{"title":"Predictive and Prognostic Value of Heart Rate Variability Analysis in Early Bedside Diagnosis and Management of COVID-19 Patients","authors":"N. Mageed","doi":"10.33552/asoaj.2020.01.000522","DOIUrl":"https://doi.org/10.33552/asoaj.2020.01.000522","url":null,"abstract":"Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in critically ill patients. Early diagnosis and early management are the key factor in improving outcome in sepsis due to viral infection, so, there is need to develop more rapid, sensitive, and specific diagnostic strategies that allow early intervention to improve patient outcome. Heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. This aim of this article is to review the HRV analysis and its value in detection early diagnosis of viral infection including COVID-19 patients. The prognostic value of clinical bedside application of HRV in the management and treatment viral infection and sepsis are highlighted in this review. The overall HRV decreased with lower low frequency component has been shown to be consistently correlated with the presence and severity of viral infection. HRV monitoring may enhance the early diagnosis, prognosis and early initiation of treatment of viral infectionCOVID-19. Bedside wearable devices that are based on photoplethysmography such as watch-like devices and mobile phone apps may be used as a useful non-invasive tool for early diagnosis of COVID -19 by analyzing the HRV.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84268851","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}
Usama Imam, Ayman Refaat Abdelhaseeb, Mohamed Hassan Abd El Mawla, M. Abdelmalak
{"title":"A Comparative Study between the Routine Using of Ultrasound Guidance versus Anatomical Guidance in Femoral Artery Access for Endovascular Treatment of Chronic Lower Limb Ischemia","authors":"Usama Imam, Ayman Refaat Abdelhaseeb, Mohamed Hassan Abd El Mawla, M. Abdelmalak","doi":"10.37532/fmic.2020.12(2).649","DOIUrl":"https://doi.org/10.37532/fmic.2020.12(2).649","url":null,"abstract":"The goal of this study is comparison between the using of ultrasound guidance versus anatomical guidance in femoral artery access for endovascular treatment of chronic lower limb ischemia, by assessment of first pass success rate, total number of attempts required for access, rate of accidental venipunctures, rate of PFA puncture and time to sheath insertion, and assessment of post procedural puncture site complications defined as bruises or hematoma formation. The study found that US guidance is superior to anatomical guidance in femoral artery access in endovascular treatment of chronic lower limb ischemia in reducing access time, total number of punctures, and number of incidental venipuncture, the incidence of PFA access and incidence of local bruises.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90439967","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":"Ventricular Assist Devices Insertion, Overview and Anesthetic Considerations","authors":"N. Mageed","doi":"10.33552/asoaj.2020.01.000520","DOIUrl":"https://doi.org/10.33552/asoaj.2020.01.000520","url":null,"abstract":"Ventricular assist devices (VAD) represent a revolution for the management of severe heart failure. Their insertion requires the use of cardiopulmonary bypass. They are used either permanently for long term treatment of refractory heart failure or temporally as a bridge until cardiac transplantation and until cardiac recovery from reversible cardiomyopathy. Insertion of VAD is a risky surgery with high incidence of complication such as bleeding, cardiac tamponade, renal failure and device failure. Anesthetic management of patients with heart failure undergoing VAD insertion requires full review of the patient critical condition, understanding VAD physiology, extensive hemodynamic monitoring and a harmony between cardiac anesthesia and surgical teams. Marinating and protection the right ventricular function is highly important for the continuation of VAD function. The aim of this review is to put new insights on anesthetic management of VAD insertion and to show their different types and their physiology.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77545927","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 Surgical Repair of Descending Thoracic Aortic Aneurysm","authors":"N. Mageed","doi":"10.33552/asoaj.2020.01.000518","DOIUrl":"https://doi.org/10.33552/asoaj.2020.01.000518","url":null,"abstract":"Anesthetic management of surgical repair of descending thoracic aortic aneurysm is a difficult mission for anesthesiologists. The surgical approach is best achieved through left postero-lateral thoracotomy with the use of one lung ventilation. The post-operative outcome is affected by the presence of associated co morbidities such as cardiac and renal diseases, the severe intra-operative hemodynamic fluctuations and the use of mechanical circulatory assisted devices. The severe hemodynamic fluctuations that result from clamping and declamping the descending thoracic aorta require an experienced cardiac anesthesiologist for the proper perioperative management of these patients. The aim of this review is to give new insights on the anesthetic management and the techniques of distal perfusion using partial cardiopulmonary bypass. Anesthetic goals are directed to provide spinal cord and renal protection with controlling the proximal hypertension.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84913164","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":"Impact of Local Anesthetics on Intrathecal Anesthesia","authors":"Carlos de la Paz Estrada","doi":"10.33552/asoaj.2019.01.000517","DOIUrl":"https://doi.org/10.33552/asoaj.2019.01.000517","url":null,"abstract":"Summary Of all regional techniques, subarachnoid block is the fastest, most predictable, and most reliable. It is a technique that has unique characteristics for use in ambulatory surgery: immediate initiation of anesthesia, predictable response according to the dose administered, and the possibility of adjusting the anesthetic duration by selecting the appropriate agent. Its main advantages are its easy realization, the quick establishment of the lock, its high effectiveness and reliability and its low toxicity. It is a simple technique to perform since anatomical references are usually easy to locate and the procedure is performed in a short time, even in obese patients. The quality of the blockage is especially evident in interventions of the lower extremities performed with tourniquet and in perineal surgery, thanks to its ability to achieve complete sacral anesthesia. It has low toxicity because the small doses of local anesthetic required eliminate the risk of systemic toxicity in case of inadvertent intravascular injection.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84625388","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":"Perioperative Management of Pulmonary Hypertension in Pediatric Cardiac Surgery","authors":"Ibrahim I. Abd El Baser","doi":"10.33552/asoaj.2020.01.000516","DOIUrl":"https://doi.org/10.33552/asoaj.2020.01.000516","url":null,"abstract":"Pediatric pulmonary hypertension (PH) is associated with many cardiovascular, and pulmonary diseases that result in a high risk of morbidity and mortality. The cause of PH in children is mainly due to congenital heart disease (CHD). The proper preoperative evaluation and the accurate anesthetic management are essential to obtain the best outcome. The perioperative anesthetic goal is directed to avoid pulmonary hypertensive crisis which is associated with poor outcome in children with PH secondary to CHD undergoing cardiopulmonary bypass. The purpose of this review is to discuss the pathophysiology of PH in children with CHD and to show how to avoid and manage the perioperative pulmonary hypertensive crisis.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89329983","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":"Cardiac Output assessed via Esophageal Doppler Monitoring Fails to Predict Changes in Renal Microvascular Perfusion","authors":"D. Read, B. Doleman, John P. Williams","doi":"10.33552/asoaj.2019.01.000510","DOIUrl":"https://doi.org/10.33552/asoaj.2019.01.000510","url":null,"abstract":"This work is licensed under Creative Commons Attribution 4.0 License ASOAJ.MS.ID.000510. Abstract Background: Vasoactive drugs are routinely used clinically to alter mean arterial blood pressure (MAP) and cardiac output (CO) and to maintain organ perfusion. However, the effect of such drugs on microvascular visceral blood flow (MiBF) is not fully understood. We aimed to track changes in renal MiBF, using the well-validated technique of Contrast Enhanced Ultrasound (CEUS), across a range of MAP and CO generated via the vasoactive drugs, phenylephrine and ephedrine. Methods: Baseline cardiovascular measurements were recorded, with renal MiBF determined via CEUS as renal microvascular transit time (RTT). Phenylephrine was then administered, via a standardized protocol, to increase MAP and CO, with repeat CEUS. Following return to baseline, the above was repeated using ephedrine. CEUS time-intensity curves were constructed and renal MiBF calculated. Results: In 11 male volunteers (median age 32), phenylephrine increased MAP (98.7 vs 110.8 mmHg, p<0.001), but not CO (4211 vs. 4089 ml.min-1, p=0.42), while ephedrine increased CO (4110 vs 6097, p<0.001) and MAP (95.6 vs 100.9, p=0.02). Phenylephrine reduced time to organ perfusion (TTOP) (22.3 vs 18.4 secs, p=0.009), but not RTT (14 vs 13.2 secs, p=0.46). Ephedrine decreased TTOP (21.1 vs 14.7 secs, p=0.003), and RTT (3.5 vs 9.6 secs, p=0.007). Change in CO predicted change in TTOP (r2=0.26, p=0.02), but not RTT (r2=0.04, p=0.43). Change in MAP did not predict change in TTOP (r2=0.02, p=0.58), or RTT (r2<0.001, p=0.89). Conclusion: Changes in MAP and CO fail to predict renal MiBF.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77518558","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":"Pregnancy-Choosing the Right Anesthesia","authors":"RN Dr. Aloma Wallace","doi":"10.33552/asoaj.2019.01.000509","DOIUrl":"https://doi.org/10.33552/asoaj.2019.01.000509","url":null,"abstract":"","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88216276","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":"Neutrophil Extracellular Traps and Acute Pancreatitis","authors":"Raed Madhi","doi":"10.33552/asoaj.2019.01.000508","DOIUrl":"https://doi.org/10.33552/asoaj.2019.01.000508","url":null,"abstract":"","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90675923","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":"Real Impact of Varicocele Surgery on Male Fertility","authors":"B. Balla","doi":"10.33552/asoaj.2019.01.000507","DOIUrl":"https://doi.org/10.33552/asoaj.2019.01.000507","url":null,"abstract":"Varicocele is among the most common causes of male infertility. It is also one of the most controversial issues in the field of Andrology, especially regarding why, when and to whom varicocelectomy should be applied. Many experts believe that the surgical repair of varicocele should be applied only in a meticulously selected group of infertile men, although there are no generally accepted criteria. Up to now, the only confirmed prognostic factor for achievement of pregnancy after varicocelectomy is the age of the female partner. We perform a retrospective study that collected 120 patients over 7 years between 2010-2017 in urological department at the Military Hospital Moulay Ismail in Meknes, Morocco, to evaluate the issues currently associated with varicocele treatment in infertile men.","PeriodicalId":92982,"journal":{"name":"Anaesthesia & surgery open access journal","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87740925","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}