Journal of anesthesia
-
Journal of anesthesia · Feb 2017
Outcomes of physician patients after non-cardiac surgery: a registry analysis.
When physicians become patients, they may expect special privileges, extra attention from caregivers, and non-routine treatments. Consequently, physician patients may not be treated per routine-which possibly worsens care rather than improving it. We thus tested the primary hypothesis that in-hospital mortality and major complications after non-cardiac surgery are more common in physician patients than in non-physician patients. ⋯ A variety of important outcomes were similar in physician patients and matched non-physician patients after non-cardiac surgery.
-
Journal of anesthesia · Feb 2017
Assessment of dexmedetomidine effects on left ventricular function using pressure-volume loops in rats.
The role of dexmedetomidine on left ventricular function is ambiguous. We analyzed pressure-volume loops to investigate whether dexmedetomidine has a myocardial depressive effect. ⋯ Dexmedetomidine had no direct myocardial depressant effect in the rat heart in doses that are similar to those encountered under clinical conditions. Dexmedetomidine did not significantly alter the ability of the heart to cope with bradycardia and greatly increased afterload. Their potentially negative impact on cardiac output was effectively attenuated by improved myocardial contractility and preserved diastolic function in healthy subjects.
-
Journal of anesthesia · Feb 2017
Review Meta AnalysisGoal directed fluid therapy decreases postoperative morbidity but not mortality in major non-cardiac surgery: a meta-analysis and trial sequential analysis of randomized controlled trials.
Optimum perioperative fluid administration may improve postoperative outcome after major surgery. This meta-analysis and systematic review has been aimed to determine the effect of dynamic goal directed fluid therapy (GDFT) on postoperative morbidity and mortality in non-cardiac surgical patients. ⋯ GDFT in major non- cardiac surgical patients has questionable benefit over a standard care in terms of postoperative mortality, length of hospital stay and length of ICU stay. However, incidence of all complications including wound infection, abdominal complications and postoperative hypotension is reduced.
-
Journal of anesthesia · Feb 2017
Case ReportsSupraglottic jet oxygenation and ventilation saved a patient with 'cannot intubate and cannot ventilate' emergency difficult airway.
The emergency difficult airway with the 'cannot intubate and cannot ventilate' (CICV) situation contributes to a high percentage of anesthesia- and emergency medicine-related morbidity and mortality. A new technique of supraglottic jet oxygenation and ventilation (SJOV) via the nasal approach was successfully used in an emergency to save a patient with a CICV difficult airway from a catastrophic outcome.