BMC anesthesiology
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The objective of this study was to describe end-user impressions and experiences in a new intensive care unit built using evidence-based design. ⋯ End-users identified design elements for creating a pleasant atmosphere, attention to the tradeoffs of space and size, designing family support areas to encourage family participation in care, and updating patient care policies and staffing to reflect the new physical space as important aspects to consider when building intensive care units. Evidence-based design may optimize ICU structure for patients, patient families and providers.
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Anemia is a common feature during sepsis that occurs due to iatrogenic blood loss, depression of serum iron levels and erythropoietin production, and a decreased lifespan of erythrocytes. However, these mechanisms are unlikely to play a role in anemia at the start of sepsis. Moreover, sequestration of fluids, renal failure and increase of intravascular space may additionally influence the change in hemoglobin concentration during intravenous fluid administration in the acute phase of sepsis. ⋯ Prior to in-hospital intravenous fluid administration, there is no significant difference in hemoglobin concentration between acute septic patients and acutely ill controls. Within several hours after hospital admission, there is a significant reduction in hemoglobin concentration, not only associated with the amount of intravenous fluids administered and the creatinine level, but also independently with sepsis itself.
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Comparative Study
Effects of changes in intraoperative management on recovery from anesthesia: a review of practice improvement initiative.
Our anesthetic practice was hindered by inadequate postanesthesia care unit space resulting in operating room inefficiencies. In response, an anesthetic protocol designed to reduce the duration of postanesthesia stay by decreasing residual anesthetic sedation and postoperative nausea and vomiting (PONV) was introduced. Here the impact of this practice change is analyzed. ⋯ Introduction of an anesthetic protocol that was designed to attenuate adverse anesthetic effects was associated with a reduction of anesthetic recovery time.
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Randomized Controlled Trial
Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial.
Bleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons. This study aimed to evaluate the effect of desmopressin premedication on blood loss and the quality of the surgical field in endoscopic sinus surgery. ⋯ Premedication with desmopressin 0.3 μg/kg can effectively reduce bleeding during endoscopic sinus surgery.
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Dexmedetomidine (DMT), a highly selective α2-adrenoceptor agonist, has been used safely as a sedative in patients under regional anesthesia. The purpose of this study was to determine the 50% effective dose (ED50) of single-dose DMT to induce adequate light sedation in elderly patients in comparison with younger patients undergoing transurethral resection of the prostate (TURP) with spinal anesthesia. ⋯ The single-dose of DMT for light sedation was lower by 21% in Group O compare with Group Y underwent TURP with spinal anesthesia.