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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Hemodynamic changes are independent risk factors for long-term patient morbidity and duration of hospital stay. According to the statistics, the three most prevalent complications in the postanaesthesia care unit were airway events, haemodynamic instability, and postoperative nausea and vomiting. Hemodynamic instability in the postanaesthesia care unit can result in serious complications, such as long-term patient morbidity and prolonged hospital stays. This study aimed to determine the incidence and factors associated with haemodynamic changes among adult surgical patients in the postanaesthetic care unit. ⋯ In general, 93 study subjects (22.7%) experienced advanced haemodynamic instability during the intraoperative period. This implies that the incidence of hemodynamic instability was high. Intraoperative haemodynamic instability, American Society of Anaesthesiology class III, postoperative respiratory adverse events, neurologic and gynaecological procedures, use of neuraxial anaesthesia, and prolonged duration of procedures were predictors of haemodynamic instability in the postanaesthesia care unit.
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Major abdominal surgery is a kind of high-risk surgery type for postoperative acute kidney injury (AKI) among non-cardiac surgeries. Despite dexmedetomidine exerts significant renal protective effects in cardiac surgeries and animal studies, whether it is associated with a lower incidence of AKI in major abdominal surgeries remains unclear. ⋯ In this single-center retrospective propensity-matched study, we did not detect a significant overall difference in post-operative AKI rates between patients treated with or without dexmedetomidine during major abdominal surgery. However, though additional prospective data are needed, our study found that administering dexmedetomidine with a loading dose may be associated with lower rates of AKI, potentially indicating a renoprotective effect of loading-dose dexmedetomidine in this setting.
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The study aimed to develop a predictive model with machine learning (ML) algorithm, to predict and manage the need for red blood cell (RBC) transfusion during hip fracture surgery. ⋯ Our study firstly demonstrated that the RF model with 10 common variables might predict intraoperative RBC transfusion in hip fracture patients.