Refresher courses in anesthesiology最新文献_第6页

Frail, Feeble, or Fit? The Oldest Old: What Should We Do Differently for the Geriatric Patient Undergoing Anesthesia—If Anything? 虚弱，虚弱，还是健康?最老的老人:如果有的话，我们应该为接受麻醉的老年病人做些什么?

Refresher courses in anesthesiology Pub Date : 2013-01-01 DOI: 10.1097/ASA.0b013e31829aeb53

Sheila R. Barnett

引用次数: 0

Hypoxia During Thoracic Surgery: Practical Advice for the Anesthesiologist 胸外科手术中的缺氧:给麻醉师的实用建议

Refresher courses in anesthesiology Pub Date : 2013-01-01 DOI: 10.1097/ASA.0B013E31829953FC

Javier H. Campos

{"title":"Hypoxia During Thoracic Surgery: Practical Advice for the Anesthesiologist","authors":"Javier H. Campos","doi":"10.1097/ASA.0B013E31829953FC","DOIUrl":"https://doi.org/10.1097/ASA.0B013E31829953FC","url":null,"abstract":"Double-lumen tubes or bronchial blockers are used to provide one-lung ventilation (OLV) in patients undergoing lung, esophageal, thoracic vascular, minimally invasive cardiac, and occasionally mediastinal surgery. During OLV, an intrapulmonary shunt may result in hypoxemia related in part to collapse of the nondependent lung and increased atelectatic areas in the dependent lung. Hypoxemia by definition is a decrease in oxygen saturation (SpO2) to less than 90% 4 or an arterial oxygen tension (PaO2) of less than 60 mmHg when the patient is being ventilated at an inspired oxygen fraction (FiO2) of 1.0. 5 The incidence of hypoxemia during OLV has been reported to be 1 to 10%. This relative infrequency is related in part to advances with routine use of a fiberoptic bronchoscope for optimal placement of lung isolation devices. It is also attributable to the introduction of newer volatile anesthetics that cause less inhibition of hypoxic pulmonary vasoconstriction (HPV) in a dose-dependent manner and less venous admixture during OLV. This review focuses on the predictors of hypoxia during OLV, the pathophysiology of HPV, protective ventilation maneuvers to restore or improve arterial oxygenation, the effects of anesthetics on hypoxia and inflammation, and cerebral desaturation episodes and hypoxia during OLV.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"41 1","pages":"38-46"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0B013E31829953FC","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62021121","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: 4

Risk Evaluation and Mitigation Strategies (REMS), Pill Mills, and Responsible Opioid Prescribing 风险评估和缓解策略(REMS)，药丸厂和负责任的阿片类药物处方

Refresher courses in anesthesiology Pub Date : 2013-01-01 DOI: 10.1097/ASA.0b013e31829a1f54

R. Miguel

{"title":"Risk Evaluation and Mitigation Strategies (REMS), Pill Mills, and Responsible Opioid Prescribing","authors":"R. Miguel","doi":"10.1097/ASA.0b013e31829a1f54","DOIUrl":"https://doi.org/10.1097/ASA.0b013e31829a1f54","url":null,"abstract":"Over the past 20 years, drug overdose deaths in the United States have tripled. More than 100 people die each day secondary to prescription drug use, whether related to drug abuse, misuse, or adverse events. In July 2012, the Drug Abuse Warning Network reported that of 4.8 million drug-related visits to US emergency departments in 2010, 46.8% were due to drug abuse or misuse. Prescription drugs had the highest representation of all abused drugs at a frequency of 435 per 100,000 population. Because Florida is the state with the greatest number of medications dispensed and the highest drug mortality, the actions of that state have a far-reaching impact because of the enormous volume of drugs diverted from Florida. Recognizing the problem, the US Food and Drug Administration (FDA) started Risk Evaluation and Mitigation Strategies (REMS) as a source of education. REMS require drug manufacturers to educate physicians who, in turn, will educate their patients about the proper use of high-risk medications, including opioids. This chapter addresses the problem of clinics that appear to operate as pain clinics but really exist to dispense prescriptions for medication, or ‘‘pill mills,’’ and their contribution to the national prescription drug epidemic. A template for responsible controlled substance prescribing, which includes complete history taking and physical examination with particular attention to comorbidities (including psychiatric disorders), is described. Finally, an overview of the available risk assessment and ongoing management tools is presented.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"27 1","pages":"70–77"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0b013e31829a1f54","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62022300","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: 0

Perioperative Acid–Base Disturbances: Evaluation and Management 围手术期酸碱干扰:评估与处理

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0B013E31825F3C30

M. Keegan

引用次数: 1

Emergency Preparedness: Managing Victims of Chemical, Biological, Radiological, Nuclear, or High-explosive (CBRNE) Agents 应急准备:管理化学、生物、辐射、核或高爆(CBRNE)剂的受害者

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0b013e3182622bab

M. Murray

{"title":"Emergency Preparedness: Managing Victims of Chemical, Biological, Radiological, Nuclear, or High-explosive (CBRNE) Agents","authors":"M. Murray","doi":"10.1097/ASA.0b013e3182622bab","DOIUrl":"https://doi.org/10.1097/ASA.0b013e3182622bab","url":null,"abstract":"Preparing to manage disasters originating from natural events, industrial accidents, or, of more interest recently, caused intentionally by terrorists using chemical, biological, radiological, nuclear, or highexplosive (CBRNE) agents is a high priority for the US government and military as well as the American Society of Anesthesiologists. Even though natural and man-made disasters have occurred for millennia, the use of CBRNE agents and devices by terrorists in recent decades has emphasized the need for increased preparedness. Natural disasters that occurred in 2011 killed tens of thousands of people and caused more than 350 billion dollars in losses. The earthquake and resulting tsunami in Japan, earthquakes in Haiti and New Zealand, the floods in Thailand and the Eastern United States (caused by Hurricane Irene), and the tornados that touched down in Joplin, Missouri, and in Alabama have produced calamities that were almost unimaginable in the past. In Alabama and Missouri, whole neighborhoods were wiped off the map. In addition to the direct damage caused by the earthquake and tsunami in Japan, the effect on the Fukushima nuclear power plant in Okuma continues to cause significant concern and morbidity. The intent of this chapter is to review and highlight what anesthesiologists need to know to manage victims when natural disasters occur or when CBRNE devices or agents, whether used by terrorists or released during an industrial accident, result in a major disaster causing a high number of casualties.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"40 1","pages":"114–118"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0b013e3182622bab","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62020512","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: 0

A Fire in the Operating Room: It Could Happen to You! 手术室失火:可能发生在你身上!

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0b013e3182622c62

J. Ehrenwerth

引用次数: 3

Physics in Anesthesiology: Basic Science Review 麻醉学中的物理学:基础科学评论

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0b013e31825da79e

K. Gipson, J. Gross

引用次数: 0

Hematological Issues in Cardiovascular Surgery Patients 心血管手术患者血液学问题

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0b013e31825e9a9e

L. Shore-lesserson, L. Enriquez

引用次数: 1

A Child With a Difficult Airway: What Do I Do Next? 一个呼吸道困难的孩子:接下来我该怎么做?

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0b013e31825e9958

S. Wald

引用次数: 11

Anesthesia in Satellite Locations 卫星位置麻醉

Refresher courses in anesthesiology Pub Date : 2012-01-01 DOI: 10.1097/ASA.0b013e31826304c3

B. Gentz

引用次数: 2