Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Effects of neuromuscular block reversal with sugammadex versus neostigmine on postoperative respiratory outcomes after major abdominal surgery: a randomized-controlled trial.
Postoperative pulmonary complications may be better reduced by reversal of neuromuscular block with sugammadex than by reversal with neostigmine because the incidence of residual block after sugammadex application is lower and diaphragm function is less impaired than after neostigmine administration. The aim of the study was to compare the effect of reversal of neuromuscular block with sugammadex or neostigmine on lung function after major abdominal surgery. ⋯ We found no differences in pulmonary function in patients reversed with sugammadex or neostigmine in a high-risk population.
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Randomized Controlled Trial
Peripheral electrical stimulation reduces postoperative hypoxemia in patients at risk for obstructive sleep apnea: a randomized-controlled trial.
Severity of hypoxemic events resulting from obstructive sleep apnea (OSA) is correlated with increased risk of complications and sudden death. We studied the use of a peripheral transcutaneous electrical stimulus (TES) on the magnitude and duration of sleep apnea associated hypoxemia in postoperative patients at high risk for OSA. ⋯ In postoperative surgical patients at risk for OSA, peripheral transcutaneous electrical stimulation applied during apneic episodes decreased the duration and magnitude of hypoxemia.
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Multicenter Study
Implementation of population-level screening for frailty among patients admitted to adult intensive care in Alberta, Canada.
A substantial proportion of patients admitted to intensive care units (ICUs) are frail; however, the epidemiology of frailty has not been explored at a population-level. Following implementation of a validated frailty measure into a provincial ICU clinical information system, we describe the population-based prevalence and outcomes of frailty in patients admitted to ICUs. ⋯ A validated measure of frailty can be implemented at the population level in ICU. Frailty is common in ICU patients and has implications for health service use and clinical outcomes.
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This narrative review summarizes the current literature on postoperative traumatic stress, namely post-traumatic stress disorder (PTSD), including defining features, epidemiology, identification of patient and perioperative risk factors, assessment tools, intervention recommendations, and future directions. ⋯ Research on postoperative traumatic stress, including PTSD, is in its infancy. Current evidence shows elevated incidence rates of postoperative traumatic stress, which can worsen overall physical and mental health outcomes. Future research on assessment, prevention, and treatment is warranted.