BMC anesthesiology
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Randomized Controlled Trial Comparative Study
Influence of liberal versus conservative oxygen therapies on the hemodynamic parameters of mechanically ventilated patients with sepsis: a randomized clinical trial.
There is no significant evidence verifying the efficacy of liberal versus conservative oxygen therapy on hemodynamics in patients with sepsis. We investigated how liberal and conservative oxygen therapy influenced stroke volume, cardiac output, and vasopressor needs in patients with sepsis undergoing mechanical ventilation. ⋯ Liberal or conservative oxygen therapy did not influence stroke volume or cardiac output measurements in mechanically ventilated patients with sepsis. Patients in the conservative oxygen group were more likely to require vasopressors than those in the liberal group.
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Neuraxial anesthesia is the gold standard for cesarean sections, but general anesthesia is sometimes necessary, especially in emergency cases. Anaphylactic shock due to succinylcholine, a commonly used neuromuscular blocking agent, is rare but life-threatening. ⋯ This case highlights the need for rapid identification and management of anaphylactic shock during emergency cesarean sections under general anesthesia, especially in high-risk patients with complex medical histories.
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Randomized Controlled Trial
Effectiveness of a new thermal insulation blanket in the control of inadvertent perioperative hypothermia and comfort: a randomized controlled trial.
Disturbances in the thermoregulatory system can precipitate inadvertent hypothermia in patients undergoing surgeries lasting over 60 min, causing serious complications in the recovery process. Cutaneous thermal protection is relevant for the control of temperature of patients in the perioperative setting. The standard thermal protection widely utilized is an electric forced warm air blanket. This study compared a new layered textile blanket with the standard protection. The hypothesis posited that the textile blanket could provide cutaneous thermal protection comparable to that of the standard protection (forced-air warming blanket), in terms of temperature variation and safety. ⋯ The tested blanket had a comparable performance to the standard protection, suggesting it as a potential sustainable alternative to the recommended measures for thermal protection. However, further investigations across diverse contexts and populations are needed to validate these findings.
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Multicenter Study
Cumulative incidence of chronic pain after visiting a Dutch emergency department with acute pain.
Chronic pain is a substantial problem in modern healthcare resulting in health care overutilization. The cumulative incidence of developing chronic pain after visiting the emergency department with acute pain has been determined for specific patient groups only. If the cumulative incidence of chronic pain in emergency department patients with acute pain is high, more proactive measures are justified to limit development of chronic pain. The primary objective was to study the cumulative incidence of chronic pain in patients visiting Dutch emergency departments with acute pain. In addition, we compared the Health-Related Quality of Life (HRQOL) and pain related interference with work. ⋯ 67.8% of the responders scored NRS ≥ 1 90 days after ED-visit with acute pain. Regardless of the used definition, chronic pain is associated with a lower HRQOL and more pain related hindrance.
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Randomized Controlled Trial
Overtime work of anesthesiologists is associated with increased delirium in older patients admitted to intensive care unit after noncardiac surgery: a secondary analysis.
Overtime work is common in anesthesiologists due to shortage of manpower. Herein, we analyzed if overtime work of anesthesiologists was associated with delirium development in older patients after surgery. ⋯ Overtime work of anesthesiologists was associated with an increased risk of delirium development in older patients admitted to ICU after major noncardiac surgery.