Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Checklist Usage Decreases Critical Task Omissions When Training Residents to Separate From Simulated Cardiopulmonary Bypass.
Separation from cardiopulmonary bypass (CPB) requires multiple preparatory steps, during which mistakes, omissions, and human errors may occur. Checklists have been used extensively in aviation to improve performance of complex, multistep tasks. The aim of this study was to (1) develop a checklist using a modified Delphi process to identify essential steps necessary to prepare for separation from CPB, and (2) compare the frequency of completed items with and without the use of a checklist in simulation. It was hypothesized that the use of a checklist would reduce the number of omissions. ⋯ A modified Delphi process can be used to create a checklist of steps in preparing to separate from CPB. Using this checklist during simulation resulted in increased frequency of completing designated tasks in comparison to relying on memory alone. Checklists may reduce omission errors during complex periods of anesthesiologists' perioperative workflow.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Meta AnalysisDexmedetomidine Reduces the Risk of Delirium, Agitation and Confusion in Critically Ill Patients: A Meta-analysis of Randomized Controlled Trials.
Delirium frequently is observed in critically ill patients in the intensive care unit (ICU) and is associated strongly with a poor outcome. Dexmedetomidine seems to reduce time to extubation and ICU stay without detrimental effects on mortality. The objective of the authors' study was to evaluate the effect of this drug on delirium, agitation, and confusion in the ICU setting. ⋯ This meta-analysis of randomized controlled studies suggests that dexmedetomidine could help to reduce delirium in critically ill patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Observational StudyPleth Variability Index Predicts Fluid Responsiveness in Mechanically Ventilated Adults During General Anesthesia for Noncardiac Surgery.
To investigate whether the pleth variability index (PVI), derived noninvasively from a pulse oximeter probe, would predict fluid responsiveness in patients undergoing noncardiac surgeries. ⋯ Pleth variability index is predictive of fluid responsiveness in adult patients undergoing noncardiac surgery.