Mount Sinai Journal of Medicine最新文献_第8页

Curing diabetes with transplantation? 用移植治疗糖尿病?

Mount Sinai Journal of Medicine Pub Date : 2012-03-01 DOI: 10.1002/msj.21304

Anja Richter, Susan M Lerner, Bernd Schröppel

引用次数: 3

Lungs in critical care: new look at old practices. 重症监护中的肺部:旧做法的新视角。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21294

Peter J Papadakos, Marcin Karcz, David Schwaiberger, Burkhard Lachmann

引用次数: 4

Value of specialized preanesthetic clinic for cardiac and major vascular surgery patients. 心脏及大血管手术患者麻醉前专科门诊的价值。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21293

Brigid C Flynn, George Silvay

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引用次数: 12

Developmental disability in the young and postoperative cognitive dysfunction in the elderly after anesthesia and surgery: do data justify changing clinical practice? 麻醉和手术后年轻人的发育障碍和老年人的术后认知功能障碍:数据证明改变临床实践是合理的吗?

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21283

James E Cottrell, John Hartung

引用次数: 16

Types of office-based anesthetics. 办公室麻醉药的种类。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21285

Laurence M Hausman, Elisha J Dickstein, Meg A Rosenblatt

引用次数: 1

Impact of red blood cell transfusion on global and regional measures of oxygenation. 红细胞输注对全球和区域氧合测量的影响。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21284

Russell S Roberson, Elliott Bennett-Guerrero

{"title":"Impact of red blood cell transfusion on global and regional measures of oxygenation.","authors":"Russell S Roberson, Elliott Bennett-Guerrero","doi":"10.1002/msj.21284","DOIUrl":"https://doi.org/10.1002/msj.21284","url":null,"abstract":"Anemia is common in critically ill patients. Although the goal of transfusion of red blood cells is to increase oxygen-carrying capacity, there are contradictory results about whether red blood cell transfusion to treat moderate anemia (e.g., hemoglobin 7-10 g/dL) improves tissue oxygenation or changes outcomes. Whereas increasing levels of anemia eventually lead to a level of critical oxygen delivery, increased cardiac output and oxygen extraction are homeostatic mechanisms the body uses to prevent a state of dysoxia in the setting of diminished oxygen delivery due to anemia. In order for cardiac output to increase in the face of anemia, normovolemia must be maintained. Transfusion of red blood cells increases blood viscosity, which may actually decrease cardiac output (barring a state of hypovolemia prior to transfusion). Studies have generally shown that transfusion of red blood cells fails to increase oxygen uptake unless oxygen uptake/oxygen delivery dependency exists (e.g., severe anemia or strenuous exercise). Recently, near-infrared spectroscopy, which approximates the hemoglobin saturation of venous blood, has been used to investigate whether transfusion of red blood cells increases tissue oxygenation in regional tissue beds (e.g., brain, peripheral skeletal muscle). These studies have generally shown increases in near-infrared spectroscopy derived measurements of tissue oxygenation following transfusion. Studies evaluating the effect of transfusion on the microcirculation have shown that transfusion increases the functional capillary density. This article will review fundamental aspects of oxygen delivery and extraction, and the effects of red blood cell transfusion on tissue oxygenation as well as the microcirculation.","PeriodicalId":51137,"journal":{"name":"Mount Sinai Journal of Medicine","volume":"79 1","pages":"66-74"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/msj.21284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 48

Perioperative medicine: innovations and challenges. 围手术期医学:创新与挑战。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21296

James B Eisenkraft, George Silvay, David L Reich

引用次数: 1

Perioperative dental evaluation. 围手术期牙科评估。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21292

Jeffrey S Yasny, Andrew Herlich

引用次数: 16

From bloodless surgery to patient blood management. 从无血手术到病人血液管理。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21290

Aryeh Shander, Mazyar Javidroozi, Seth Perelman, Thomas Puzio, Gregg Lobel

{"title":"From bloodless surgery to patient blood management.","authors":"Aryeh Shander, Mazyar Javidroozi, Seth Perelman, Thomas Puzio, Gregg Lobel","doi":"10.1002/msj.21290","DOIUrl":"https://doi.org/10.1002/msj.21290","url":null,"abstract":"Safety and efficacy concerns of allogeneic blood transfusions and their impact on patient outcomes and associated staggering costs and restricted supply have fueled the quest for other modalities and strategies to reduce use of blood components. Patient blood management focuses on multidisciplinary and multimodal preventive measures to reduce or obviate the need for transfusions and ultimately to improve the clinical outcomes of patients. Patient blood management strategies can be applied at every stage of care to surgical and nonsurgical patients, and they generally fall under one of these three categories (the so-called pillars of blood management): optimizing hematopoiesis and appropriate management of anemia, minimizing bleeding and blood loss, and harnessing and optimizing physiological tolerance of anemia through employing all available modalities while treatment is initiated. Several tools and modalities are available to address each of these pillars. Examples include hematinic agents, systemic and topical hemostatic agents, autotransfusion, and blood-sparing perfusion and surgical techniques. Additionally, changes in practice of clinicians (e.g., adherence to restrictive, evidence-based transfusion strategies with emphasis on physiologic indications for transfusion, minimization of iatrogenic blood loss, and adequate planning) play an important role in patient blood management. Emerging evidence supports that appropriate use of these strategies as part of a multimodal program is a safe and effective way of reducing allogeneic transfusions and improving patient outcomes.","PeriodicalId":51137,"journal":{"name":"Mount Sinai Journal of Medicine","volume":"79 1","pages":"56-65"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/msj.21290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380216","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}

引用次数: 93

Long-term outcomes in elderly surgical patients. 老年手术患者的长期疗效。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21288

Stacie Deiner, Jeffrey H Silverstein

引用次数: 0