Anesthesiology
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Comparative Study
Exceptionally stable fluorous emulsions for the intravenous delivery of volatile general anesthetics.
IV delivery of volatile fluorinated anesthetics has a number of potential advantages when compared with the current inhalation method of administration. We reported previously that the IV delivery of sevoflurane can be achieved through an emulsion composed of a linear fluorinated diblock copolymer, a stabilizer, and the anesthetic. However, this original emulsion was subject to particle size growth that would limit its potential clinical utility. We hypothesized that the use of bulkier fluorous groups and smaller polyethylene glycol moieties in the polymer design would result in improved emulsion stability while maintaining anesthetic functionality. ⋯ Hemifluorinated dibranched polymers can be used to generate exceptionally stable sevoflurane nanoemulsions, as required of formulations intended for clinical use. IV delivery of the emulsion in rats resulted in induction of anesthesia with rapid onset and smooth and rapid recovery.
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Comparative Study
Influence of supervision ratios by anesthesiologists on first-case starts and critical portions of anesthetics.
Anesthesia groups may wish to decrease the supervision ratio for nontrainee providers. Because hospitals offer many first-case starts and focus on starting these cases on time, the number of anesthesiologists needed is sensitive to this ratio. The number of operating rooms that an anesthesiologist can supervise concurrently is determined by the probability of multiple simultaneous critical portions of cases (i.e., requiring presence) and the availability of cross-coverage. A simulation study showed peak occurrence of critical portions during first cases, and frequent supervision lapses. These predictions were tested using real data from an anesthesia information management system. ⋯ Decreasing the supervision ratio from 1:2 to 1:3 has a large effect on supervision lapses during first-case starts. To mitigate such lapses, either staggered starts or additional anesthesiologists working at the start of the day would be required.
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Comparative Study
Molecular changes induced in rat liver by hemorrhage and effects of melanocortin treatment.
Melanocortin peptides improve hemodynamic parameters and prevent death during severe hemorrhagic shock. In the present research we determined influences of a synthetic melanocortin 1/4 receptor agonist on the molecular changes that occur in rat liver during hemorrhage. ⋯ Melanocortin treatment significantly prevents most of the systemic and hepatic detrimental changes induced by hemorrhage.