Near-Infrared Spectroscopy and Vascular Occlusion Test for Predicting Clinical Outcome in Pediatric Cardiac Patients: A Prospective Observational Study
This study is designed to determine the feasibility and utility of vascular occlusion test variables as measured by INVOS (Medtronic, Dublin, Ireland) in pediatric cardiac patients. Design: A prospective observational study. Setting: A tertiary children’s hospital. Patients: Children less than or equal to 8 years old who were scheduled for elective cardiac surgery under cardiopulmonary bypass. Interventions: A vascular occlusion test (3 min of ischemia and reperfusion) was performed on the calf at three time points: after induction of anesthesia (T0), during cardiopulmonary bypass (T1), and after sternal closure (T2). Measurements and Main Results: Baseline regional tissue hemoglobin oxygen saturation, deoxygenation rate, minimum regional tissue hemoglobin oxygen saturation, and reoxygenation rate were measured using INVOS. Influence of age on variables at each measurement point was also checked using linear regression analysis. Receiver operating characteristics curve analysis was performed to determine the ability of vascular occlusion test variables at T2 to predict the occurrence of major adverse events. Both the deoxygenation and reoxygenation rates were lowest in T1. There was a tendency to decreased regional tissue hemoglobin oxygen saturation in younger patients at T0 (r = 0.37; p
Summary Surgery and anaesthesia might affect cognition in middle‐aged people without existing cognitive dysfunction. We measured memory and executive function in 964 participants, mean age 54 years, and again four years later, by when 312 participants had had surgery and 652 participants had not. Surgery between tests was associated with a decline in immediate memory by one point (out of a maximum of 30), p = 0.013: memory became abnormal in 77 out of 670 participants with initially normal memory, 21 out of 114 (18%) of whom had had surgery compared with 56 out of 556 (10%) of those who had not, p = 0.02. The number of o...
ConclusionAn LFCN block consisting of 8 ml 0.75% ropivacaine had limited coverage of the posterior and lateral incision lines.
This study assessed the short- and long-term impact of general anesthesia of various durations on intellectual development and cognitive performance in school age children.BMC Anesthesiology
SGLT2 inhibitors create new management challenges for anesthesiologists. What are the unique considerations for diabetic patients taking these agents perioperatively?Anesthesia &Analgesia
ConclusionsSo far examples are given for almost every possible patient position in the third trimester except the right lateral one. All the previously presented positionings (prone, left lateral) were equally effective regarding the outcome with none being better than another. For left-sided lumbar pathologies performed in the third trimester the right lateral position might be an alternative option for easier access. Based on the literature an epidural and general anesthesia can be applied successfully in the third trimester. Spinal anesthesia might be another anesthesia consideration.
ConclusionsAny obstacle or injury during the migration process of embryonic development may result in maldevelopment. If an obstacle or injury occurs during the medial migration of the medial nasal process, congenital polypoid remnant tissue may remain along the migration route, resulting in an accessory skin appendage of the nasal columella. The location of the accessory columellas ranged from the nostril sill to the soft triangle along the anterior border of the medial crus of the alar cartilage. These anatomical distributions correspond exactly to the migration route of the medial nasal process during embryonic developm...
PMID: 29461326 [PubMed - in process]
PMID: 29461325 [PubMed - in process]
PMID: 29461324 [PubMed - in process]
PMID: 29461323 [PubMed - in process]