Journal of clinical anesthesia
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Review Meta Analysis
Preoperative ultrasound assessment of gastric content in patients with diabetes: A meta-analysis based on a systematic review of the current literature.
To conduct a systematic literature review of the current evidence on the effect of diabetes mellitus on gastric volume observed during a preoperative ultrasound examination. Using the results of this systematic literature review, a meta-analysis was performed to investigate whether there was an association between diabetes mellitus and an increased risk of presenting with a high-risk stomach (gastric volume associated with an increased risk of pulmonary aspiration). ⋯ Diabetes mellitus is associated with an increased rate of high-risk stomachs. The authors recommend large prospective trials to ascertain the safety of the current fasting guidelines for patients with diabetes undergoing surgery.
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Review Meta Analysis
Preoperative ultrasound assessment of gastric content in patients with diabetes: A meta-analysis based on a systematic review of the current literature.
To conduct a systematic literature review of the current evidence on the effect of diabetes mellitus on gastric volume observed during a preoperative ultrasound examination. Using the results of this systematic literature review, a meta-analysis was performed to investigate whether there was an association between diabetes mellitus and an increased risk of presenting with a high-risk stomach (gastric volume associated with an increased risk of pulmonary aspiration). ⋯ Diabetes mellitus is associated with an increased rate of high-risk stomachs. The authors recommend large prospective trials to ascertain the safety of the current fasting guidelines for patients with diabetes undergoing surgery.
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Acute kidney injury occurs frequently in the perioperative setting. The renal medulla often endures hypoxia or hypoperfusion and is susceptible to the imbalance between oxygen supply and demand due to the nature of renal blood flow distribution and metabolic rate in the kidney. ⋯ Thus, urine oxygenation can be a candidate for reflecting the change of oxygen in the renal medulla. In this review, we discuss the basic physiology of acute kidney injury, as well as techniques for monitoring urine oxygen tension, confounding factors affecting the reliable measurement of urine oxygen tension, and its clinical use, highlighting its potential role in early detection and prevention of acute kidney injury.
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Review Meta Analysis
Influence of different volumes and frequency of programmed intermittent epidural bolus in labor on maternal and neonatal outcomes: A systematic review and network meta-analysis.
In labor, programmed intermittent epidural bolus (PIEB) can be defined as the bolus administration of epidural solution at scheduled time intervals. Compared to continuous epidural infusion (CEI) with or without patient controlled epidural analgesia (PCEA), PIEB has been associated with decreased pain scores and need for rescue analgesia and increased maternal satisfaction. The optimal volume and dosing interval of PIEB, however, has still not been determined. ⋯ Future research should focus on PIEB 5/30 and PIEB 10/60 and how the method of analgesia initiation, nature and concentration of local anesthetic, design of epidural catheter and rate of administration might influence outcomes related to the mother and neonate.
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Review Meta Analysis
Influence of different volumes and frequency of programmed intermittent epidural bolus in labor on maternal and neonatal outcomes: A systematic review and network meta-analysis.
In labor, programmed intermittent epidural bolus (PIEB) can be defined as the bolus administration of epidural solution at scheduled time intervals. Compared to continuous epidural infusion (CEI) with or without patient controlled epidural analgesia (PCEA), PIEB has been associated with decreased pain scores and need for rescue analgesia and increased maternal satisfaction. The optimal volume and dosing interval of PIEB, however, has still not been determined. ⋯ Future research should focus on PIEB 5/30 and PIEB 10/60 and how the method of analgesia initiation, nature and concentration of local anesthetic, design of epidural catheter and rate of administration might influence outcomes related to the mother and neonate.