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Closing the gap: applying the Theoretical Domains Framework to improve knowledge translation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

A comparison of methods for determining the ventilatory threshold: implications for surgical risk stratification
AbstractPurposeThe ventilatory threshold (VT) is an objective physiological marker of the capacity of aerobic endurance that has good prognostic applications in preoperative settings. Nevertheless, determining the VT can be challenging due to physiological and methodological issues, especially in evaluating surgical risk. The purpose of the current study was to compare different methods of determining VT and to highlight the implications for assessing perioperative risk.MethodsOur study entailed analysis of 445 treadmill cardiopulmonary exercise tests from 140 presurgical candidates with an aortic abdominal aneurysm ( ≥...
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

A randomized comparison between costoclavicular and paracoracoid ultrasound-guided infraclavicular block for upper limb surgery
ConclusionCostoclavicular and paracoracoid ultrasound-guided infraclavicular blocks resulted in similar onset times. Furthermore, no intergroup differences were found in terms of performance times and success rates. Future dose-finding trials are required to elucidate the minimum effective volume of local anesthetic for costoclavicular infraclavicular blocks. This trial was registered atwww.clinicaltrials.in.th (Study ID: TCTR20160525001). (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Manual of ICU Procedures
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Deep anesthesia: too much of a good thing?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Performance feedback in anesthesia: a post-implementation survey
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Parkinsonism-hyperthermia syndrome and deep brain stimulation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

In reply: Parkinsonism-hyperthermia syndrome and deep brain stimulation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Cardiac surgery-associated acute kidney injury: tools for enriching clinical trial populations
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 12, 2017 Category: Anesthesiology Source Type: research

A systematic review of vasopressor blood pressure targets in critically ill adults with hypotension
AbstractPurposeClinicians must balance the risks from hypotension with the potential adverse effects of vasopressors. Experts have recommended a mean arterial pressure (MAP) target of at least 65 mmHg, and higher in older patients and in patients with chronic hypertension or atherosclerosis. We conducted a systematic review of randomized-controlled trials comparing highervs lower blood pressure targets for vasopressor therapy administered to hypotensive critically ill patients.MethodsWe searched MEDLINE ®, EMBASE™, and the Cochrane Central Register of Controlled Trials for studies of highervs lower blood pressure...
Source: Canadian Journal of Anesthesia - May 11, 2017 Category: Anesthesiology Source Type: research

CCCS-SSAI WikiRecs Clinical Practice Guideline: vasopressor blood pressure targets in critically ill adults with hypotension
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2017 Category: Anesthesiology Source Type: research

CCCS-SSAI WikiRecs Clinical Practice Guideline: vasopressors in early traumatic shock
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2017 Category: Anesthesiology Source Type: research

The next frontier in critical care guidelines: rapid and trustworthy recommendations
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2017 Category: Anesthesiology Source Type: research

Perioperative implications of thoracic decortications: a retrospective cohort study
ConclusionThere has been a ninefold increase in decortications over an eight-year period. Potential causes include an increase in the incidence of pneumonia, increased organism virulence, host changes, and changes in practice patterns. Patients undergoing decortication for infectious causes had an increased risk for adverse perioperative outcomes. Anesthesiologists need to be aware of the high perioperative morbidity of these patients and the potential need for postoperative admission to an intensive care unit. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 10, 2017 Category: Anesthesiology Source Type: research

Barriers to collaborative anesthetic care between anesthesiologists and nurses on the labour and delivery unit: a study using a modified Delphi technique
This study also shows the feasibly of using the modified Delphi technique in L&D units seeking to improve collaborative care. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 5, 2017 Category: Anesthesiology Source Type: research

Anesthesia bronchoscopes and CSA Standard Z314.8-14
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 4, 2017 Category: Anesthesiology Source Type: research

In reply: Anesthesia bronchoscopes and CSA Standard Z314.8-14
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 4, 2017 Category: Anesthesiology Source Type: research

Development of a Canadian deceased donation education program for health professionals: a needs assessment survey
ConclusionsBoth ICU nurses and ER practitioners expressed low comfort levels with their competencies regarding organ donation. Intensive care unit physicians had a much higher level of comfort; however, the majority of these respondents were specialty trained and working in academic centres with active donation and transplant programs. A national organ donation curriculum is needed. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 3, 2017 Category: Anesthesiology Source Type: research

Harold Griffith ’s legacy: a tribute on the 75 th anniversary of the introduction of curare into anesthetic practice
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 2, 2017 Category: Anesthesiology Source Type: research

Airway management outside the operating room: how to better prepare
This article provides a practical review of how that evidence applies during emergency airway management outside of the operating room. To counter the challenges of airway management outside the operating room, we offer a mnemonic that combines both technical and non-technical insights summarized using the seven letters of the word PREPARE (P: pre-oxygenate/position; R: reset/resist; E: examine/explicit; P: plan A/B; A: adjust/attention; R: remain/review; E: exit/explore). We hope it can unite potentially disparate personnel with a structure that allows them to make acute decisions, coordinate action, and communicate unequ...
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Proper use and interpretation of diaphragmatic ultrasonography
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Practical dosing of propofol in morbidly obese patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Content analysis of resident evaluations of faculty anesthesiologists: supervision encompasses some attributes of the professionalism core competency
ConclusionsThe de Oliveira Filho clinical supervision scale includes some attributes of anesthesiologists ’ professionalism. The core competency of professionalism, however, is multidimensional, and the supervision scale and/or residents’ comments did not address many of the other established attributes of professionalism. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Mycobacterium infection from a cardiopulmonary bypass heater-cooler unit in a patient with steroid-induced immunosuppression
ConclusionHeater-cooler units manufactured by LivaNova prior to September 2014 and used during cardiopulmonary bypass have been linked toM. chimera, which causes a latent infection that may be activated and become disseminated in cases of immunosuppression related to steroid use. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

In reply: Proper use and interpretation of diaphragmatic ultrasonography
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Assessment of fluid responsiveness with end-tidal carbon dioxide using a simplified passive leg-raising maneuver: a prospective observational study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Erratum to: Access to controlled medicines for anesthesia and surgical care in low-income countries: a narrative review of international drug control systems and policies
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Erratum to: The effectiveness of apneic oxygenation during tracheal intubation in various clinical settings: a narrative review
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

In reply: Assessment of fluid responsiveness with end-tidal carbon dioxide using a simplified passive leg-raising maneuver: a prospective observational study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research

Difficultintubationapp.com version 2.0: difficult airway app?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 8, 2017 Category: Anesthesiology Source Type: research

A survey of focused cardiac ultrasonography training in Canadian anesthesiology residency programs
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 8, 2017 Category: Anesthesiology Source Type: research

In reply: Difficultintubationapp.com version 2.0: difficult airway app?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 8, 2017 Category: Anesthesiology Source Type: research

Propofol induction: normalizing the dose in morbidly obese patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 2, 2017 Category: Anesthesiology Source Type: research

Emergency thromboembolectomy for a massive saddle embolism crossing an atrial septal defect
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 1, 2017 Category: Anesthesiology Source Type: research

Perioperative isoproterenol infusion in a patient with Brugada syndrome
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 31, 2017 Category: Anesthesiology Source Type: research

Janeway lesions and Osler ’s nodes: an indication for prompt transesophageal echocardiography
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 31, 2017 Category: Anesthesiology Source Type: research

Emergency Echocardiography, Second Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 30, 2017 Category: Anesthesiology Source Type: research

Successful treatment of inadvertent subclavian artery cannulation by arterial closure device
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 30, 2017 Category: Anesthesiology Source Type: research

Essential Echocardiography: Transesophageal Echocardiography for Non-Cardiac Anesthesiologists
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 29, 2017 Category: Anesthesiology Source Type: research

Electronic reminders for intraoperative antibiotic re-dosing
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 26, 2017 Category: Anesthesiology Source Type: research

Atlas of Pain Management Injection Techniques, Fourth Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 23, 2017 Category: Anesthesiology Source Type: research

Anesthetic considerations for patients with esophageal achalasia undergoing peroral endoscopic myotomy: a retrospective case series review
This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND).MethodsOne hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study. Procedure-related changes in peak inspiratory pressure (pmax), end-tidal CO2 levels (etCO2), minute ventilation (MV), mean arterial pressure (MAP), and heart rate (HR) were analyzed. We also quantified the impact of PND on these cardiorespiratory parameters.ResultsDuring the endoscopic procedure, cardiorespiratory parameters increased from baseline: pmax 1...
Source: Canadian Journal of Anesthesia - January 22, 2017 Category: Anesthesiology Source Type: research

Central retinal artery occlusion after percutaneous nephrolithotomy lithotripsy in the prone position
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 16, 2017 Category: Anesthesiology Source Type: research

Mentorship in anesthesia: a survey of perspectives among Canadian anesthesia residents
ConclusionOur study confirms that, despite positive perceptions among residents, mentorship remains underutilized in anesthesia programs. We identify barriers to effective mentorship, including the need to consider resident choice as a means to improve formal anesthesia mentorship programs. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 12, 2017 Category: Anesthesiology Source Type: research

Impact of celecoxib on inflammation during cancer surgery: a randomized clinical trial
DiscussionStandard dosing of the cyclooxygenase-2 inhibitor celecoxib slightly reduced perioperative cyclooxygenase activity during cancer surgery. Given cyclooxygenase ’s role in cancer pathways, we recommend dose-finding studies be undertaken before prospective clinical trials are conducted testing the currently unsubstantiated hypothesis that perioperative anti-inflammatory administration improves long-term cancer outcomes. This trial was registered at: Austra lian New Zealand Clinical Trial Registry: ACTRN12615000041550;www.anzctr.org.au (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 12, 2017 Category: Anesthesiology Source Type: research

Abstracts 2016
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2017 Category: Anesthesiology Source Type: research

Postoperative real-time electrocardiography monitoring detects myocardial ischemia: a case report
ConclusionThis case report illustrates the use of remote ECG monitoring and clinician response in real time with the use of a smartphone. With each alert, a small ECG strip is transmitted to the smartphone for viewing. In our view, this technology and management system provides a possible means to interrupt myocardial ischemic cascades in real time and prevent postoperative myocardial infarction. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2017 Category: Anesthesiology Source Type: research

Epistaxis during nasotracheal intubation: a randomized trial of the Parker Flex-Tip ™ nasal endotracheal tube with a posterior facing bevel versus a standard nasal RAE endotracheal tube
ConclusionThere was no difference in the incidence or severity of epistaxis following nasal intubation using the Parker Flex-Tip nasal ETT when compared with a standard nasal RAE ETT. This trial was registered at ClinicalTrials.gov, identifier: NCT02315677. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2017 Category: Anesthesiology Source Type: research

Disruptive behaviour in the perioperative setting: a contemporary review
ConclusionsDisruptive behaviour remains a part of operating room culture, with many associated deleterious effects. There is a widely accepted view that disruptive behaviour can lead to increased patient morbidity and mortality. This is mechanistically plausible, but more rigorous studies are required to confirm the effects and estimate their magnitude. An important measure that individual clinicians can take is to monitor and control their own behaviour, including their responses to disruptive behaviour. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2017 Category: Anesthesiology Source Type: research

Non-opioid anesthetic drug abuse among anesthesia care providers: a narrative review
ConclusionEarly detection, effective therapy, and long-term follow-up help ACPs cope more effectively with the problem and, when possible, resume their professional activities. There is insufficient evidence to determine the ability of ACPs to return safely to anesthesia practice after rehabilitation, though awareness of the issue and ongoing treatment are necessary to minimize patient risk from potentially related clinical errors. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2017 Category: Anesthesiology Source Type: research