British journal of anaesthesia
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Observational Study
Emergence from general anaesthesia and evolution of delirium signs in the post-anaesthesia care unit.
Emergence from anaesthesia is often accompanied by signs of delirium, including fluctuating mental status and inattention. The evolution of these signs of delirium requires investigation since delirium in the post-anaesthesia care unit (PACU) may be associated with worse outcomes. ⋯ A significant proportion of patients develop delirium signs in the immediate postoperative period, primarily manifesting with a hypoactive subtype. These signs often persist to PACU discharge, suggesting the need for structured delirium monitoring in the PACU to identify patients potentially at risk for worse outcomes in the postoperative period.
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Multicenter Study Observational Study
Peripheral nerve catheters in children: an analysis of safety and practice patterns from the pediatric regional anesthesia network (PRAN).
Peripheral nerve catheters (PNCs) are used with increasing frequency in children. Although adult studies have demonstrated safety with this technique, there have been few safety studies in children. The main objective of the current investigation was to examine the incidence of PNC complications in children undergoing surgery. ⋯ Our data support the safety of placing PNCs in children, with adverse event rates similar to adult studies. Catheter problems are common, yet minor, in severity.
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Comparative Study
Five algorithms that calculate cardiac output from the arterial waveform: a comparison with Doppler ultrasound.
Different mathematical approaches are used to calculate arterial pulse pressure wave analysis (PPWA) cardiac output. The CardioQ-Combi is a research oesophageal Doppler (COODM) monitor that includes these five fundamental PPWA algorithms. We compared these PPWA cardiac output readings to COODM and suprasternal USCOM Doppler (COUS) over a range of cardiac output values induced by dopamine infusion in patients undergoing major surgery. USCOM acted as a control. ⋯ The Liljestrand-Zander PPWA formula was most reliable compared with oesophageal Doppler in major surgical patients under general anaesthesia, but not better than USCOM.