Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2010
Special article: personal protective equipment for care of pandemic influenza patients: a training workshop for the powered air purifying respirator.
Virulent respiratory infectious diseases may present a life-threatening risk for health care professionals during aerosol-generating procedures, including endotracheal intubation. The 2009 Pandemic Influenza A (H1N1) brings this concern to the immediate forefront. The Centers for Disease Control and Prevention have stated that, when performing or participating in aerosol-generating procedures on patients with virulent contagious respiratory diseases, health care professionals must wear a minimum of the N95 respirator, and they may wish to consider using the powered air purifying respirator (PAPR). ⋯ We provide on line a PAPR training workshop. Supporting information is presented here. Anesthesia and critical care providers may use this workshop to supplement, but not substitute for, the manufacturers' detailed use and maintenance instructions.
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Anesthesia and analgesia · Oct 2010
Review Comparative StudyHeparin dose response is independent of preoperative antithrombin activity in patients undergoing coronary artery bypass graft surgery using low heparin concentrations.
Unfractionated heparin's primary mechanism of action is to enhance the enzymatic activity of antithrombin (AT). We hypothesized that there would be a direct association between preoperative AT activity and both heparin dose response (HDR) and heparin sensitivity index (HSI) in patients undergoing coronary artery bypass graft surgery. ⋯ Although enhancing AT activity is the primary mechanism by which heparin facilitates cardiopulmonary bypass anticoagulation, low preoperative AT activity is not associated with impaired response to heparin or to clinical outcomes when using target ACTs of 300 to 350 seconds.
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Anesthesia and analgesia · Oct 2010
Comparative StudyEpidemiology of ambulatory anesthesia for children in the United States: 2006 and 1996.
There are few data that describe the frequency, anesthetic type, provider, or disposition of children requiring outpatient anesthesia in the United States (US). Since the early 1980s, the frequency of ambulatory surgery has increased dramatically because of advances in medical technology and changes in payment arrangements. Our primary aim in this study was to quantify the number of ambulatory anesthetics for children that occur annually and to study the change in utilization of pediatric anesthetic care over a decade. ⋯ The number and rate of ambulatory anesthesia episodes for US children increased dramatically over a decade. This study provides an example of how databases can provide useful information to health care policy makers and educators on the utilization of ambulatory surgical centers by children.
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Anesthesia and analgesia · Oct 2010
Multicenter Study Comparative Study Clinical TrialPostoperative activity, but not preoperative activity, of antithrombin is associated with major adverse cardiac events after coronary artery bypass graft surgery.
Low levels of antithrombin (AT) have been independently associated with prolonged intensive care unit stay and an increased incidence of neurologic and thromboembolic events after cardiac surgery. We hypothesized that perioperative AT activity is independently associated with postoperative major adverse cardiac events (MACEs) in patients undergoing coronary artery bypass graft (CABG) surgery. ⋯ Preoperative AT activity is not associated with MACE after CABG surgery. MACE is independently associated with postoperative AT activity but only at time points occurring predominantly after the MACE.