Journal of clinical anesthesia
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Difficult airway management is a significant challenge in clinical anesthesia, critical care, and emergency medicine. Inadequate management can lead to severe complications including organ damage and death. This study assessed the variability in difficult airway management across China and focused on how patient and operator factors influenced outcomes in operating rooms. ⋯ The accuracy of difficult airway assessment and first attempt intubation success is influenced by both patient-related factors and the anesthesiologist's expertise. Regional and institutional variability in decision-making and tool selection underscores the critical need for standardized guidelines and comprehensive training to enhance airway management outcomes across diverse clinical settings in China.
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Blood loss resulting in severe anemia is the most common indication for postoperative allogenic red blood cell (RBC) transfusions. In high-income countries, the majority of transfusions is received by elderly patients. Preservatives extend the storage of RBCs, though concerns exist about potential harm from transfusing older RBCs. This study tested the hypothesis that RBC storage duration effects hemoglobin increase in patients older than 70 years who underwent non-cardiac surgery. ⋯ The aspired increase in hemoglobin can be achieved with red blood cell concentrates of any storage duration. In general, elderly patients exhibit a sufficient hemoglobin rise following transfusion. However, if this is associated with improved outcomes cannot be answered.
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Accurate blood pressure monitoring is essential in many clinical scenarios for adults and children and, when continuous measurement is critical, necessitates the insertion of an arterial line. A novel continuous non-invasive arterial pressure monitoring device using a pulse contour algorithm (Pulse Decomposition Analysis), Vitalstream™, is approved by the United States Food and Drug Administration for use in adults. In this study the performance and accuracy of the device compared to intraarterial blood pressure monitoring were assessed in children ages 2-17 undergoing major surgeries. We report the results using comparison to aspects of the recently published ISO 81060-3:2022 standard for continuous automated blood pressure measurement. ⋯ gov: NCT04817137 The trial was registered at clinicaltrials.gov (NCT048I7173).
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To explore risk factors for 1-year postoperative mortality and to identify its association with the Revised Cardiac Risk Index (RCRI). ⋯ RCRI is significantly correlated with 1-year postoperative mortality regardless of sex, age, and type of anesthesia. Further studies to validate these findings are warranted.