Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
The impact of intraoperative transfusion of platelets and red blood cells on survival after liver transplantation.
Intraoperative transfusion of red blood cells (RBC) is associated with adverse outcome after orthotopic liver transplantation (OLT). Although experimental studies have shown that platelets contribute to reperfusion injury of the liver, the influence of allogeneic platelet transfusion on outcome has not been studied in detail. In this study, we evaluate the impact of various blood products on outcome after OLT. ⋯ This retrospective study indicates that, in addition to RBC, platelet transfusions are an independent risk factor for survival after OLT. These findings have important implications for transfusion practice in liver transplant recipients.
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Anesthesia and analgesia · Jan 2008
Comparative StudyAn assessment of dynamic autoregulation from spontaneous fluctuations of cerebral blood flow velocity: a comparison of two models, index of autoregulation and mean flow index.
Various methods of assessment of cerebral autoregulation, using spontaneous slow fluctuations of blood flow velocity (FV), arterial blood pressure, and cerebral perfusion pressure, have been used in clinical practice. We studied the association between the dynamic index of autoregulation (ARI) and time correlation index (mean flow index, Mx) in a group of patients after head injury. ⋯ ARI and Mx agree relatively well in head-injured patients. Autoregulation affects outcome after head injury.
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Anesthesia and analgesia · Jan 2008
Case ReportsNonfatal cerebral air embolism after dental surgery.
After removal of four impacted third molars under general anesthesia, our patient developed subcutaneous emphysema, pneumothorax, pneumopericardium, and pneumomediastinum. Soon thereafter, coma with generalized epileptic status ensued. ⋯ The likely mechanism was injection of air by the high-speed dental drill through the soft tissue adjacent to the roots of the lower molars. We were unable to find any previous report of systemic air embolism after oral surgery.
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Anesthesia and analgesia · Jan 2008
Real-time checking of electronic anesthesia records for documentation errors and automatically text messaging clinicians improves quality of documentation.
The quality of electronic anesthesia documentation is important for downstream communication and to demonstrate appropriate diligence to care. Documentation quality will also impact the success of reimbursement contracts that require timely and complete documentation of specific interventions. We implemented a system to improve completeness of clinical documentation and evaluated the results over time. ⋯ Electronic anesthesia documentation performance can be rapidly managed and improved by using an automatic process monitoring and alerting system.
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Anesthesia and analgesia · Jan 2008
Comparative StudyA comparison of two emergency cricothyroidotomy kits in human cadavers.
We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate. ⋯ In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.