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Ibarra 15

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23 papers 0 to 25 followers
J Adam Law
No abstract text is available yet for this article.
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
June 2016: Anesthesiology
P Nivatpumin, V Thamvittayakul
BACKGROUND: Maternal hypotension is common after spinal anesthesia for cesarean delivery. We compared the effects of prophylactic ephedrine with ondansetron on post-spinal blood pressure. METHODS: One hundred and sixty-eight term, singleton parturients were enrolled in this prospective, double-blind, placebo-controlled trial. Patients were randomized to receive either prophylactic intravenous ephedrine 10mg (Group E), ondansetron 8mg (Group O) or normal saline (Group P) immediately after spinal anesthesia...
August 2016: International Journal of Obstetric Anesthesia
Frédérique Hovaguimian, Paul S Myles
BACKGROUND: Blood transfusions are associated with morbidity and mortality. However, restrictive thresholds could harm patients less able to tolerate anemia. Using a context-specific approach (according to patient characteristics and clinical settings), the authors conducted a systematic review to quantify the effects of transfusion strategies. METHODS: The authors searched MEDLINE, EMBASE, CENTRAL, and grey literature sources to November 2015 for randomized controlled trials comparing restrictive versus liberal transfusion strategies applied more than 24 h in adult surgical or critically ill patients...
July 2016: Anesthesiology
Ravi Pokala Kiran, Alice C A Murray, Cody Chiuzan, David Estrada, Kenneth Forde
OBJECTIVES: To clarify whether bowel preparation use or its individual components [mechanical bowel preparation (MBP)/oral antibiotics] impact specific outcomes after colorectal surgery. METHODS: National Surgical Quality Improvement Program-targeted colectomy data initiated in 2012 capture information on the use/type of bowel preparation and colorectal-specific complications. For patients undergoing elective colorectal resection, the impact of preoperative MBP and antibiotics (MBP+/ABX+), MBP alone (MBP+/ABX-), and no bowel preparation (no-prep) on outcomes, particularly anastomotic leak, surgical site infection (SSI), and ileus, were evaluated using unadjusted/adjusted logistic regression analysis...
September 2015: Annals of Surgery
David R Anderson, Michael J Dunbar, Eric R Bohm, Etienne Belzile, Susan R Kahn, David Zukor, William Fisher, Wade Gofton, Peter Gross, Stephane Pelet, Mark Crowther, Steven MacDonald, Paul Kim, Susan Pleasance, Nicki Davis, Pantelis Andreou, Philip Wells, Michael Kovacs, Marc A Rodger, Tim Ramsay, Marc Carrier, Pascal-Andre Vendittoli
BACKGROUND: The role of aspirin in thromboprophylaxis after total hip arthroplasty (THA) is controversial. OBJECTIVE: To compare extended prophylaxis with aspirin and dalteparin for prevention of symptomatic venous thromboembolism (VTE) after THA. DESIGN: Multicenter randomized, controlled trial with a noninferiority design based on a minimal clinically important difference of 2.0%. Randomization was electronically generated; patients were assigned to a treatment group through a Web-based program...
June 4, 2013: Annals of Internal Medicine
Emmanuel Futier, Jean-Michel Constantin, Catherine Paugam-Burtz, Julien Pascal, Mathilde Eurin, Arthur Neuschwander, Emmanuel Marret, Marc Beaussier, Christophe Gutton, Jean-Yves Lefrant, Bernard Allaouchiche, Daniel Verzilli, Marc Leone, Audrey De Jong, Jean-Etienne Bazin, Bruno Pereira, Samir Jaber
BACKGROUND: Lung-protective ventilation with the use of low tidal volumes and positive end-expiratory pressure is considered best practice in the care of many critically ill patients. However, its role in anesthetized patients undergoing major surgery is not known. METHODS: In this multicenter, double-blind, parallel-group trial, we randomly assigned 400 adults at intermediate to high risk of pulmonary complications after major abdominal surgery to either nonprotective mechanical ventilation or a strategy of lung-protective ventilation...
August 1, 2013: New England Journal of Medicine
Hollmann D Aya, Maurizio Cecconi
PURPOSE OF REVIEW: Most of our blood volume is contained in the venous compartment. The so-called 'compliant veins' are an adjustable blood reservoir, which is playing a paramount role in maintaining haemodynamic stability. The purpose of this study is to review what is known about this blood reservoir and how we can use this information to assess the cardiovascular state of critically ill patients. RECENT FINDINGS: The mean systemic filling pressure (Pmsf) is the pivot pressure of the circulation, and a quantitative index of intravascular volume...
June 2015: Current Opinion in Critical Care
Mohamed Elshaer, Gianpiero Gravante, Katie Thomas, Roberto Sorge, Salem Al-Hamali, Hamdi Ebdewi
IMPORTANCE: Subtotal cholecystectomy (SC) is a procedure that removes portions of the gallbladder when structures of the Calot triangle cannot be safely identified in "difficult gallbladders." OBJECTIVE: To conduct a systematic review and meta-analysis to evaluate current studies and present an evidence-based assessment of the outcomes for the techniques available for SC. DATA SOURCES: A literature search of the PubMed/MEDLINE (1954 to November 2013) and EMBASE (1974 to November 2013) databases was conducted...
February 2015: JAMA Surgery
Rupert M Pearse, David A Harrison, Neil MacDonald, Michael A Gillies, Mark Blunt, Gareth Ackland, Michael P W Grocott, Aoife Ahern, Kathryn Griggs, Rachael Scott, Charles Hinds, Kathryn Rowan
IMPORTANCE: Small trials suggest that postoperative outcomes may be improved by the use of cardiac output monitoring to guide administration of intravenous fluid and inotropic drugs as part of a hemodynamic therapy algorithm. OBJECTIVE: To evaluate the clinical effectiveness of a perioperative, cardiac output-guided hemodynamic therapy algorithm. DESIGN, SETTING, AND PARTICIPANTS: OPTIMISE was a pragmatic, multicenter, randomized, observer-blinded trial of 734 high-risk patients aged 50 years or older undergoing major gastrointestinal surgery at 17 acute care hospitals in the United Kingdom...
June 4, 2014: JAMA: the Journal of the American Medical Association
B A McGrath, K Wilkinson
No abstract text is available yet for this article.
August 2015: British Journal of Anaesthesia
M A Gillies, A S V Shah, J Mullenheim, S Tricklebank, T Owen, J Antonelli, F Strachan, N L Mills, R M Pearse
BACKGROUND: Evidence suggests that cardiac output-guided haemodynamic therapy algorithms improve outcomes after high-risk surgery, but there is some concern that this could promote acute myocardial injury. We evaluated the incidence of myocardial injury in a perioperative goal-directed therapy trial. METHODS: Patients undergoing major gastrointestinal surgery (n=723) were randomly assigned to cardiac output-guided haemodynamic therapy (intervention group) or usual care as part of the OPTIMISE trial...
August 2015: British Journal of Anaesthesia
P E Marik
No abstract text is available yet for this article.
September 2015: British Journal of Anaesthesia
M Muñoz, S Gómez-Ramírez, S Kozek-Langeneker, A Shander, T Richards, J Pavía, H Kehlet, A G Acheson, C Evans, R Raobaikady, M Javidroozi, M Auerbach
In major surgery, the implementation of multidisciplinary, multimodal and individualized strategies, collectively termed Patient Blood Management, aims to identify modifiable risks and optimise patients' own physiology with the ultimate goal of improving outcomes. Among the various strategies utilized in Patient Blood Management, timely detection and management of preoperative anaemia is most important, as it is in itself a risk factor for worse clinical outcome, but also one of the strongest predisposing factors for perioperative allogeneic blood transfusion, which in turn increases postoperative morbidity, mortality and costs...
July 2015: British Journal of Anaesthesia
S Romagnoli, M Becatti, E Bonicolini, C Fiorillo, G Zagli
No abstract text is available yet for this article.
July 2015: British Journal of Anaesthesia
Christoph Czarnetzki, Nadia Elia, Jean-Louis Frossard, Emiliano Giostra, Laurent Spahr, Jean-Luc Waeber, Gordana Pavlovic, Christopher Lysakowski, Martin R Tramèr
IMPORTANCE: Patients undergoing emergency procedures under general anesthesia have impaired gastric emptying and are at high risk for aspiration of gastric contents. Erythromycin has strong gastric prokinetic properties. OBJECTIVE: To evaluate the efficacy of erythromycin lactobionate in gastric emptying in patients undergoing emergency surgery. DESIGN, SETTING, AND PARTICIPANTS: The Erythro-Emerge trial was a single-center, randomized, double-blinded, placebo-controlled clinical trial in patients undergoing emergency surgery under general anesthesia at Geneva University Hospitals...
August 2015: JAMA Surgery
John E Scarborough, Christopher R Mantyh, Zhifei Sun, John Migaly
OBJECTIVE: To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS: Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent elective colorectal resection were included for analysis and assigned to 1 of 4 groups based on the type of preoperative preparation they received [combined mechanical and oral antibiotic preparation (OAP), mechanical preparation only, OAP only, or no preoperative bowel preparation]...
August 2015: Annals of Surgery
Terri G Monk, Michael R Bronsert, William G Henderson, Michael P Mangione, S T John Sum-Ping, Deyne R Bentt, Jennifer D Nguyen, Joshua S Richman, Robert A Meguid, Karl E Hammermeister
BACKGROUND: Although deviations in intraoperative blood pressure are assumed to be associated with postoperative mortality, critical blood pressure thresholds remain undefined. Therefore, the authors estimated the intraoperative thresholds of systolic blood pressure (SBP), mean blood pressure (MAP), and diastolic blood pressure (DBP) associated with increased risk-adjusted 30-day mortality. METHODS: This retrospective cohort study combined intraoperative blood pressure data from six Veterans Affairs medical centers with 30-day outcomes to determine the risk-adjusted associations between intraoperative blood pressure and 30-day mortality...
August 2015: Anesthesiology
Christopher P Scally, Andrew M Ryan, Jyothi R Thumma, Paul G Gauger, Justin B Dimick
BACKGROUND: In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented additional restrictions on resident work hours. Although the impact of these restrictions on the education of surgical trainees has been examined, the effect on patient safety remains poorly understood. METHODS: We used national Medicare Claims data for patients undergoing general (n = 1,223,815) and vascular (n = 475,262) surgery procedures in the 3 years preceding the duty hour changes (January, 2009-June, 2011) and the 18 months thereafter (July, 2011-December, 2012)...
December 2015: Surgery
Amanda A Fox
No abstract text is available yet for this article.
August 2015: Anesthesiology
2015-06-21 12:17:48
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