Journal of anesthesia
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Journal of anesthesia · Feb 2024
Effect of acute normovolemic hemodilution in patients undergoing cardiac surgery with remimazolam anesthesia.
The reduced effects of allogeneic transfusion with acute normovolemic hemodilution (ANH) have been reported. Harvesting a large volume of blood may maximize the effect in patients with low body weight, and the prevention of hypotension is important. Remimazolam is an anesthetic with few circulatory responses. Our aim was to evaluate whether high-volume ANH reduces the need for transfusion in cardiac patients under remimazolam anesthesia. ⋯ In patients undergoing CPB, ANH reduced intraoperative transfusion amount and postoperative bleeding. Hemodynamic changes during blood collection were minimal under remimazolam anesthesia and high-volume ANH was feasible.
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Journal of anesthesia · Feb 2024
Alleviated cerebral infarction in male mice lacking all nitric oxide synthase isoforms after middle cerebral artery occlusion.
The role of the nitric oxide synthases (NOSs) system in cerebral infarction has been examined in pharmacological studies with non-selective NOSs inhibitors. However, due to the non-specificity of the non-selective NOSs inhibitors, its role remains to be fully elucidated. We addressed this issue in mice in which neuronal, inducible, and endothelial NOS isoforms were completely disrupted. ⋯ These results provide the first evidence that the NOSs system exerts a deleterious effect against acute ischemic brain injury in the male.
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Journal of anesthesia · Feb 2024
Perioperative loss of the psoas major muscle area index in elderly patients with hip fracture: spinal anesthesia versus general anesthesia-a retrospective cohort study.
In hip fracture patients aged ≥ 80 years, we investigated whether the perioperative reduction in the psoas major muscle index (PMI) for spinal anesthesia was less than that for general anesthesia. ⋯ There was no significant difference in ΔPMI between hip fracture patients ≥ 80 years of age receiving spinal versus general anesthesia undergoing surgical treatment.
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Journal of anesthesia · Feb 2024
Observational StudyAmplitude at 10 min in thromboelastography predicts maximum amplitude: a single-center observational study.
Thromboelastography is a quantitative test widely used to measure the efficiency of blood clotting. However, awaiting the results of maximum amplitude (MA) is necessary for determining the need for platelet- and fibrinogen-containing products. A more rapid prediction of MA could facilitate faster preparation and administration of blood transfusion products, thereby resulting in coagulation improvement. ⋯ The relationship between citrated rapid TEG (CRT)-A10 and CRT-MA, as well as between citrated functional fibrinogen (CFF)-A10 and CFF-MA, were evaluated if A10 and MA showed a good correlation. The results showed good correlations between CRT-A10 and CRT-MA, as well as between CFF-A10 and CFF-MA. Therefore, evaluating A10 using TEG6s could predict MA.