Critical incidents, including cardiac arrest, associated with pediatric anesthesia at a tertiary teaching children's hospital

ConclusionDespite recent improvements in safety of pediatric anesthesia, many preventable factors still remain that can lead to critical incidents.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research

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This article highlights several key recent advances in the management of ischaemic cardiogenic shock, including the use of early bedside echocardiography to confirm the diagnosis, and culprit only lesion strategies of early revascularization. Furthermore, we appraise the variety of mechanical cardiac supports that are increasingly being used to assist the management of ischaemic cardiogenic shock in those cases refractory to pharmacological intervention.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 23 January 2020Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Nadja Rifaie, Fuat H. SanerAbstractAcute liver failure is defined as severe hepatic dysfunction (marked transaminases elevation, detoxification disorder (jaundice and coagulopathy with INR> 1.5)Presence of hepatic encephalopathy and exclusion of underlying chronic liver disease and a secondary cause like sepsis or cardiogenic shock.Reasons for acute liver failure includes paracetamol -and warfarin toxicity, autoimmune – and viral (mainly hepatitis B and E) hepatitis, herbal and dietary supplemen...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Conclusions: The severity of cardiogenic shock following asystolic cardiac arrest is dependent on the length of cardiac arrest prior to cardiopulmonary resuscitation and is mediated by myocardial stunning resulting from mitochondrial electron transport chain complex I dysfunction. A novel pharmacologic agent targeting this mechanism, suppressor of site IQ electron leak, represents a potential, practical therapy for improving sudden cardiac arrest resuscitation outcomes.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Laboratory Investigations Source Type: research
PERIPARTUM CARDIAC complications account for 41% of all maternal deaths in the United States.1 In parturients with cardiogenic shock from peripartum cardiomyopathy, amniotic fluid embolism, and pulmonary emboli, mechanical circulatory support (MCS) devices are increasingly used. Such devices include intra-aortic balloon pumps (IABP), veno-venous and veno-arterial extracorporeal membrane oxygenation (ECMO), left ventricular assist devices, and paracorporeal ventricular assist devices (PVAD).2-4 Respiratory syndromes exacerbated by pregnancy, such as influenza-induced acute respiratory distress syndrome, are also potentially...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Research Source Type: research
AN INTRA-AORTIC balloon pump (IABP) is a temporary mechanical assist device that uses synchronized counterpulsation to improve coronary and systemic perfusion in the setting of cardiogenic shock or for perioperative support. Since its introduction in the 1960s, IABP use has become widespread owing to the increasing number of recognized indications and the relative ease of percutaneous insertion.1-3 Although its popularity has increased, an IABP continues to have complications. The following case report describes a 64-year-old man with a ruptured and entrapped IABP following a 4-vessel coronary artery bypass grafting (CABG)...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
CARDIOGENIC shock is an important health care issue associated with significant socioeconomic and financial implications. Its incidence has been rising steadily, and despite improvements in treatment, mortality remains formidable at approximately 50%.1,2 In addition, the costs associated with managing cardiogenic shock have risen rapidly to astronomical levels. A recent analysis of the Nationwide Inpatient Sample database spanning the years 2004 to 2014 revealed a 2-fold increase in discharges complicated by cardiogenic shock.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
CARDIOGENIC shock is an important health care issue associated with significant socioeconomic and financial implications. Its incidence has been rising steadily, and despite improvements in treatment, mortality remains formidable at approximately 50%.1,2 In addition, the costs associated with managing cardiogenic shock have risen rapidly to astronomical levels. A recent analysis of the Nationwide Inpatient Sample database spanning the years 2004 to 2014 revealed a 2-fold increase in discharges complicated by cardiogenic shock.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
PATIENTS UNDERGOING cardiac surgery are at risk for cardiovascular collapse from a variety of pathologies including, but not limited to, hemorrhage, tamponade, myocardial infarction, arrhythmias, or cardiogenic shock. Tension pneumothorax is a rare complication after cardiac surgery and requires prompt recognition and treatment. The subsequent case report describes an occurrence of tension pneumothorax and hemodynamic instability after the use of an airway exchange catheter (AEC) to extubate and reintubate a patient with a difficult airway following cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
CARDIOGENIC SHOCK is a state of inadequate end-organ perfusion resulting from myriad causes, including ischemia, myocarditis, acute and chronic heart failure, postcardiotomy, and post-transplantation. It is the leading cause of death among patients experiencing acute myocardial infarction, with a mortality of 40% to 50%.1 Treatment generally includes revascularization for ischemia and supportive care with inotropes, vasopressors, and fluids as needed. Refractory cardiogenic shock is defined as ongoing hypoperfusion despite the administration of multiple vasoactive medications and treatment of the underlying cause.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
CONCLUSION: In patients with cardiogenic shock after delivery, early transthoracic echocardiography is a non-invasive tool that can rapidly narrow the differential diagnosis. PMID: 31324480 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
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