Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Semaglutide, delayed gastric emptying, and intraoperative pulmonary aspiration: a case report.
We report a case in which the use of semaglutide for weight loss was associated with delayed gastric emptying and intraoperative pulmonary aspiration of gastric contents. ⋯ Patients using semaglutide and other glucagon-like peptide 1 agonists for weight management may require specific precautions during induction of anesthesia to prevent pulmonary aspiration of gastric contents.
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Multicenter Study
Association between preoperative cardiac risk assessment and health care costs in major noncardiac surgery: a multicentre health economic analysis.
Patients with impaired functional capacity who undergo major surgery are at increased risk of postoperative morbidity including complications and increased length of stay. These outcomes have been associated with increased hospital and health system costs. We aimed to assess whether common preoperative risk indices are associated with postoperative cost. ⋯ In patients undergoing major noncardiac surgery, common measures of functional capacity are not consistently associated with total postoperative cost. Until further data exist that differ from this analysis, clinicians and health care funders should not assume that preoperative measures of cardiac risk are associated with annual health care or hospital costs for such surgeries.
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Observational Study
Determining residual gastric volume in healthy children using ultrasound.
Fasting guidelines for children recommend restricting clear fluids for one or two hours before a procedure to reduce pulmonary aspiration. Gastric volumes < 1.5 mL·kg-1 do not seem to present an increased risk of pulmonary aspiration. Our aim was to quantify the time to achieve a gastric volume < 1.5 mL·kg-1 after clear fluid ingestion in children. ⋯ Our results show that total gastric fluid volume was < 1.5 mL·kg-1 after 60 min, suggesting that current fasting guidelines for children could be liberalized.
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Most North American trauma systems have designated trauma centres (TCs) including level I (ultraspecialized high-volume metropolitan centres), level II (specialized medium-volume urban centres), and/or level III (semirural or rural centres). Trauma system configuration varies across provinces and it is unclear how these differences influence patient distributions and outcomes. We aimed to compare patient case mix, case volumes, and risk-adjusted outcomes of adults with major trauma admitted to designated level I, II, and III TCs across Canadian trauma systems. ⋯ Our results suggest that differences in the functional role of TCs according to their designation level across provinces leads to significant variations in the distribution of patients, case volumes, resource use, and clinical outcomes. These results highlight opportunities to improve Canadian trauma care and underline the need for standardized population-based injury data to support national quality improvement efforts.
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Observational Study
The correlation between patient satiety sensation and total gastric fluid volume: a prospective observational study.
Surgical patients are asked to adhere to preoperative fasting guidelines to minimize gastric contents. Large fluid volumes or solid content can still be present as shown with gastric ultrasound. It has been suggested that additional rating of patients' satiety, measured as the feeling of hunger and thirst, could help clinicians to better judge emptying of the stomach. ⋯ ClinicalTrials.gov (NCT04884373); registered 13 May 2021.