Surrogate indices of aortic peak systolic velocity variation to monitor fluid responsiveness in pediatric non-cardiac surgery: a prospective observational study
AbstractAortic peak systolic velocity variation ( ΔVpeakAo) is a reliable dynamic indicator of preload in mechanically ventilated children. However, easily measurable alternative parameters like carotid peak systolic velocity variation ( ΔVpeakCa) and suprasternal peak systolic velocity variation ( ΔVpeakSs) are not well evaluated in children. The aim of the study was to find correlation between ΔVpeakCa and ΔVpeakSs to ΔVpeakAo, as potential surrogate markers of fluid responsiveness. 52 children, 1 –12 years old, undergoing major non-cardiac surgeries under general endotracheal anaesthesia were recruited for this single-centre prospective observational study. ΔVpeakAo, ΔVpeakCa and ΔVpeakSs were measured by pulsed wave Doppler in appropriate windows, measuring maximum and minimum peak flow velocity over a single respiratory cycle. Calculated parameters were compared by a repeated measures study design. Correlation coefficients were 0.82 between ΔVpeakAo and ΔVpeakSs and 0.73 between ΔVpeakAo and ΔVpeakCa. Bland –Altman analysis showed minimal bias of 1.86 percentage points with limits of agreement of 11.21 to − 7.49 (ΔVpeakAo and ΔVpeakSs) and 3.93 percentage points with limits of agreement of 14.04 to − 6.18 (ΔVpeakAo and ΔVpeakCa). ΔVpeakSs and ΔVpeakCa also showed good discrimination to predict ΔVpeakAo (lying i...
Regional anesthesia (RA)-induced vasodilation increases the proportion of patients with vein anatomy suitable for arteriovenous fistula (AVF) creation. The functional outcomes of AVFs created with veins initially small for size on preoperative duplex ultrasound mapping ( ≤2.4 mm) that are recruited under RA have not been clearly defined. We aimed to evaluate freedom from revision or thrombosis, time to first cannulation, and reintervention rates of AVFs created with veins recruited after induction of RA.
ConclusionsThese GCaMP6 transgenic lines thus provide useful tools for functional analysis of neuronal circuits in both central and peripheral nervous systems.
Compared with placebo, cannabinoids show no improvement in pain scores in adult cancer patients
Peer - delivered program tied to improvements in quality of life, physical activity, pain
Watching news this morning and the NP commercial came on. Patients talking about how close they are to their NPs and prefer them. Consider an NP. “When patients choose, patients win” is their tag line. When the hell are WE going to do a commercial to promote us? Or is that not allowed lest we upset our colleague PROVIDERS? We need to play fire with fire.
Hello. Coming over from the surgery world. I’d like to start by saying that I have been a long time reader of this forum and highly respect the expertise and opinions of many of you seasoned anesthesiologists on this board. Your comments on a variety of topics have been some of the most intelligent and well thought out on the internet period. I am switching to anesthesia after a few years from a surgical subspecialty. I am on a research year and have applied to both advanced and R... Ranking: Should I delay start of CA1 year (Advanced vs. R Position?)
Hey everyone, I have question about dead space. In a healthy patient, the number I read is that the dead space is about 25-30% of the tidal volume. But, when you actually calculate the ratio of dead space to tidal volume (Vd/Vt) in a healthy patient, you get a much smaller number. The formula I am using is (Vd/Vt) = (PaCO2 - EtCO2)/PaCO2. In a healthy patient, we say the difference between End tidal CO2 and PaCO2 is about 3-5. Assuming EtCO2 is 35, and PaCO2 is 40, you get (40-35)/40... Question about Dead Space
We are looking for 1 cardiac anesthesiologist to round out our recruiting efforts. The job is a newly formed partnership at Abbott Northwestern Hospital, a quaternary care center in Minneapolis. The case mix includes ~1000 bypass cases annually including LVADs and heart transplants. Approximately 50% of clinical time would be cardiac and the rest covering an attached 38-suite main OR and attached dedicated OB hospital. Approximate start date of June 30 but flexible. Please contact... Seeking Cardiac Anesthesiologist for Partnership Track (Minneapolis)
Conclusions: Our study demonstrated that the rich-club reorganization in functional brain networks is characterized by switching of rich-club nodes between the high-order cognitive and sensory and motor networks during propofol-induced alteration of consciousness and natural sleep. These findings will help understand the common neurological mechanism of pharmacological and physiological unconsciousness.
Most medical devices that are placed within the gastrointestinal tract have to be removed eventually. Such procedures can be challenging to perform and require anesthesia, with all its associated risks and costs. For example, thousands of bariatric b...