Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Retraction Of Publication
Retraction note to: Nicardipine enhances diaphragmatic fatigue. Can J Anaesth 1994; 41: 435-9, DOI 10.1007/BF03009869.
Further to the Expression of Concern posted online on March 13th, 2012, it is with considerable regret that the Canadian Journal of Anesthesia hereby retracts the above-cited article by Dr. Yoshitaka Fujii as a result of:(1) overwhelming evidence of fabrication relating to the fact that the distributions of many variables reported by Dr. ⋯ We extend our sincere appreciation to Toride Kyodo General Hospital for their review of the status of Dr. Fujii’s research and to the investigating committee for their review of his research findings
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Massive transfusion has recently been given a dynamic definition, namely, the replacement of more than four red cell concentrates within an hour. The purpose of this continuing professional development module is to review the pathophysiology of hemorrhagic shock in the trauma patient and the current management strategies of the massively bleeding trauma patient. ⋯ After reading this module, the reader should be able to: 1. Enumerate the complications associated with massive transfusion in the trauma context; 2. Understand how the coagulopathy present in the trauma patient differs from that seen in the elective setting; 3. Identify the modifications suggested by the recent literature for the management of massive transfusion in the trauma setting; 4. Appreciate the evidence for the institution of massive transfusion protocols.
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Continuous catheterized nerve blockade has been used for many years to provide effective analgesia postoperatively. We report a potential complication of interscalene nerve block performed with the traditional catheter-through-needle insertion technique. Specifically, leakage from the catheter insertion site posed a risk of contamination to the sterile surgical field. We also describe an alternative catheter design to overcome this leakage problem. ⋯ This case report serves as a reminder that leakage from the catheter entry site remains a troublesome and hazardous issue during continuous peripheral nerve block. Leakage from the catheter insertion site often occurs due to the loose fit of the catheter in the larger diameter hole left by the Tuohy needle. We have also shown the successful use of an alternative catheter-over-needle design to minimize the risk of leakage from the catheter entry site. This technique resulted in being particularly vital for shoulder surgery with the patient in the beach chair position.
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Postoperative acute kidney injury (AKI) following arthroplasty has not been well studied. Our aim was to identify factors associated with increased risk of AKI. ⋯ In this case-control investigation, we identified several factors associated with the development of postoperative AKI. Recognition of these risk factors could allow for the adoption of perioperative renal protective strategies in patients undergoing arthroplasty.
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Interscalene nerve blocks provide adequate analgesia, but there are no objective criteria for early assessment of correct catheter placement. In the present study, pulse oximetry technology was used to evaluate changes in the perfusion index (PI) in both blocked and unblocked arms, and changes in the plethysmographic variability index (PVI) were evaluated once mechanical ventilation was instituted. ⋯ The perfusion index increases after successful interscalene nerve blockade and may be used as an indicator for successful block placement in awake patients. The PVI values before and after a fluid challenge can be useful to detect changes in preload, and this can be performed in both blocked and unblocked arms.