Journal of Anesthesia & Critical Care: Open Access最新文献

{"title":"Invasive, minimally invasive and non-invasive hemodynamic monitoring in perioperative medicine","authors":"Guerrero Gutiérrez Manuel Alberto, Pérez Nieto Orlando Rubén, Eder Iván Zamarrón López, Jesús Salvador Sánchez Díaz, Escarraman-Martinez Diego, E. D. Tomás, L. Morales, Luis Villaseñor, Martínez Camacho Miguel Ángel, Soriano-Orozco Raul, D. Alfredo","doi":"10.15406/JACCOA.2020.12.00423","DOIUrl":"https://doi.org/10.15406/JACCOA.2020.12.00423","url":null,"abstract":"The hemodynamic monitoring is a fundamental part of the patient in the perioperative period, during the last decade the monitoring at the patient's bedside has grown at giant steps, from the emergency area, operating room, to the Intensive Care area. One of its most important advances is the decrease in the use of pulmonary artery catheter, which is being replaced by ultrasound and less invasive monitoring techniques, in this article we will review from the beginning of the monitoring to the most used less invasive monitors currently.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83308356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perioperative application of High Flow Nasal Cannula: a single center experience","authors":"I. Hilmi, P. Carullo, D. Phillips, Ezeldeen Abuelkasem","doi":"10.15406/JACCOA.2020.12.00422","DOIUrl":"https://doi.org/10.15406/JACCOA.2020.12.00422","url":null,"abstract":"High-flow nasal cannula (HFNC) therapy has been used in a variety of clinical scenarios in recent years, particularly in the intensive care unit (ICU) setting. The HFNC system provides heated and humidified oxygen at flows much higher than standard oxygen modalities (up to 70 liters per minute) and it is well-tolerated by patients. The high flow provides several physiologic benefits with promising utilization in the perioperative setting. These benefits include reduction of the ApneaHypopnea Index in patients with obstructive sleep apnea (OSA) by 64%, with flows greater than 20 lpm and nasally-generated positive end-expiratory pressure (PEEP) of 3-5 mmHg at flows greater than 35 lpm.1,2 Unlike traditional non-invasive ventilation approaches such as bilevel positive pressure (BiPAP), these benefits are created from the high flow of gas, therefore allowing airway manipulation with prevention of apnea and hypoxia and preservation of PEEP effects.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"56 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80484926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean anesthetic management in a patient with Monoclonal Gammopathy. can we trust analytics? case report","authors":"García Martínez J A","doi":"10.15406/jaccoa.2019.11.00421","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00421","url":null,"abstract":"In the 29th week of gestation, the patient presented in the Emergency Department, due to a severe asthenia and drowsiness, accompanied by an analytical picture compatible with normochromic normocytic anemia (Hb 8.5g/dl, VCM 93 fl) and a slight elevation of plasma calcium (11.1 mg/dl). It is decided to enter charge of the gynecology service to complete study and interconsultation to the hematology service. The patient is diagnosed with MM, after an elevation of total proteins (10.3g/dl) with an M component in the gamma region in the proteinogram (5.2g/dl) and medullary plasmacyte in sternal puncture of 26%. Elective caesarean section is scheduled to end pregnancy at week 34, and to be able to start chemotherapy treatment.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88594784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical audit on quality of post anesthesia extubation in the operation theatres in a specialized university hospital","authors":"Wubie Birlie Chekol","doi":"10.15406/jaccoa.2019.11.00420","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00420","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79332037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical spinal cord injury and ultrasound evaluation of diaphragm function","authors":"L. M. Charco-Roca","doi":"10.15406/jaccoa.2019.11.00418","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00418","url":null,"abstract":"of the C3, C4 and C5 cervical nerves. Therefore, patients with complete motor injury above C5 will almost invariably need ventilatory support.2 Injuries below C5 result in paralysis of the intercostal and abdominal musculature; therefore, some patients will require respiratory support. The loss of respiratory capacity in patients with cervical spinal cord injury occurs due to exhaustion of the musculature involved in the ventilatory process, haemorrhage or ascending spinal oedema, accumulation of secretions, atelectasis, other associated traumas or other conditions of the patient. Tracheotomy is required in 11-35% of patients with cervical spinal cord injury for the treatment of pulmonary complications and pulmonary hygiene.3Tracheotomy reduces the duration of respiratory cycles, improves lung capacity to mobilize secretions and reduces resistance of the respiratory tract. As a result, the weaning of the ventilator becomes easier and reduces the mechanical ventilation duration. There is evidence that early tracheotomy reduces the incidence of pneumonia, shortens the duration of mechanical ventilation, reduces the stay in the ICU and reduces the rates of serious complications associated with orotracheal intubation, such as tracheal stenosis.4 Tracheotomy does not appear to have deleterious effects when performed shortly after cervical fixation surgery and does not promote cross infection despite the proximity of the incisions.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77233958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral hypoglossal nerve and recurrent laryngeal nerve weakness following endotracheal intubation","authors":"Walaa Ali Kheir","doi":"10.15406/jaccoa.2019.11.00417","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00417","url":null,"abstract":"Endotracheal intubation with cuffed tube is a safe procedure associated with few complications in majority of patients. Immediate complications are primarily associated with problems dring intubation and extubation while early and late complications represent the short- and long-term effets of epithelial trauma. True vocal cord paralysis may follow endotracheal intubation and be the result of peripheral nerve damage. This damage can occur as the result of compressing the nerve between an inflated endotracheal tube cuff and the overlying thyroid cartilage.1 The hypoglossal nerve (12th cranial nerve) is motor nerve. It supplys the tongue muscle and help in speech, Food manipulation, and swallowing. Hypoglossal nerve injury following endotracheal intubation under general anesthesia is a rare complication and can cause symptoms, such as dysarthria and dysphagia.2","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86273052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management of down syndrome patients in surgical procedures","authors":"A. Eroğlu","doi":"10.15406/jaccoa.2019.11.00419","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00419","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87336704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endotracheal Cardiac Output Monitoring (ECOM)","authors":"V. Chandrasekhar, C. Krishnamurti","doi":"10.15406/jaccoa.2019.11.00416","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00416","url":null,"abstract":"Cardiac output reflects the amount of blood expelled by the heart in one minute and calculated as the product of the heart rate by the stroke volume. The variables that affect systolic volume are preload, afterload, and contractile function. Cardiac output is the main determinant of oxygen transport and its monitoring helps to establish the differential diagnosis of the possible causes of shock and optimizes its treatment. A less invasive technique to monitor cardiac output in real time is always preferable as it can be evaluated more quickly and easily, even if it is slightly less accurate, especially in critical situations that require a rapid assessment of the patient’s condition. There are a number of techniques that allow us to obtain measurements of cardiac output in a very effective and non-invasive way. The endotracheal cardiac output monitoring (ECOM) is an emerging technology for intubated patients enabling rapid real time and accurate data on the status of the cardiac output and various derived parameters. ECOM is poised to be the new gold standard in critical care management and an emerging toll in the armamentarium of intensivists.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"325 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75045452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nalbuphine and addiction: from the basic science to clinical set","authors":"Franciele da Silva Conter","doi":"10.15406/jaccoa.2019.11.00415","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00415","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81429478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the results of patients who had undergone lateral internal sphincterotomy due to chronic anal fissure: analysis of 281 cases","authors":"Ç. Akalın","doi":"10.15406/jaccoa.2019.11.00404","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00404","url":null,"abstract":"Introduction and purpose: Pharmacological and surgical treatment options are available for the treatment of chronic anal fissure (CAF). Pharmacological treatments include treatment modalities such as glyceryl trinitrate, calcium channel blockers and alpha-adrenoreceptor antagonists. Surgical treatment options include anal dilatation and sphincterotomy, and among many sphincterotomy procedures open lateral internal sphincterotomy (open LIS) is now considered the gold standard. The aim of this study was to investigate the demographic data, complaints, early and late complications of patients who have undergone LIS due to chronic anal fissure and to contribute to the literature. Material and method: Data of 281 patients who have undergone open LIS operation between 2013-2018 due to chronic anal fissure that did not respond to conservative treatment were analyzed retrospectively. Age, gender, complaint (pain, bleeding, constipation, itching), follow-up period and postoperative complication (infection, bleeding, pain, fistula, gas or stool incontinence) data of the patients were evaluated retrospectively. Patients with gas or fecal incontinence were evaluated with Wexner incontinence score. Results: Out of 281 patients, 197 were female (70.1%), 84 were male (29.9%). Female / male ratio was 2.34. The mean age was 40.31 ± 13.59 (min 18-max 84) years. The mean follow-up period was 24.53 (min 6 - max 67) months. In 248 (88.3%) patients, pain was noted during defecation, while bleeding was noted in 208 (74%) patients, constipation was noted in 133 (47.3) patients and perianal itching was noted in 91 (32.4%) patients. In 7 (2.5%) patients, infection occurred at the site of operation. Perianal fistula was seen in one patient (0.4%), recurrence was seen in 12 (4.3%), transient gas incontinence was seen in 4 (1.8%) and fecal incontinence was seen (0.35%) in 1 patient. Seven patients who had developed infection responded to oral antibiotic treatment and none of them developed abscesses. Result: As a result, open LIS operation is an efficient and effective surgical treatment method for the treatment of CAF.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90243193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}