Maybe the Wand Does Matter?
(Abstracted from Anesth Analg, 124(1):7–8, 2017)
This editorial reviews both the work of Kellner et al1 and other studies that have examined the potentially relevant effects of volatile anesthetic agents on inflammation in the injured lung. The authors point out that in general most anesthesiologists likely believe the choice of anesthetic agent matters less than the anesthesiologist's skill at using it. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Sevoflurane Abolishes Oxygenation Impairment in a Long-term Rat Model of Acute Lung Injury
(Abstracted from Anesth Analg, 124:194–203, 2017)
The purpose of this in vivo rat model preclinical study was to evaluate the effect of 2 sedative agents—sevoflurane and propofol—on pulmonary inflammation and lung function in ventilated and sedated rats with acute lung injury (ALI) for up to 24 hours. Acute lung injury or acute respiratory distress syndrome, which accounts for 10% of patients treated in the intensive care unit (ICU), usually requires both mechanical ventilation and sedation. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
It’s About Time
(Abstracted from Anesthesiology, 126:4–5, 2017)
This editorial accompanied and commented on the article by Sato et al1 (“Mask Ventilation During Induction of General Anesthesia: Influences of Obstructive Sleep Apnea”) on the pathophysiology of difficult mask ventilation. The article by Sato et al1 emphasizes how mask ventilations can save lives, yet it is still not always the preferred course of action, and intubation continues to be the primary focus in airway management. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Mask Ventilation During Induction of General Anesthesia: Influences of Obstructive Sleep Apnea
(Abstracted from Anesthesiology, 126(1):28–38, 2017)
The main objective of this study was to outline and further define the mechanisms involved in difficult mask ventilation (MV), especially in those with sleep-disordered breathing (SDB). The authors hope these goals will lead to the development of new MV techniques for safe airway management during the induction of general anesthesia. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Impact of Focused Intraoperative Transthoracic Echocardiography by Anaesthesiologists on Management in Hemodynamically Unstable High-Risk Noncardiac Surgery Patients
(Abstracted from J Cardiothorac Vasc Anesth, 31:602–609, 2017)
Perioperative hemodynamic monitoring and intervention using transthoracic echocardiography (TTE) in high- risk surgery patients can decrease the rates of adverse events, morbidity, and mortality; however, evidence regarding its benefits is required. This prospective interventional study aimed at evaluating the efficacy of intraoperative TTE to alter patient management in high-risk and extensively monitored surgical patients susceptible to hemodynamic instability. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Intrathecal Morphine Versus Intravenous Opioid Administration to Impact Postoperative Analgesia in Hepato-Pancreatic Surgery: A Randomized Controlled Trial
(Abstracted from J Anesth, 31:237–245, 2017)
Inadequate analgesia following abdominal surgery may increase postoperative morbidity, delay recovery, and increase hospital length of stay. Postoperative coagulopathy in hepatic surgeries complicates the safe removal of epidural catheters, thus limiting the use of analgesics, emphasizing the need for alternate analgesic techniques. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Think Drink! Current Fasting Guidelines Are Outdated
(Abstracted from Br J Anaesth, 118(3):291–293, 2017)
This editorial reviews current fasting guidelines and the benefits of allowing patients clear liquid intake up to 2 hours before surgery in the context of the findings of the articles by Chauvin et al.1 and van de Putte et al.2 in the current issue of the British Journal of Anaesthesia. When under anesthesia, pulmonary aspiration of gastric contents occurs in 1:900 to 1:10,000 adults and in 2:10,000 children, although it is more frequent during emergency surgeries. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Prevalence and Factors Predictive of Full Stomach in Elective and Emergency Surgical Patients: A Prospective Cohort Study
(Abstracted from Br J Anaesth, 118(3):372–379, 2017)
The purpose of this prospective cohort study was to determine whether the stomachs of patients undergoing surgery, either elective or emergency, were empty or full. In addition, the authors sought to assess the causes and risks of a full stomach, which can lead to pulmonary aspiration of gastric contents as well as surgical mortality from general anesthesia. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Accuracy and Precision of Non-invasive Cardiac Output Monitoring Devices in Perioperative Medicine: A Systematic Review and Meta-analysis
(Abstracted from Br J Anaesth, 118(3):298–310, 2017)
The main purpose of this article is to provide a systematic review of all medical literature (37 studies; 1543 patients) comparing cardiac output (CO) measured with a commercially available completely noninvasive CO monitoring device against bolus thermodilution (TD) in various clinical settings such as the intensive care unit, emergency department, and the operating room. In addition, the authors provide a meta-analysis of the data extracted from the systematic review to calculate the precision of these noninvasive CO monitoring devices when used perioperatively by f...
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Overnight Call and Cognitive Functioning: Will Tablet-Based Assessment Be the Solution for Safety Check in Residents?
(Abstracted from J Clin Anesth, 40:123–124, 2017)
Sleep deprivation and circadian rhythm disruption in overnight call residents cause cognitive function deficits and increase workplace accidents, causing increased rates of patient care errors. Williams et al1 (“Sensorimotor and Executive Function Slowing in Anesthesiology Residents After Overnight Shifts”) evaluated the slowing of sensorimotor and executive function following a single overnight call shift compared with a routine daytime shift using 2 tablet-based pointing tasks in anesthesiology residents. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: Educational Issues Source Type: research
Vasopressin, Norepinephrine, and Vasodilatory Shock After Cardiac Surgery: Another “VASST” Difference?
This article reviews the trial by Hajjar et al1` comparing the effectiveness of 0.01 to 0.06 U/min vasopressin and 10 to 60 μg/min norepinephrine for treatment of vasodilatory shock after cardiac surgery. Vasodilatory shock was defined as hypotension requiring vasopressors with a cardiac index of greater than 2.2 L/min per m2. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: Critical Care Source Type: research
Vasopressin Versus Norepinephrine in Patients With Vasoplegic Shock After Cardiac Surgery: The VANCS Randomized Controlled Trial
(Abstracted from Anesthesiology, 126(1):85–93, 2017)
The purpose of this prospective, double-blind, randomized controlled trial was to gauge whether vasopressin is superior to norepinephrine in reducing postoperative complications in patients with vasoplegic syndrome. This complication, which presents in 5% to 25% of cardiac surgery patients, is characterized by low arterial pressure with either normal or elevated cardiac output but reduced systemic vascular resistance. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: Critical Care Source Type: research
Thoracic Anesthesia Intubated Versus Nonintubated General Anesthesia for Video-Assisted Thoracoscopic Surgery—A Case-Control Study
(Abstracted from J Cardiothorac Vasc Anesth, 31:411–417, 2017)
Although deemed mandatory to provide safe and optimal operating conditions for surgical manipulation, general anesthesia with endobronchial intubation and 1-lung positive-pressure ventilation for thoracic surgery has been known to cause lung injury. Nonintubated thoracic anesthetic techniques for video-assisted thoracoscopic surgery (VATS) in awake and sedated patients can be an alternate method to decrease the overall invasiveness and surgical stress. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: Cardiothoracic Anesthesia Source Type: research
Targeted Bleeding Management Reduces the Requirements for Blood Component Therapy in Lung Transplant Recipients
(Abstracted from J Cardiothorac Vasc Anesth, 31:426–433, 2017)
High rates of bleeding and allogeneic blood transfusions to treat bleeding are associated with adverse outcomes in bilateral sequential lung-transplant patients. The aim of this study was to determine if point-of-care coagulation testing could minimize unnecessary transfusion in lung-transplant patients. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: Cardiothoracic Anesthesia Source Type: research
Thromboelastometry Guided Fibrinogen Replacement Therapy in Cardiac Surgery: A Retrospective Observational Study
(Abstracted from J Anesth, 31:286–290, 2017)
Bleeding causes increased morbidity and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Inadequate management of bleeding and allogeneic blood products leads to prolonged hospital stays and adverse outcomes. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - August 1, 2017 Category: Anesthesiology Tags: Cardiothoracic Anesthesia Source Type: research
