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

{"title":"Anesthesia department Interim guidelines in managing airway and surgeries regaring COVID-19 hepatic patients in national liver institute, Menoufia university, Egypt","authors":"N. Gaballa, M. Khalil, E. A. Fattah, Eman kamal Awad","doi":"10.15406/jaccoa.2020.12.00447","DOIUrl":"https://doi.org/10.15406/jaccoa.2020.12.00447","url":null,"abstract":"Anesthesiologists, intensivists, anesthesia nursing/operating room staff the first and may be the only category dealing with patients airway, secretions for this anesthesia department took the responsibility to train and protect all team members with the lines of infection control and tailoring internal guidelines from international ones to suit the facilities and the fund in National Liver Institute (NLI), Menoufia, Egypt. And the unique category of patients we are serving.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115014365","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":"Fluid management in continuous renal replacement therapy","authors":"Jose J. Zaragoza, Jose Manuel Lomeli-Teran, Job Rodriguez-Guillen","doi":"10.15406/jaccoa.2020.12.00433","DOIUrl":"https://doi.org/10.15406/jaccoa.2020.12.00433","url":null,"abstract":"The purpose of intravenous fluid administration is to increase cardiac output. Excessive fluid administration can lead to accumulation of interstitial fluid, worsening hypoperfusion and hence develop organic dysfunction. Therefore, fluid overload is a poor prognostic factor for hospitalized patients and those admitted to the Intensive Care Unit (ICU). A resuscitation strategy divided in four phases has been described; the last phase consists in the elimination of those fluids that have been administrated in the previous phases. When fluid overload is complicated by acute kidney injury renal replacement therapy may be used for this purpose. A successful fluid treatment of a patient depends on a proper, accurate and frequent evaluation, and in the correct understanding of the basic principles and clear objectives of the treatment. In the continuous renal replacement therapy, the rate of the fluid eliminated can be adjusted safely according to each patient needs and it allows additional support of other complications. The ideal strategy to guide the elimination rate is unknown. This review presents the basic principles for an optimum fluid management in the continuous renal replacement therapy.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125233544","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":"Early resuscitation - what is changed in the treatment of Traumatic Brain Injury (TBI)","authors":"M. Sholjakova, V. Durnev, V. Demjanski, Aleksandar Kishman","doi":"10.15406/jaccoa.2020.12.00431","DOIUrl":"https://doi.org/10.15406/jaccoa.2020.12.00431","url":null,"abstract":"Background: The classical therapeutic approaches to thetraumatic brain injury (TBI) are based on astandardized care and prevention of secondary brain injuries and insults.Brain is the most sensitive tissue to hypoxemia what consequently burdens maintenance of adequate circulation. The development of hypoxia hypoxemia during traumatic brain injury (TBI) with severe shock and anaemia is the main cause for the development of secondary brain injury, which is responsible for the high fatality of the TBI. Objectives and method: The aim of this review is to discuss the available literature and guidelines for this field and to find out the possible benefits of early resuscitation. Results: Initial resuscitation starts with infusions of isotonic crystalloid solutions (e.g. sodium chloride). The main goal of the treatment is to achieve normal blood pressure and adequate oxygen supply to the tissue. Aggressive resuscitation with excessive fluid load in TBI patients may aggravate the brain oedema. The data, about early use of blood and its products in TBI patients with severe haemorrhage are poor with controversial opinions. Conclusion: The resent published guidelines do not support any specific fluid or specific transfusion practices in this setting.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133081951","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":"Complications after duodenopancreatectomy within eras protocols in a developing country","authors":"Juan Pablo Aristizábal Linares, Jose Julian Estrada Quiroz, Diego Fernando Davila Martinez, Carolina Hoyos Gomez, Ó. Palacios, P. Zapata","doi":"10.15406/jaccoa.2019.11.00413","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00413","url":null,"abstract":"Background: Recent studies have suggested that intraoperative fluid overload is associated with the presence of postoperative pancreatic fistula after duodenopancreatectomy. Finding the ideal balance between hypoperfusion and tissue edema with fluids administration during major gastrointestinal surgery is challenging. The aim of this study was to evaluate whether intraoperative fluid management along with enhanced recovery protocols could affect the outcome after a major pancreatic resection. Methods: Data from 67 consecutive patients who underwent duodenopancreatectomy from January 2012 to January 2017 were analyzed. Patients were divided into two groups according to the use of enhanced recovery after surgery protocols. Patients in ERAS protocols had a fluid therapy algorithm which consists: Systolic Volume Variation (SVV) less than 13%, Cardiac Index (CI) higher than 2.5 L/Min/M2 and Delta CO2 less than 6 mmHg. Results: A total of 67 patients were analyzed from July 2012 to January 2017, of these 49.3 % correspond to the female gender. The most frequent diagnosis was Pancreatic Cancer n:48 (71.6%), followed by Intraductal Papillary Mucinous Neoplasm (IPMN) n:6 (9%). The majority of patients were in the ERAS Group with a total of 46 patients (68.7%). In the ERAS group, 80.4% and 95.7% did not develop POPF and Delayed Gastric Emptying (DGE) respectively. The incidence of POFP in all the patients was 11.94% (Grade A are considered biochemical leak and NOT a proper fistula). The incidence of DGE was 11.94%. The probability of intraoperative blood loss less than 300ml was higher in the ERAS group; however, the probability to need a transfusion was lower in the ERAS Group. The probability to use less than 5000ml of fluid therapy was higher in the ERAS group. The total length of stay was statistically significant shorter in the ERAS group. No differences in 30-days mortality were found. Conclusion: The implementation of ERAS protocols in PD did show a decrease in intraoperative blood loss, intravenous fluids therapy, need for transfusion, DGE, and total hospital stay; however, intraoperative fluid restriction in PD did not show to significantly affect POPF.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125521804","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":"Spinal anesthesia with low dose bupivacaine and fentanyl for femur surgeries in elderly patients","authors":"Devyani Desai, Pinal Bumiya, Mr, Upadhyay, A. Vashishtha","doi":"10.15406/jaccoa.2019.11.00412","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00412","url":null,"abstract":"Background and objectives: Decreasing the dose of intrathecal Bupivacaine may be useful to provide surgical anaesthesia with less hemodynamic disturbances especially in elderly patients but may be associated with inadequate anaesthesia for orthopaedic surgeries to perform. This can be overcome by adding Fentanyl to it. Materials and method: 60 elderly patients of American Society of Anaesthesiologists (ASA) grade II, scheduled for femur surgeries were randomly assigned to one of the two groups. Group B:(n=30) patients receiving Bupivacaine (0.5%) heavy 2.5ml (12.5mg) and Group BF:(n=30) patients receiving Bupivacaine (0.5%) heavy 1.5ml (7.5mg)+Fentanyl (25ug) 0.5ml+0.5 ml normal saline, total volume being 2.5ml. The characteristics of sensory and motor blockade, duration of effective analgesia, perioperative hemodynamics and complications were recorded. Results: The mean onset of sensory block and time to achieve peak sensory level was early, time to achieve regression to L1 level and duration of effective analgesia was longer in group BF ad the difference was highly significant (p<0.001). There was no significant difference in motor blockade characteristics between two groups. Incidences of hypotension were more in group B compared to group BF. Conclusion: Low dose intrathecal bupivacaine (7.5 mg) with fentanyl (25mcg) can provide adequate surgical anaesthesia and better hemodynamics and can be used in elderly patients for femur surgeries.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124436666","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":"Magnitude of post dural puncture headache and associated factors in obstetric mothers undergone spinal anesthesia for caesarean section","authors":"Dawit Tafesse, Abateneh Melkamayew","doi":"10.15406/jaccoa.2019.11.00410","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00410","url":null,"abstract":"Background: Although modern anesthesiology has made great progress in the last decades, neuraxial anesthesia (NA) is still the keynote of regional blockade. It is popular for its effectiveness in producing anesthesia and analgesia. As the NA techniques popularly used in clinics, post dural puncture headache (PDPH), a common iatrogenic complication resulted from post-spinal taps or accidental dural puncture (ADP) subsequent to epidural block, frequently reported and becomes a challenging to health caregivers. The objective of the study was to assess the magnitude of post dural puncture headache (PDPH) and Associated Factors in Obstetric Mothers Undergone Spinal Anesthesia for Cesarean Section from February 1 – June 30, 2018 Methods and Materials: Institutional based cross-sectional study design conducted in Dilchora Hospital and Sabian Primary Hospital from February 1 – June 30, 2018. 391 obstetric mothers was systematically selected every 2 other patient interval. The data was collect from both patient chart review and interview using structured checklist. Results: 85/391 (21.7%) obstetric mothers present with headache characteristic of post-dural puncture headache (PDPH). Larger gauge spinal needle [AOR= 3.105: 95% CI (1.116 - 8.638), P = 0.03] and multiple spinal attempts [AOR 0.374; 95% CI (0.220 - 0.635) P = 0.000] was statistically significantly related with PDPH after Spinal anesthesia. Conclusion and Recommendation: In our study, we observe a relatively higher prevalence of PDPH (21.7%), as compared to other literatures. Large gauge spinal needles (≥ 23 G) and multiple spinal attempts is also find statistically significantly related with PDPH after Spinal Anesthesia. In order to decrease the higher prevalence of PDPH in those Hospitals, Anesthetists should avoid utilization of large gauge spinal needles, and repeated dural puncture during Spinal Anesthesia.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114491479","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":"Protocol for rapid recovery pathways after surgery in children: a systematic review and meta-analysis","authors":"K. C, B. T, De Cock A, W. A, Harte C, Querciagrossa S, Orliaguet G, Melot C","doi":"10.15406/jaccoa.2019.11.00409","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00409","url":null,"abstract":"Background: In adult surgical patients rapid recovery pathways after surgery have shown improvement in postoperative complications and length of hospital stay . Enhanced recovery after surgery is a concept which includes patient management protocols beginning from the preoperative period, continues in the intraoperative period and the postoperative period. This concept aims to improve postoperative outcome. In pediatric patients rapid recovery pathways are beginning to develop. This study is undertaken to analyse whether enhanced recovery after surgery improves postoperative outcome in children. Methods: systematic review and meta-analysis of randomized and randomized trials starting in April 2019 until July 2019. Statistic analysis will be realised with RevMan 5.3 software. Results are expected by July 2019. Conclusion: This protocol was realised to describe the systematic review and meta-analysis which will be undertaken to clarify the impact on postoperative outcome of rapid recovery pathways after surgery in children.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"613 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116076249","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":"A review of aortic stenosis: an anesthetic perspective","authors":"A. Schneider","doi":"10.15406/JACCOA.2018.10.00401","DOIUrl":"https://doi.org/10.15406/JACCOA.2018.10.00401","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127720711","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":"Does a supreme laryngeal mask airway (SLMA) selected on the basis of a patient’s weight provide an optimal fit in Indian population?","authors":"A. Chatterjee, Anamika Yadav","doi":"10.15406/JACCOA.2018.10.00396","DOIUrl":"https://doi.org/10.15406/JACCOA.2018.10.00396","url":null,"abstract":"Background: The Supreme laryngeal mask (SLMA), is a second generation Laryngeal mask airway (LMA) introduced in 2007. Designed in the West on Caucasian population, most studies have been conducted on the same population. There is no study to evaluate the fit of a SLMA chosen on the weight based criteria in Indian population. Aim: The aim or objective of the study was to identify whether SLMA selected on the basis of weight criteria provides an appropriate fit in Indian population?","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131093070","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":"Cardiorespiratory responses of ambulatory hemiplegic stroke survivors to treadmill walking exercises in Tehran, Iran","authors":"Morteza Alibakhshikenari","doi":"10.15406/jaccoa.2018.10.00391","DOIUrl":"https://doi.org/10.15406/jaccoa.2018.10.00391","url":null,"abstract":"Stroke is one of the leading causes of disability and post challenges in the society due to impaired neuromuscular control, decreased functional mobility, balance deficits and reduced cardiorespiratory fitness, and hence physiotherapy interventions can play a significant role in facilitating individuals with impairment, disability and functional limitations. Exercise training among the post stroke population can facilitates improvement in cardiovascular, respiratory and neuromuscular function. However there appear to be a dearth of knowledge and literature on the response of cardiorespiratory parameters of stroke survivors to treadmill walking exercises in Iran. This study was therefore designed to investigate the cardiorespiratory response of ambulatory hemiplegic stroke survivors to treadmill walking exercise. The 32 participants for this study were recruited using consecutive sampling technique, in which 17 were male while 15 were female. An Informed consent and data form were used to obtain the participants’ consent and socio-demographic information. The study was a pre and post experimental design involving the participant’s own maximum walking ability on the treadmill. The Descriptive statistics of mean and standard deviation were used to describe the participants’ demographic and baseline characteristics which were Age, Weight, Height, and Body Mass Index. The inferential statistics of paired t-test was used to compare the cardiorespiratory parameters of the participants’ within gender, while unpaired t-test was used for comparison between genders. The level of statistical significance was set at alpha equal 0.05. The result showed that 53.1% of the participants were male while 46.9% were female. The mean age of the participants was 52.37±10.15 years (range of 33-74 years), Mean weight was 68.82±8.6, Mean height was 1.68±0.18 and Mean BMI was 27.71±7.64 respectively. There was a significant difference between male and female participants before and after treadmill walking exercise in their Pulse rate (t=3.19, p=0.006), Systolic blood pressure (t=2.67, p=0.03) and Respiratory rate (t=6.19, p=0.001), except for Diastolic blood pressure which showed no significant difference (t=0.79, p=0.4). Comparison between male and female selected parameters all showed significant difference in their Systolic blood pressure (t=24.38, p=0.001), Diastolic blood pressure (t=9.36, p=0.001) and Respiratory rate (t=15.12, p=0.001) respectively, except for pulse rate which showed no significant difference (p = 0.86, t = 0.17). It was concluded that there was significant increase in the pulse rate, systolic blood pressure and respiratory rate following treadmill walking exercises but changes seen in diastolic blood pressure were not significant. It is recommended that treadmill walking exercise be considered by rehabilitation professionals when developing exercise prescription programs for rehabilitation of ambulatory hemiplegic stroke survivors to optimize the c","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117259027","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}