Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Members of the CAS and subscribers to the CJA are first invited to read the introduction that follows and the articles cited in the bibliography to prepare for the Self-Assessment Program. The reader should then go to the Journal's website (www.cja-jca.org) for the Problem Based Learning session. Completion of the Self-Assessment Program will entitle subscribers to claim ten hours of Continuing Professional Development (CPD) under section 3 of CPD options, for a total of 20 Maintenance of Certification credits (note that section 3 hours are not limited to a maximum number of credits per five-year period). There is no requirement to succeed: the goal of participating is to define potential areas for improvement.
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Case Reports
Hyperemia and impaired cerebral autoregulation in a surgical patient with diabetic ketoacidosis.
We describe cerebral hyperemia and impaired cerebral autoregulation documented with transcranial Doppler (TCD) ultrasonography in an adult patient with diabetic ketoacidosis (DKA) and sepsis presenting for surgery. ⋯ To our knowledge, this is the first description of impaired cerebral autoregulation in adult DKA. Our observations suggest a relationship between cerebral hyperemia and impaired cerebral autoregulation in DKA.
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In order to review changes and progress in anesthesiology in the second half of the 20th century, and to recognize the first half-century of the Journal's existence. ⋯ Although profound advances in knowledge, techniques, and relationships, have shaped the pattern and practice of anesthesiology in this half-century, the basic concerns of anesthesiologists relating to the practice of anesthesia and to their patients remained unchanged. At the same time, the many advances that have shaped anesthesiology in this half-century have extended the understanding of the phenomenon of anesthesia and enhanced the quality of patient care, which gives rise to the hope that anesthesiologists will continue to fully achieve these twin goals in the next half-century.
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Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery. ⋯ Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode.
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To survey Canadian pediatric anesthesiologists to assess practice patterns in managing pediatric patients with difficult airways. ⋯ Inhalational anesthesia remains the preferred technique for management of the difficult pediatric airway amongst Canadian pediatric anesthesiologists. Intravenous techniques are relatively more commonly chosen in cases where there is a shared airway but little concern regarding difficulty of intubation. In cases of anticipated difficult intubation, direct laryngoscopy remains the technique of choice and fibreoptic laryngoscopy makes a good alternate technique. The use of the laryngeal mask airway was preferred to facilitate fibreoptic intubation.