Journal of Anesthesia and Critical Care: Open access最新文献

{"title":"Hyperchloremia and mortality in the ICU: a prospective cohort study","authors":"Ronald Antonio Medina-Lombo, Edward Julián Blanco-Pinzón, Angie Tatiana Ortiz- Palacios, Diana Catalina Sanabria-Waldron, Ana María Morales-Saenz, Alejandra Morales","doi":"10.15406/jaccoa.2022.14.00535","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00535","url":null,"abstract":"Introduction: Part of the interventions in patients admitted to intensive care units (ICU) consist of the administration of crystalloids, implying a risk for the development of side effects. One of these is hyperchloremia, linked to the appearance of metabolic acidemia and systemic inflammatory response. Given these findings, observational studies have been developed, trying to establish an association between hyperchloremia and outcomes such as mortality and kidney failure; however, its diverse results prompt the development of new studies. In Colombia, there are no prospective cohort studies that establish any type of association with hard outcomes. Goal. To determine the association between the development of hyperchloremia and mortality and acute renal failure, in patients hospitalized in the ICU, in two hospitals in Bogotá D.C. Methodology: Analytical prospective cohort study conducted between June 1, 2019 and August 31, 2021. Results: 325 patients were analyzed, the cumulative incidence of hyperchloremia and acute renal failure in the entire study population was 44.6% and 29.5%, respectively. The cumulative incidence of death in the exposed was 36.5% vs 23.3% in the unexposed, with a relative risk RR=1.57, (95% CI 1.11-2.2) (p=<0.001). The cumulative incidence of acute renal failure was 43.4% in exposed patients and 18.3% in non-exposed patients, with a RR=2.37 with a (95% CI 1.65-3.4) (p<0.001). Conclusion: There is an association between the development of hyperchloremia and the outcomes of mortality and acute renal failure in critically ill patients.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128922252","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":"Anesthesia and elderly patient","authors":"Siniša Franjić","doi":"10.15406/jaccoa.2022.14.00532","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00532","url":null,"abstract":"Anesthesia is a state of insensitivity of the whole body or part of the body to environmental stimuli and pain. Depending on the type of anesthesia, it may involve some degree of change in consciousness. General anesthesia is a sleep-like condition in which the patient consciously does not experience any stimuli from the environment. Regional anesthesia involves a series of procedures that prevent the transmission of painful stimuli from a specific part of the body to the central nervous system and is not associated with a change in the patient's state of consciousness. Depending on the type, regional anesthesia can lead to numbness of the entire lower body, limbs, or parts of them. Local anesthesia consists of giving the medicine in the same area where the procedure will be performed, which leads to insensitivity to pain only in that small, limited area of skin and subcutaneous tissue.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127241690","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":"Relation between preoperative fasting time and the plestimographic variability index (PVI)","authors":"Luis E Carreto, Erandy G. Rangel, Kimberly Montes","doi":"10.15406/jaccoa.2022.14.00531","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00531","url":null,"abstract":"Preoperative fasting can also lead to physiological deleterious effects such as dehydration, and hypovolemia. The Plethysmographic Variability Index (PVI, Masimo Corp, Irvine, CA, USA), is a dynamic measurement and its variability could be related to hydration status. Objective: Find a correlation between the number of hours of preoperative fasting and the measurements of PVI. Studio and design: Experimental, prospective, longitudinal. Material and methods: During one-year, patients ASA I scheduled for elective general anesthesia, in an outpatient plastic surgery clinic, the nurse staff recorded PVI (%) values by MightySat® Masimo finger oximeter pulse and the hours of fasting carried out the night before their admission by direct interrogation of the patient. a simple linear regression with Pearson correlation coefficient, perfect = 1, to find a relation between fasting hours and PVI, being considered significant with a p< 0.05. Results: 140 patients were included, women (90%), mean age 35 years, the mean PVI values were 21.01 (SD +/- 7.20) means hours of preoperative fasting performed by patients 11.85 (SD+/- 2.34). Pearson correlation coefficient between fasting hours and PVI was 0.005 (t-student 0.0054, p bilateral 0.47) Conclusion: This study did not show a linear relation, direct or inverse, between fasting hours and PVI values. PVI as a dynamic measurement of preload or stroke volume did not show changes in terms of fasting time in our patients.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"220 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116187562","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":"Primary tracheal resection - the last resort to manage a difficult airway in a patient with tracheal stenosis – a rare case report","authors":"Deepanwita Das, Dr. Chaitali Sen","doi":"10.15406/jaccoa.2022.14.00529","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00529","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122656871","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":"Triad of safety, efficacy and patient comfort: videolaryngoscopic awake nasotracheal intubation using a lignocaine and propofol based technique","authors":"Shah S B, Vishnoi G, Chawla R, Bhardwaj M, Shah S B","doi":"10.15406/jaccoa.2022.14.00528","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00528","url":null,"abstract":"Currently there is a paucity of guidelines for anticipated difficult airways but awake intubation holds a pivotal position in all of these. Although awake fiberoptic intubation has long been considered the gold standard for difficult airway, awake videolaryngoscopic intubation is a promising alternative which is safe and effective, with myriad benefits like shorter duration of intubation, lesser technical skills required, shorter learning curve and better visualization when blood, copious secretions, tenacious sputum or debris obscures the glottic view. A detailed description of a lignocaine-topicalization with adjunctive propofol-sedation based technique for awake C-Mac D-Blade videolaryngoscopic intubation for anticipated extremely difficult airways in three patients follows.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128179641","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":"Polyuria-polydipsia syndrome approach: clinical case and review","authors":"Martín Es, Sánchez-Escobedo Y","doi":"10.15406/jaccoa.2022.14.00527","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00527","url":null,"abstract":"Polyuria-polydipsia syndrome (PPS) compared three-pathologies: nephrogenic or central diabetes insipidus and primary polydipsia. The initial approach considers different causes, and it requires a complete evaluation of the fluid-status support by physician. The diagnosis must exclude frequent abnormalities. Clinical case: A 57-year-old male during his hospitalization documents polydipsia and polyuria with urine volume of 3.5 to 8.45 L/day. We did a test for identify to etiology and other causes was eliminated, concluding a primary polydipsia in a patient with the most important risk was his psychiatric component. An algorithm is proposed according to this experience obtained with the case presented with a review of the topic from the point of view of the internist physician in a patient with a PPS in a controlled-environment.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132268920","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":"Posterior reversible encephalopathy syndrome in a patient with mixed connective tissue disorder: a case report","authors":"S. Khanal, Kripa Kc, Marisha Shrestha, Chandani Sainju","doi":"10.15406/jaccoa.2022.14.00526","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00526","url":null,"abstract":"Our case report includes a 42-year-old female patient; a known case of Mixed Connective Tissue Disorder (MCTD) who presented with focal seizure. Magnetic Resonance Imaging (MRI) brain showed the features of Posterior Reversible Encephalopathy syndrome (PRES) to be the cause of seizure. Given the timely diagnosis of PRES, the seizure was controlled with anti-epileptic drug and the possibility of having poor neurological outcome was successfully prevented. Although Mixed Connective Tissue Disorder is rarely associated with PRES, MCTD should be considered when there are supportive clinical and radiological findings as in our case.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115516592","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":"An illustration of the evolution of various injection points for circumventing supraclavicular brachial plexus block failure","authors":"Dr. Sripriya R, Dr. Surya R","doi":"10.15406/jaccoa.2022.14.00525","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00525","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"CE-30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126547147","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":"Vaccine induced immune thrombocytopenia","authors":"Fatima Saeed, G. Gupta, Muhammad Noor","doi":"10.15406/jaccoa.2022.14.00524","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00524","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132084090","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":"Effectiveness of post-operative pain management among patients who underwent general and orthopedic surgeries at a national referral hospital Asmara, Eritrea","authors":"Samuel Fikremariam Beyn, Betiel Yihdego Kidamemariam, Meron Yemane Hidremichael, Merhawi Kidane Habte, Mahmud Mohammed Adem, Micheal Beraki Mengistu, Eyasu Habte Habtemariam, Yonatan Mehari Andemeskel","doi":"10.15406/jaccoa.2022.14.00523","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00523","url":null,"abstract":"Background: Post-operative pain poses significant challenges with high global prevalence. Inadequately managed pain can result in patients increased medical complications, prolonged hospital stays and reduced effective pain management. The study was aimed at comparing the effectiveness of existing and severity-based POP management of patients who underwent general and orthopedic surgeries in Halibet National Referral Hospital. Methods: This was a quasi-experimental study conducted among 118 patients who underwent general and orthopedic surgeries. Data was collected by using socio-demographic, clinical characteristics and visual analogue scale (VAS). The intervention group received a severity based (SBM) POP management, whereas the comparative group received the existing management (EM). Data on severity of POP and effectiveness of its management was collected using VAS. Descriptive statistics for the demographic and clinical data, median pain reduction, and Mann-Whitney U value were used to analyze data. P< 0.05 was taken as statistically significant. Results:98.3% of the patients in the EM and 88.1% in the SBM experienced pain at the initial point after surgery with mild pain (30.5%) (11.9%), moderate pain (37.3%) (54.2%) and severe pain (30.5%) (22%) respectively. The common type of analgesic used in the EM was Diclofenac (63.72%). The median pain reduction was statistically insignificant (p=0.056) in the EM group, while a significant pain reduction (p<0.001) was seen in the SBM group. Significant difference in the effectiveness of POP management was found between EM and SBM groups in middle aged adults (p=0.026), females (p= 0.016), patients who took GA (p<0.001) and patients who had general surgery (p<0.001). Conclusion: The management of POP should be based on the severity of pain experienced by the patient and use of the most suitable analgesics. Pain assessment should be performed for every post-operative patient using appropriate pain assessing tool and documented.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"19 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116099420","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}