BMC anesthesiology
-
Observational Study
Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class.
The aim of this study was to evaluate pre- and post-operative brain natriuretic peptide (BNP) levels and compare the power of this test in predicting in-hospital major adverse cardiac events (MACE: atrial fibrillation, flutter, acute heart failure or non-fatal/fatal myocardial infarction) in patients undergoing elective prosthesis orthopedic surgery to that of the Revised Cardiac Risk Index (RCRI) and American Society of Anesthesiology (ASA) class, the most useful scores identified to date. ⋯ Both pre- and post-operative BNP concentrations are predictors of MACE in patients undergoing elective prosthesis orthopedic surgery.
-
Observational Study
Transcranial Doppler to assess sepsis-associated encephalopathy in critically ill patients.
Transcranial Doppler can detect cerebral perfusion alteration in septic patients. We correlate static Transcranial Doppler findings with clinical signs of sepsis-associated encephalopathy. ⋯ Cerebral perfusion disturbance observed with Transcranial Doppler could explain clinical symptoms of sepsis-associated encephalopathy.
-
Presepsin is useful for differentiating sepsis from non-infection related systemic inflammatory response syndrome. However, there are no studies investigating the usefulness of presepsin in diagnosing sepsis involving patients with acute kidney injury (AKI). The purpose of this study is to determine levels of blood presepsin in patients with or without sepsis and among non-AKI patients or patients with different degrees of AKI severity. ⋯ Presepsin level can be a reliable indicator of sepsis not only among non-AKI patients but also patients with less severe forms of AKI. However, it may not be a reliable indicator of sepsis in patients with a more advanced form of AKI.
-
Randomized Controlled Trial
Perioperative transfusion threshold and ambulation after hip revision surgery--a randomized trial.
Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision surgery. ⋯ A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing.
-
In critically ill patients, glucose control with insulin mandates time- and blood-consuming glucose monitoring. Blood glucose level fluctuations are accompanied by metabolomic changes that alter the composition of volatile organic compounds (VOC), which are detectable in exhaled breath. This review systematically summarizes the available data on the ability of changes in VOC composition to predict blood glucose levels and changes in blood glucose levels. ⋯ There is a relation between blood glucose levels and VOC composition in exhaled air. These results warrant clinical validation of exhaled breath analysis to monitor blood glucose levels.