Prewarming : Yesterday's luxury, today's minimum requirements.
[Prewarming : Yesterday's luxury, today's minimum requirements.] Anaesthesist. 2014 Apr 3; Authors: Bräuer A, Brandes IF, Perl T, Wetz AJ, Bauer M Abstract Prewarming is a useful and effective measure to reduce perioperative hypothermia. Due to §23(3) of the German Infektionsschutzgesetz (Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen, Infection Act, act on protection and prevention of infectious diseases in man) and the recommendations of the Hospital Hygiene and Infection Prevention Committee of the Robert Koch Institute, implementation of prewarming is clearly recommended. There are several technically satisfactory and practicable devices available allowing prewarming on the normal hospital ward, in the preoperative holding area or in the induction room of the operating theater (OR) The implementation of prewarming requires additional equipment and training of staff. Using a locally adapted concept for the implementation of prewarming does not lead to inefficiency in the perioperative process. In contrast, the implementation can help to achieve stable arrival times for patients in the OR. PMID: 24691948 [PubMed - as supplied by publisher]
In conclusion, isoflurane protected against BBB disruption caused by carbogen inhalation in mice and rats, but unlike isoflurane-mediated protection against ischemic BBB disruption, the effect could not be explained by anesthesia-induced hypothermia.
CONCLUSION: In children undergoing cardiac surgery in our department, the use of sevoflurane-balanced anesthesia during cardiopulmonary bypass showed no superiority of inhalational agents over total intravenous anesthesia with opioids and benzodiazepines preventing phases of superficial anesthesia, but a marked advantage for the postoperative ventilation time compared with total intravenous anesthesia. PMID: 31928325 [PubMed - as supplied by publisher]
Amber Rawat, Richa Rai, Anil K Paswan, Vaibhav PandeySaudi Journal of Anaesthesia 2020 14(1):100-103 Conjoined twins are one of the most fascinating human malformations. Here, we report the anesthetic management and challenges faced in performing the successful separation surgery of 4-day-old thoraco-omphalopagus conjoined twins, born at term to a multigravida by elective caesarean section weighing 3.5 kg with APGAR score of more than 7. Computerized tomography scan revealed fused anterior surface of the left lobe of liver with common left portal vein. Confirmation of cross-circulation between the twins was done by giving...
CONCLUSION: Reducing perioperative blood loss requires a multimodal and multidisciplinary approach. Although high-quality evidence exists in certain areas, the overall evidence base for reducing intraoperative blood loss remains limited. PMID: 31903592 [PubMed - in process]
Authors: Murata I, Imanari M, Komiya M, Kobayashi J, Inoue Y, Kanamoto I Abstract Crush syndrome (CS), a serious medical condition, which is characterized by damage to myocytes due to pressure and is associated with high mortality, even when patients receive fluid therapy. Icing therapy over the affected muscle has been reported to be effective in improving mitochondrial dysfunction and inflammation. These effects are thought to be secondary to improvements in the leakage of potassium and myoglobin from the damaged myocytes in the early stages of disease. However, their effects on the various symptoms of CS are unc...
This article will review the basic science the practical aspects of delivering targeted temperature management and evaluate the evidence behind its use for acute brain injuries. With a lack of high-quality evidence for hypothermia, recent consensus statements are shifting the paradigm away from hypothermia to the maintenance of normothermia and prevention of pyrexia.
Background: Although hypothermia is known to have protective effects against ischemic injuries, the effects of hypothermia on kidney injury have not yet been elucidated. Therefore, this study aimed to identify the association between intraoperative hypothermia and postoperative acute kidney injury (AKI) in patients who underwent spine surgery under general anesthesia. Methods: In this retrospective observational study, we analyzed the medical records of adult patients who underwent elective spine surgery between January 2010 and March 2018. Patients were classified into the normothermia group (36.5 to 37.5°C), mil...
Publication date: December 2019Source: Anaesthesia Critical Care &Pain Medicine, Volume 38, Issue 6Author(s): Romain Rozier, Vincent Bruckert, Jean-Christophe Orban
PATIENTS undergoing cardiac surgery are highly prone to reduced renal perfusion and thereby postoperative acute kidney injury (AKI). Many insults during cardiopulmonary bypass and deep hypothermic circulatory arrest result in microcirculatory and renal vasoconstriction, including continuous nonpulsatile perfusion, hypothermia, coagulopathy and hemolysis, activation of cytokine and complement inflammatory pathways, activation of the renin-angiotensin system, and pituitary secretion of arginine vasopressin in response to low-flow states.
Conclusions: At hypothermic conditions, the vessel area response to dobutamine is diminished compared to hyperthermic conditions where the vessel area response mimics normothermic dobutamine conditions. The varied response emphasizes the need to monitor and control body temperature during medical conditions or treatments that may be accompanied by hypothermia, especially when vasoactive agents are used. PMID: 31744344 [PubMed - in process]