Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2024
Feasibility of Focused Cardiac Ultrasound Performed by Trainees During Cesarean Delivery.
Anesthesiology experts advocate for formal education in maternal critical care, including the use of focused cardiac ultrasound (FCU) in high-acuity obstetric units. While benefits and feasibility of FCU performed by experts have been well documented, little evidence exists on the feasibility of FCU acquired by examiners with limited experience. The primary aim of this study was to assess how often echocardiographic images of sufficient quality to guide clinical decision-making were attained by trainees with limited experience performing FCU in term parturients undergoing cesarean delivery (CD). ⋯ FCU is feasible in the parturient undergoing CD and images of sufficient quality for clinical decision-making were obtained by trainees with limited experience in almost all parturients. Image acquisition and quality in the A4CH view may be impacted by the individual trainee performing the FCU.
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Anesthesia and analgesia · Aug 2024
A Slow-Exchange Interstitial Fluid Compartment in Volunteers and Anesthetized Patients: Kinetic Analysis and Physiology.
Physiological studies suggest that the interstitial space contains 2 fluid compartments, but no analysis has been performed to quantify their sizes and turnover rates. ⋯ Kinetic analysis supported that Ringer's solution distributes in 2 interstitial compartments with different turnover times. The slow compartment became dominant when large amounts of fluid were infused and during general anesthesia. These findings may explain why fluid accumulates in peripheral tissues during surgery and why infused fluid can remain in the body for several days after general anesthesia.
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Anesthesia and analgesia · Aug 2024
Development of an Artificial Intelligence-Based Image Recognition System for Time-Sequence Analysis of Tracheal Intubation.
Total intubation time (TIT) is an objective indicator of tracheal intubation (TI) difficulties. However, large variations in TIT because of diverse initial and end targets make it difficult to compare studies. A video laryngoscope (VLS) can capture images during the TI process. By using artificial intelligence (AI) to detect airway structures, the start and end points can be freely selected, thus eliminating the inconsistencies. Further deconstructing the process and establishing time-sequence analysis may aid in gaining further understanding of the TI process. ⋯ YOLOv3 is a powerful tool for analyzing images recorded by VLS. By using AI to detect the airway structures, the start and end points can be freely selected, resolving the heterogeneity resulting from the inconsistencies in the TIT cut points across studies. Time-sequence analysis involving the deconstruction of VLS-recorded TI images into several phases should be conducted in further TI research.
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Anesthesia and analgesia · Aug 2024
Perioperative Plasma in Addition to Red Blood Cell Transfusions Are Associated With Increased Venous Thromboembolism Risk Postoperatively.
Perioperative red blood cell (RBC) transfusions increase venous thromboembolic (VTE) events. Although a previous study found that plasma resuscitation after trauma was associated with increased VTE, the risk associated with additional perioperative plasma is unknown. ⋯ When compared with perioperative RBC transfusion, adding plasma was associated with increased 30-day postoperative mortality, VTE, PE, and DIC risk among surgical and cardiovascular surgical patients. Reducing unnecessary plasma transfusion should be a focus of patient blood management to improve overall value in health care.