Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2016
Anaesthetists stress is induced by patient ASA grade and may impair non-technical skills during intubation.
The aims of this study were to determine if patient ASA grade was associated with increased stress in anaesthetists with a subsequent effect on non-technical skills. ⋯ This study suggests that higher patient ASA grade can increase stress in anaesthetists, which may impair non-technical skills.
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Acta Anaesthesiol Scand · Aug 2016
CommentArterial pressure, end-tidal carbon dioxide, and central venous oxygen saturation in reflecting compression depth.
We sought to investigate the utility of arterial pressure, end-tidal carbon dioxide (ETCO2 ), and central venous oxygen saturation (SCVO2 ) to guide compression depth adjustment. Thus, in a pig model of cardiac arrest, we observed these parameters during cardiopulmonary resuscitation (CPR) with optimal and suboptimal compression depths. ⋯ In a pig model of cardiac arrest, systolic arterial pressure reflected compression depth immediately and accurately. The performance of ETCO2 was comparable with that of systolic arterial pressure. SCVO2 did not reflect compression depth.
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Acta Anaesthesiol Scand · Aug 2016
Comment ReviewAdverse event assessment and reporting in trials of newer treatments for post-operative pain.
Assessment and reporting of adverse events (AEs) in studies of perioperative interventions is critical given the potential for unintended and preventable iatrogenic morbidity and mortality. This focused review evaluated the quality of AE assessment and reporting in acute post-operative pain treatment trials. Since older analgesics (e.g., opioids, NSAIDs) already have a well-characterized safety profile, we concentrated on trials of pregabalin and gabapentin as a representative sample of studies where the perioperative safety profile was relatively unknown. ⋯ Considerable widespread improvements are needed in AE reporting for post-operative pain treatment trials. In addition to heightened awareness among clinical investigators, mandatory journal editorial policies may further facilitate improvements in safety assessment and reporting.
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Acta Anaesthesiol Scand · Aug 2016
Teaching ultrasound-guided regional anesthesia remotely: a feasibility study.
Ultrasound-guided regional anesthesia (UGRA) requires acquisition of new skills. Learning requires one-on-one teaching, and can be limited by time and mentor availability. We investigate whether the skills required for UGRA can be developed and subsequently assessed remotely using a novel online teaching platform. This platform was developed at the University of Toronto to teach laparoscopic surgery remotely and has been termed Telesimulation. ⋯ This study demonstrates that UGRA can be taught remotely. Future research will focus on comparing this method to on-site teaching and its application in resource-restricted countries.
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Acta Anaesthesiol Scand · Aug 2016
Observational StudyCerebral microemboli detected by transcranial doppler in patients treated with extracorporeal membrane oxygenation.
Cerebrovascular complications rate in patients treated with extracorporeal membrane oxygenation (ECMO) is about 7%. Ischemic stroke may be caused by solid or gaseous microemboli due to thrombosis within the circuit or cannula. Transcranial Doppler (TCD) is the only method able to detect microembolic signals (MES) in real time. The objective of this study was to detect possible MES by TCD in patients treated with veno-venous (VV) and veno-arterial (VA) ECMO and to test for a relation between the number of MES and the 6-month clinical outcome of these patients. ⋯ MES were found in both ECMO configurations; independently from their pathophysiology, MES do not seem to influence clinical outcome. Multicenter studies are still required with more extensive cases to confirm these results.