modified by trans-spinal direct current stimulation (tsDCS) in rats.

J Appl Physiol (1985) 2019 Feb 21. Epub 2019 Feb 21.

Department of Neurobiology, Poznan University of Physical Education, Poland.

Spinal polarization evoked by direct current stimulation (tsDCS) is a novel method for altering spinal network excitability; however, it remains not well understood. The aim of this study was to determine whether tsDCS influences spinal motoneuron activity. 20 Wistar rats under general pentobarbital anesthesia were subjected to 15 min. Read More

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http://dx.doi.org/10.1152/japplphysiol.00803.2018DOI Listing
February 2019

Neuroprotective potential of ketamine prevents developing brain structure impairment and alteration of neurocognitive function induced via isoflurane through the PI3K/AKT/GSK-3β pathway.

Drug Des Devel Ther 2019 4;13:501-512. Epub 2019 Feb 4.

Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province 250021, People's Republic of China,

Background: The aim of the current experimental study was to scrutinize the neuroprotective effect of ketamine on the isoflurane (iso)-induced cognitive dysfunction in rats via phosphoinositide 3 kinase (PI3K)/protein kinase B (AKT)/glycogen synthase kinase 3β (GSK-3β) pathway.

Materials And Methods: Sprague-Dawley rats were used for the current experimental study. The rats were divided into six groups and rats were treated with ketamine and memantine. Read More

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http://dx.doi.org/10.2147/DDDT.S188636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366353PMC
February 2019

Uses and mechanisms of apnoeic oxygenation: a narrative review.

Authors:
C Lyons M Callaghan

Anaesthesia 2019 Feb 19. Epub 2019 Feb 19.

Department of Anaesthesia, Galway University Hospitals, Galway, Ireland.

Apnoeic oxygenation refers to oxygenation in the absence of spontaneous respiration or mechanical ventilation. It has been described in humans for over half a century and has seen a resurgence in interest given its potential to delay oxygen desaturation during airway management, especially with the advent of high-flow nasal cannulae. This narrative review summarises our current understanding of the mechanisms of gas exchange during apnoeic oxygenation and its diverse range of clinical applications, including its use at induction of anaesthesia and for the facilitation of 'tubeless anaesthesia'. Read More

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http://dx.doi.org/10.1111/anae.14565DOI Listing
February 2019

Cost-effectiveness of cell salvage and donor blood transfusion during caesarean section: results from a randomised controlled trial.

BMJ Open 2019 Feb 19;9(2):e022352. Epub 2019 Feb 19.

Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Objectives: To evaluate the cost-effectiveness of routine use of cell salvage during caesarean section in mothers at risk of haemorrhage compared with current standard of care.

Design: Model-based cost-effectiveness evaluation alongside a multicentre randomised controlled trial. Three main analyses were carried out on the trial data: (1) based on the intention-to-treat principle; (2) based on the per-protocol principle; (3) only participants who underwent an emergency caesarean section. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022352DOI Listing
February 2019

The renoprotective effects of naringin and trimetazidine on renal ischemia/reperfusion injury in rats through inhibition of apoptosis and downregulation of micoRNA-10a.

Biomed Pharmacother 2019 Feb 16;112:108568. Epub 2019 Feb 16.

Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; The Persian Gulf Physiology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address:

Renal Ischemia-Reperfusion (IR) injury occurs due to circulatory shock and renal transplantation, leading to mortality and morbidity worldwide. The primary purpose of the current study was to evaluate the renoprotective effects of the naringin (NAR) and trimetazidine (TMZ) on IR injury, renal hemodynamics, antioxidant capacity, microRNA-10a, and expression of apoptosis factors. Forty rats were divided into five groups randomly: Sham, IR injury, (TMZ, 5 mg/kg), (NAR pretreatment, 100 mg/kg), and TMZ plus NAR. Read More

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http://dx.doi.org/10.1016/j.biopha.2019.01.029DOI Listing
February 2019

Opioid-induced bowel dysfunction: suggestions from a multidisciplinary expert Board.

Support Care Cancer 2019 Feb 18. Epub 2019 Feb 18.

Medical Oncology, Sapienza University of Rome and IDI-IRCCS of Rome, Rome, Italy.

Constipation, one of the adverse effects of opioid therapy with a major impact on quality of life, is still an unmet need for cancer patients, particularly those with an advanced and progressive disease, and for non-cancer patients chronically treated with opioids. The awareness of this condition is poor among healthcare providers, despite the recent publication of guidelines and consensus conferences. An early multidisciplinary approach of opioid-induced bowel dysfunction (OIBD), based on available therapies of proven effectiveness, could support clinicians in managing this condition, thus increasing patients' adherence to pain therapy. Read More

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http://dx.doi.org/10.1007/s00520-019-04688-2DOI Listing
February 2019

A Simple Protocol to Stratify Pulmonary Risk Reduces Complications After Total Joint Arthroplasty.

J Arthroplasty 2019 Jan 29. Epub 2019 Jan 29.

Department of Orthopaedic Surgery, Rothman Orthopaedics at Thomas Jefferson University, Egg Harbor Township, NJ.

Background: Pulmonary complications after total joint arthroplasty are a burden to patients and the healthcare system. The aim of this study is to demonstrate the effectiveness of a pulmonary screening questionnaire and intervention protocol developed at our institution to prevent pulmonary complications.

Methods: Between 2010 and 2015, 7658 consecutive total joint arthroplasty patients at our institution were reviewed. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.048DOI Listing
January 2019

A randomised comparison of C-MAC™ and King Vision® videolaryngoscopes with direct laryngoscopy in 180 obstetric patients.

Int J Obstet Anesth 2018 Dec 29. Epub 2018 Dec 29.

Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia; Institute of Anatomy, Medical Faculty Ljubljana, Vrazov trg 2, Ljubljana, Slovenia. Electronic address:

Background: Current evidence suggests that there is uncertainty about which videolaryngoscope performs best in obstetric anaesthesia. The aim of this study was to compare C-MAC and King Vision® videolaryngoscopes and direct laryngoscopy for tracheal intubation of patients undergoing caesarean section.

Methods: One hundred and eighty women were randomly assigned. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.008DOI Listing
December 2018

Sensitization in Heart Transplantation: Emerging Knowledge: A Scientific Statement From the American Heart Association.

Circulation 2019 Feb 19:CIR0000000000000598. Epub 2019 Feb 19.

Sensitization, defined as the presence of circulating antibodies, presents challenges for heart transplant recipients and physicians. When present, sensitization can limit a transplantation candidate's access to organs, prolong wait time, and, in some cases, exclude the candidate from heart transplantation altogether. The management of sensitization is not yet standardized, and current therapies have not yielded consistent results. Read More

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http://dx.doi.org/10.1161/CIR.0000000000000598DOI Listing
February 2019

Venous pressure during intravenous regional anesthesia: Implications for setting tourniquet pressure.

J Anaesthesiol Clin Pharmacol 2018 Oct-Dec;34(4):507-512

Department of Anesthesiology and Perioperative Medicine, University of Vermont College of Medicine, Burlington, VT, USA.

Background And Aims: Intravenous regional anesthesia (IVRA) is utilized for upper extremity surgery, but higher tourniquet pressure and longer inflation time increase the risk of soft tissue and nerve injury. We investigated the duration and magnitude of elevated venous pressure during IVRA to assess the possibility of safely lowering the tourniquet pressure during surgery.

Material And Methods: Twenty adult patients scheduled for distal upper extremity surgery were enrolled. Read More

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http://dx.doi.org/10.4103/joacp.JOACP_69_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360886PMC
February 2019

Evaluation of cerebral oxygen saturation during hypotensive anesthesia in functional endoscopic sinus surgery.

J Anaesthesiol Clin Pharmacol 2018 Oct-Dec;34(4):503-506

Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background And Aims: Controlled hypotensive anesthesia in endoscopic sinus surgery would provide a clean surgical field. Cerebral oxygen saturation (ScO) is important in endoscopic sinus surgery patients and it may be low during controlled hypotension. The aim of the present study was to assess ScO in these patients. Read More

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http://dx.doi.org/10.4103/joacp.JOACP_248_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360878PMC
February 2019

Strategies for prevention of lower limb post-amputation pain: A clinical narrative review.

J Anaesthesiol Clin Pharmacol 2018 Oct-Dec;34(4):439-449

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Postamputation limb pain or phantom limb pain (PLP) develops due to the complex interplay of peripheral and central sensitization. The pain mechanisms are different during the initial phase following amputation as compared with the chronic PLP. The literature describes extensively about the management of established PLP, which may not be applicable as a preventive strategy for PLP. Read More

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http://dx.doi.org/10.4103/joacp.JOACP_126_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360885PMC
February 2019

Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study.

Int J Obstet Anesth 2019 Jan 12. Epub 2019 Jan 12.

Department of Anesthesiology, University Hospitals of the KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

Introduction: This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital.

Methods: Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in the current pregnancy, between 2001 and 2016. Pregnancy outcomes of these women were firstly compared with all contemporary non-exposed patients (n=35 411), and secondly with 684 non-exposed control patients, matched for age, time of delivery and parity. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.006DOI Listing
January 2019

Impact of gender on echocardiographic characteristics in heart transplant recipients.

Clin Physiol Funct Imaging 2019 Feb 15. Epub 2019 Feb 15.

Lund University, Department of Clinical Sciences Lund, Cardiology, Lund, Sweden.

Aims: Assessment following heart transplantation (HTx) is routinely performed using transthoracic echocardiography. Differences in long-term mortality following HTx related to donor-recipient matching have been reported, but effects of gender on cardiac size and function are not well studied. The aims of this study were to evaluate differences in echocardiographic characteristics of HTx recipients defined by gender. Read More

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http://dx.doi.org/10.1111/cpf.12565DOI Listing
February 2019
1 Read

The Use of Subcostal Echocardiographic Views to Guide the Insertion of a Right Ventricular Temporary Transvenous Pacemaker-Description of the Technique.

J Cardiothorac Vasc Anesth 2019 Jan 16. Epub 2019 Jan 16.

University of Ottawa Department of Anesthesiology, Ottawa, Ontario, Canada; Department of Anesthesiology and Perioperative Medicine, Western University, London, Ontario, Canada. Electronic address:

The need for temporary cardiac pacing may occur in emergency and elective situations and may require transvenous right ventricular lead placement. The treatment of bradyarrhythmias presents the most common perioperative emergency indication. Intraoperatively, temporary rapid right ventricular pacing is accepted as a safe, titratable, and highly reliable method to achieve deliberate hypotension, and it has become a routine practice in the anesthetic management of cardiovascular interventions. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10530770193006
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http://dx.doi.org/10.1053/j.jvca.2019.01.033DOI Listing
January 2019
5 Reads

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy.

Anesth Analg 2019 Feb 12. Epub 2019 Feb 12.

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

Enhanced recovery pathways have quickly become part of the standard of care for patients undergoing elective surgery, especially in North America and Europe. One of the central tenets of this multidisciplinary approach is the use of multimodal analgesia with opioid-sparing and even opioid-free anesthesia and analgesia. However, the current state is a historically high use of opioids for both appropriate and inappropriate reasons, and patients with chronic opioid use before their surgery represent a common, often difficult-to-manage population for the enhanced recovery providers and health care team at large. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004018DOI Listing
February 2019

Developmental Neurotoxicity: An Update.

J Neurosurg Anesthesiol 2019 Jan;31(1):108-114

Department of Anesthesiology, Columbia University, New York, NY.

In the section of "Developmental Neurotoxicity: An Update" of the Pediatric Anesthesia Neurodevelopmental Assessment (PANDA) symposium 2018 the speakers presented the current literature in translational and clinical research. Dr. Brambrink spoke about translational research in anesthetic neurotoxicity, beginning with discovery in the rodent model, then focusing on evidence from nonhuman primates. Read More

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http://dx.doi.org/10.1097/ANA.0000000000000557DOI Listing
January 2019

Report on the Sixth Pediatric Anesthesia Neurodevelopmental Assessment (PANDA) Symposium, "Anesthesia and Neurodevelopment in Children".

J Neurosurg Anesthesiol 2019 Jan;31(1):103-107

Department of Anesthesiology, Columbia University Medical Center, New York, NY.

On April 14 and 15, 2018, the Sixth Biennial Pediatric Anesthesia Neurodevelopmental Assessment (PANDA) Symposium convened at Columbia University Medical Center and New York Presbyterian/Morgan Stanley Children's Hospital of New York. Since its inception over 10 years ago, the PANDA Symposium has served as a key forum for clinicians, researchers, and other major stakeholders to gather and review the current state of preclinical and clinical research related to anesthetic neurotoxicity in the developing brain. It has also served as an important venue for participants to gain insight and leverage support from various public and private regulatory bodies. Read More

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http://dx.doi.org/10.1097/ANA.0000000000000538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383795PMC
January 2019

Perioperative Lung Protective Ventilatory Management During Major Abdominal Surgery: A Hungarian Nationwide Survey.

J Crit Care Med (Targu Mures) 2019 Jan 4;5(1):19-27. Epub 2019 Feb 4.

University of Szeged, Department of Anaesthesiology and Intensive Therapy, Szeged, Hungary.

Lung protective mechanical ventilation (LPV) even in patients with healthy lungs is associated with a lower incidence of postoperative pulmonary complications (PPC). The pathophysiology of ventilator-induced lung injury and the risk factors of PPCs have been widely identified, and a perioperative lung protective concept has been elaborated. Despite the well-known advantages, results of recent studies indicated that intraoperative LPV is still not widely implemented in current anaesthesia practice. Read More

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http://dx.doi.org/10.2478/jccm-2019-0002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369570PMC
January 2019
2 Reads

Ultrasound-guided biodegradable subacromial spacer implantation in a patient with massive irreparable rotator cuff tears.

Wideochir Inne Tech Maloinwazyjne 2019 Jan 8;14(1):145-148. Epub 2018 Aug 8.

National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

The aim of this manuscript is to present a modification of the current arthroscopic implantation technique of a biodegradable subacromial spacer. This modified ultrasound-guided technique was intended to maximally reduce the invasiveness of the procedure. The ultrasound technique was used to measure the subacromial space for an optimal fit and to verify subacromial spacer placement in the sagittal and frontal planes. Read More

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http://dx.doi.org/10.5114/wiitm.2018.77555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372862PMC
January 2019

Genetic pathway analysis reveals a major role for extracellular matrix organization in inflammatory and neuropathic pain.

Pain 2019 Jan 3. Epub 2019 Jan 3.

Alan Edwards Centre for Research on Pain, McGill University, Montre[Combining Acute Accent]al, QC, Canada.

Chronic pain is a debilitating and poorly treated condition whose underlying mechanisms are poorly understood. Nerve injury and inflammation cause alterations in gene expression in tissues associated with pain processing, supporting molecular and cellular mechanisms that maintain painful states. However, it is not known whether transcriptome changes can be used to reconstruct a molecular pathophysiology of pain. Read More

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http://dx.doi.org/10.1097/j.pain.0000000000001471DOI Listing
January 2019
3 Reads

Prevention of Postoperative Pneumonia in Noncardiac Surgical Patients: A Prospective Study Using the National Surgical Quality Improvement Program Database.

Am Surg 2019 Jan;85(1):8-14

Postoperative pneumonia increases morbidity, length of stay, and hospital readmission rates. Current data support the use of perioperative chlorhexidine gluconate in elective cardiac surgery patients to prevent postoperative pneumonia. The objectives of this study were to implement a resident-driven quality improvement project and determine the efficacy of an oral care bundle in preventing postoperative pneumonia among noncardiac surgical patients. Read More

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January 2019

Pediatric ventricular assist devices: Bridge to a new era of peri-operative care.

Paediatr Anaesth 2019 Feb 13. Epub 2019 Feb 13.

Pediatric Cardiology, Stanford Children's Hospital, Stanford University Medical Center, Palo Alto, USA.

Pediatric ventricular assist devices (VADs) are evolving as a standard therapy for end stage heart failure in children. Major recent developments include the increased use of continuous flow (CF) devices in children and increased experience with congenital heart disease (CHD) and outpatient management. In the current and future era anesthesiologists will encounter more children presenting for VAD implantation, subsequent procedures and heart transplantation. Read More

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http://dx.doi.org/10.1111/pan.13609DOI Listing
February 2019
1 Read

Towards precision medicine for pain: diagnostic biomarkers and repurposed drugs.

Mol Psychiatry 2019 Feb 12. Epub 2019 Feb 12.

Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.

We endeavored to identify objective blood biomarkers for pain, a subjective sensation with a biological basis, using a stepwise discovery, prioritization, validation, and testing in independent cohorts design. We studied psychiatric patients, a high risk group for co-morbid pain disorders and increased perception of pain. For discovery, we used a powerful within-subject longitudinal design. Read More

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http://dx.doi.org/10.1038/s41380-018-0345-5DOI Listing
February 2019

Tranexamic Acid in Reducing Gross Hemorrhage and Transfusions of Spine Surgeries (TARGETS): study protocol for a prospective, randomized, double-blind, non-inferiority trial.

Trials 2019 Feb 12;20(1):125. Epub 2019 Feb 12.

Department of Anesthesiology, Peking Union Medical College Hospital, No.1 Shuai Fu Yuan, Wang Fu Jing Street, Beijing, 100730, People's Republic of China.

Background: Tranexamic acid (TXA) has been routinely delivered in multisegmental spinal decompression and bone graft fusion surgeries with satisfactory outcomes in minimizing gross blood loss and transfusion demands. However, concerns remain that intravenously delivered TXA (ivTXA) may increase risks of postoperative convulsive seizures and systemic thrombogenicity. Topical use of TXA (tTXA), being more targeted to the surgical bleeding site while minimizing patient systemic exposure to ivTXA, has been successfully applied to attenuate blood losses and transfusion requirements in hip and knee arthroplasty. Read More

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http://dx.doi.org/10.1186/s13063-019-3231-9DOI Listing
February 2019
2 Reads

Clinical complications during veno-arterial extracorporeal membrane oxigenation in post-cardiotomy and non post-cardiotomy shock: still the achille's heel.

J Thorac Dis 2018 Dec;10(12):6993-7004

Clinical Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior in Warsaw, Poland.

Extracorporeal membrane oxygenation (ECMO) is life-saving for potentially reversible heart failure and respiratory injuries not responsive to conventional therapies. Technological innovations have produced over the years significant improvements in ECMO devices (pump, cannula design and oxygenator) and have allowed a better risk/benefit profile. Alongside with recognized advantages in the treatment of very sick patients, ECMO remains an invasive procedure for mechanical circulatory support (MCS) and it is associated with complications that strongly influence the prognosis. Read More

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http://dx.doi.org/10.21037/jtd.2018.11.103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344687PMC
December 2018
1 Read

Management of the brain-dead donor in the ICU: general and specific therapy to improve transplantable organ quality.

Intensive Care Med 2019 Feb 11. Epub 2019 Feb 11.

Neuro-Intensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, ASST, Monza, Italy.

Purpose: To provide a practical overview of the management of the potential organ donor in the intensive care unit.

Methods: Seven areas of donor management were considered for this review: hemodynamic management; fluids and electrolytes; respiratory management; endocrine management; temperature management; anaemia and coagulation; infection management. For each subchapter, a narrative review was conducted. Read More

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http://dx.doi.org/10.1007/s00134-019-05551-yDOI Listing
February 2019
1 Read

Salvage Strategy for Long-Term Central Venous Catheter-Associated Infections in Children.

Front Pediatr 2018 25;6:427. Epub 2019 Jan 25.

Department of General Pediatrics and Infectious Diseases, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France.

Current international guidelines strongly recommend catheter removal in case of central line-associated bloodstream infection (CLASBI), but a catheter salvage strategy may be considered in children given age-related specificities. No data is available regarding the outcome of this strategy in children. This study aims to evaluate catheter salvage strategy in children with CLABSI, and to determine treatment failure rates and associated risk factors. Read More

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http://dx.doi.org/10.3389/fped.2018.00427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355702PMC
January 2019

Cerebral Oxygen Saturation and Negative Postoperative Behavioral Changes in Pediatric Surgery: A Prospective Observational Study.

J Pediatr 2019 Feb 5. Epub 2019 Feb 5.

Anesthesiology and Surgical Critical Care Department, Clinical University Hospital of Valladolid, Valladolid, Spain; Biomedical Research Group in Critical Care Medicine (BioCritic), Clinical University Hospital of Valladolid, Valladolid, Spain; Department of Anesthesiology, University of Valladolid, Valladolid, Spain.

Objective: To evaluate if an intraoperative cerebral regional oxygen saturation (crSO) decrease, less pronounced than 20% below baseline (the current threshold believed to be associated with cognitive dysfunction in adults), is associated with negative postoperative behavioral changes (NPOBC) in the pediatric population after noncardiac surgeries.

Study Design: A prospective observational study was conducted with 198 children aged 2-12 years old scheduled for noncardiac procedures under general anesthesia. Intraoperatively, crSO was monitored with a cerebral oximeter. Read More

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http://dx.doi.org/10.1016/j.jpeds.2018.12.047DOI Listing
February 2019

Chewing gum for 1 h does not change gastric volume in healthy fasting subjects. A prospective observational study.

J Clin Anesth 2019 Feb 5;56:100-105. Epub 2019 Feb 5.

Department of Anesthesia, Toronto Western Hospital, 399 Bathurst St, Main Pavilion 2-405, Toronto, ON M5T 2S8, Canada.

Study Objective: Perioperative fasting guidelines differ in their approaches to chewing gum in the preoperative period. Current recommendations range from canceling the surgery to proceeding with it. Given this lack of consensus, we performed gastric ultrasound assessments in healthy volunteers before and after a standardized period of chewing gum. Read More

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http://dx.doi.org/10.1016/j.jclinane.2019.01.021DOI Listing
February 2019
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Incidence of severe critical events in paediatric anaesthesia in Scandinavia: Secondary analysis of Anaesthesia PRactice In Children Observational Trial (APRICOT).

Acta Anaesthesiol Scand 2019 Feb 6. Epub 2019 Feb 6.

Department of Anaesthesiology and Intensive Care Medicine, Queen Silvia Children Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background: The Anaesthesia PRactice In Children Observational Trial (APRICOT) in 261 European hospitals revealed a 5.2% incidence of severe critical events in the perioperative period and wide variability in practice.

Methods: A sub-analysis of the Scandinavian data was undertaken to investigate differences from the rest of Europe in the incidence and nature of perioperative severe critical events and to attempt to identify areas for quality improvement. Read More

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http://dx.doi.org/10.1111/aas.13333DOI Listing
February 2019

Antibiotic Prophylaxis in the Management of Open Fractures: A Systematic Survey of Current Practice and Recommendations.

JBJS Rev 2019 Feb 5. Epub 2019 Feb 5.

Department of Health Research Methods, Evidence, and Impact (Y.C., M.B., R.K., S.S., L.J., M.W., R.A.C.S., and G.H.G.), Division of Orthopedic Surgery, Department of Surgery (M.B., B.P., and B.R.), School of Rehabilitation Science (A.N.), Department of Medicine (K.L.Z., R.D.M., and G.H.G.), Health Science Library (N.B.), Division of Vascular Surgery (F.N.N.), Department of Anesthesia (L.W.), and Michael G. DeGroote Institute for Pain Research and Care (L.W.), McMaster University, Hamilton, Ontario, Canada.

Background: Evidence with regard to antibiotic prophylaxis for patients with open fractures of the extremities is limited. We therefore conducted a systematic survey addressing current practice and recommendations.

Methods: We included publications from January 2007 to June 2017. Read More

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http://dx.doi.org/10.2106/JBJS.RVW.17.00197DOI Listing
February 2019

An Update of Current Cannabis-Based Pharmaceuticals in Pain Medicine.

Pain Ther 2019 Feb 5. Epub 2019 Feb 5.

Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA.

Cannabis users have long reported therapeutic properties of the plant for a variety of conditions, some of which include nausea, emesis, seizures, cancer, neurogenic diseases and pain control. Research has elucidated many cannabinoid pharmacodynamic and pharmacokinetic properties, expanding the potential use of cannabinoids as a medical therapy. Due to the inconsistent delivery and control of the active components involved with smoking, pharmaceutical companies are investigating and prioritizing routes other than smoke inhalation for therapeutic use of cannabinoids. Read More

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http://dx.doi.org/10.1007/s40122-019-0114-4DOI Listing
February 2019
2 Reads

An exploratory clinical evaluation of a head-worn display based multiple-patient monitoring application: impact on supervising anesthesiologists' situation awareness.

J Clin Monit Comput 2019 Feb 5. Epub 2019 Feb 5.

Department of Anesthesia and Critical Care, University Hospital of Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.

Purpose: Supervising anesthesiologists overseeing several operating rooms must be aware of the status of multiple patients, so they can consult with the anesthetist in single operating rooms or respond quickly to critical events. However, maintaining good situation awareness can be challenging when away from patient bedsides or a central monitoring station. In this proof-of-concept study, we evaluated the potential of a head-worn display that showed multiple patients' vital signs and alarms to improve supervising anesthesiologists' situation awareness. Read More

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http://dx.doi.org/10.1007/s10877-019-00265-4DOI Listing
February 2019

Surgical Treatment of Proximal Segmental Occlusion of the Internal Carotid Artery.

Surg Res Pract 2019 2;2019:2976091. Epub 2019 Jan 2.

Department of Vascular Surgery, Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia.

Purpose: To present the feasibility, safety, and efficacy of carotid endarterectomy in patients with type II internal carotid artery occlusions, including the long-term outcomes.

Methods: From March 2008 to August 2015, 74 consecutive patients (48 men with a mean age of 65.1 ± 8. Read More

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http://dx.doi.org/10.1155/2019/2976091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334308PMC
January 2019
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Efficacy and safety of fexapotide triflutate in outpatient medical treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia.

Ther Adv Urol 2019 Jan-Dec;11:1756287218820807. Epub 2019 Jan 14.

University of Texas Southwestern Medical Center, Dallas, TX, USA.

Male lower urinary tract symptoms (LUTS) is an increasingly important problem for the majority of late middle aged and elderly men. Fexapotide triflutate (FT) is a first in-class compound given by local injection the transrectal intraprostatic route under ultrasound guidance. Data from >1700 FT and control injections in prospective randomized blinded controlled multicenter trials are reviewed and discussed in relation to current developments in the field of treatments for LUTS associated with benign prostatic hyperplasia (BPH). Read More

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http://dx.doi.org/10.1177/1756287218820807DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348527PMC
January 2019
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Responsible, Safe, and Effective Use of Antithrombotics and Anticoagulants in Patients Undergoing Interventional Techniques: American Society of Interventional Pain Physicians (ASIPP) Guidelines.

Pain Physician 2019 Jan;22(1S):S1-S74

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Interventional pain management involves diagnosis and treatment of chronic pain. This specialty utilizes minimally invasive procedures to target therapeutics to the central nervous system and the spinal column. A subset of patients encountered in interventional pain are medicated using anticoagulant or antithrombotic drugs to mitigate thrombosis risk. Read More

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January 2019
2 Reads
3.542 Impact Factor

Bisoprolol, Known to Be a Selective β₁-Receptor Antagonist, Differentially but Directly Suppresses I and I in Pituitary Cells and Hippocampal Neurons.

Int J Mol Sci 2019 Feb 2;20(3). Epub 2019 Feb 2.

Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan 70101, Taiwan.

Bisoprolol (BIS) is a selective antagonist of β₁ adrenergic receptors. We examined the effects of BIS on M-type K⁺ currents (I) or -mediated K⁺ currents (I) in pituitary GH R1220 cells, and hippocampal mHippoE-14 cells. As GH₃ cells were exposed to BIS, amplitude of I was suppressed with an IC value of 1. Read More

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http://dx.doi.org/10.3390/ijms20030657DOI Listing
February 2019
2.862 Impact Factor

Office-Based Sedation/General Anesthesia for COPD Patients, Part I.

Anesth Prog 2018 ;65(4):261-268

Private Practice, CarePoint Anesthesia, Denver, Colorado.

The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office-based settings can be quite complex without a current understanding of the etiology, course, severity, and treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other comorbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Read More

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http://dx.doi.org/10.2344/anpr-65-04-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318726PMC
January 2018
1 Read

Protein arginine methyltransferase 5 promotes bladder cancer growth through inhibiting NF-kB dependent apoptosis.

EXCLI J 2018 20;17:1157-1166. Epub 2018 Nov 20.

Department of Urology, the Affiliated Fourth Hospital of China Medical University, Shenyang, Liaoning, China.

Protein arginine methyltransferase 5 (PRMT5) has emerged as a key regulator of tumorigenesis. However, how PRMT5 functions in bladder cancer, the most common malignancy of the urological system, is unknown. We described here that PRMT5 is highly expressed in bladder cancer cell lines and primary human bladder cancer tissues. Read More

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http://dx.doi.org/10.17179/excli2018-1719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341427PMC
November 2018