Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2014
Technology diffusion of anesthesia information management systems into academic anesthesia departments in the United States.
Anesthesia information management systems (AIMS) are electronic health records that automatically import vital signs from patient monitors and allow for computer-assisted creation of the anesthesia record. When most recently surveyed in 2007, it was estimated that at least 16% of U.S. academic hospitals (i.e., with an anesthesia residency program) had installed an AIMS. At least an additional 28% reported that they were in the process of implementing, or searching for an AIMS. In this study, we updated the adoption figures as of May 2013 and examined the historical trend of AIMS deployment in U.S. anesthesia residency programs from the perspective of the theory of diffusion of technologic innovations. ⋯ By the end of 2014, approximately 75% of U.S. academic anesthesiology departments will be using an AIMS, with 84% adoption expected between 2018 and 2020. Historical adoption of AIMS has followed Roger's 1962 formulation of the theory of diffusion of innovation.
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Anesthesia and analgesia · Mar 2014
Randomized Controlled Trial Observational StudyThe effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study.
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Anesthesia and analgesia · Mar 2014
Randomized Controlled TrialBronchial blocker lung collapse technique: nitrous oxide for facilitating lung collapse during one-lung ventilation with a bronchial blocker.
Effective lung collapse of the nonventilated lung can facilitate thoracic surgery. Previous studies showed that using a bronchial blocker could delay the time of lung collapse compared with using a double-lumen endotracheal tube. We hypothesized that the use of nitrous oxide (N2O) in the inspired gas mixture during 2-lung ventilation would lead to clinically relevant improvement of lung collapse during subsequent 1-lung ventilation with a bronchial blocker. ⋯ Filling the lung with 50% N2O before 1-lung ventilation facilitated lung collapse 5 minutes after opening the chest compared with 100% oxygen when a bronchial blocker was used. The N2O/O2 mixture (FIO2 = 0.5) did not have a harmful effect on subsequent arterial oxygenation during 1-lung ventilation.