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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

Use of colour Doppler and M-mode ultrasonography to confirm the location of an epidural catheter - a retrospective case series
ConclusionOur preliminary data suggest the feasibility of using colour Doppler and M-mode ultrasonography to confirm proper epidural catheter placement. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 9, 2017 Category: Anesthesiology Source Type: research

Assessing the accuracy of algorithm-derived cardiorespiratory fitness in surgical patients: a prospective cohort study
AbstractPurposeTo determine if a non-exercise algorithm-derived assessment of cardiorespiratory fitness (CRFA) accurately predicted estimated values obtained using a six-minute walk test (CRF6MWD) and the Duke Activity Status Index (CRFDASI).MethodsFollowing research ethics board approval, an observational cohort study was conducted in selected, consenting patients undergoing elective surgery. Participants completed questionnaires assessing their self-reported exercise capacity. Their height, weight, waist circumference, and vital signs were measured. A six-minute walk test was performed twice with a 45-min rest interval b...
Source: Canadian Journal of Anesthesia - January 8, 2017 Category: Anesthesiology Source Type: research

Muscular body build and male sex are independently associated with malignant hyperthermia susceptibility
This study investigated the association between MHS and muscular body build.MethodsData were obtained from existing reports in the North American Malignant Hyperthermia Registry, including the Report of Muscle Biopsy and Contracture Testing (caffeine-halothane contracture test [CHCT]) as well as Adverse Metabolic or Muscular Reaction to Anesthesia (AMRA) reports. Malignant hyperthermia susceptible individuals were compared with MH negative individuals with regard to body build and reason for testing. Males were also compared with females. Both the CHCT and the AMRA forms were reviewed for comments.ResultsOf the 1,292 indiv...
Source: Canadian Journal of Anesthesia - January 5, 2017 Category: Anesthesiology Source Type: research

The “war on drugs” you did not hear about: the global crisis of access to essential anesthesia medications
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 3, 2017 Category: Anesthesiology Source Type: research

Erratum to: Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 3, 2017 Category: Anesthesiology Source Type: research

Access to controlled medicines for anesthesia and surgical care in low-income countries: a narrative review of international drug control systems and policies
ConclusionImproving the capacity and quality of anesthesia care in low- and middle-income countries requires attention to improving access to controlled medicines. Anesthesiologists and others involved in global health work should collaborate with policymakers and others to improve national and international drug control legislation to ensure that attempts to thwart illicit drug trafficking and use do not compromise availability of controlled medicines. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 2, 2017 Category: Anesthesiology Source Type: research

Low dose intravenous dexamethasone (4 mg and 10 mg) significantly prolongs the analgesic duration of single-shot interscalene block after arthroscopic shoulder surgery: a prospective randomized placebo-controlled study
This study evaluated the impact of intravenous dexamethasone (4 mg and 10 mg) on the analgesic duration of single-shot interscalene block after arthroscopic shoulder surgery. We hypothesized that both doses would prolong the analgesic duration compared with placebo.MethodsThis was a prospective double-blind randomized placebo-controlled study in patients undergoing elective arthroscopic shoulder surgery under regional anesthesia with a single-shot interscalene block (0.5% ropivacaine 20 mL). Patients received dexamethasone 4 mg (D4), dexamethasone 10 mg (D10), or a placebo (normal saline [NS]) intravenously at the time of ...
Source: Canadian Journal of Anesthesia - January 2, 2017 Category: Anesthesiology Source Type: research

The effectiveness of apneic oxygenation during tracheal intubation in various clinical settings: a narrative review
ConclusionSixteen of the 19 studies showed that apneic oxygenation prolongs safe apneic time and reduces the incidence of arterial oxygen desaturation. Overall, studies in this review show that apneic oxygenation prolongs the time to oxygen desaturation during tracheal intubation. Nevertheless, the majority of the studies were small in size, and they neither measured nor were adequately powered to detect adverse respiratory events or other serious rare complications. Prolonged apneic oxygenation (with its consequent hypercarbia) can have risks and should be avoided in patients with conditions such as increased intracranial...
Source: Canadian Journal of Anesthesia - January 2, 2017 Category: Anesthesiology Source Type: research

Participation of Canadian anesthesiology departments in undergraduate medical education
ConclusionThe contribution of anesthesiology departments to pre-clerkship has increased over the past fifteen years but remains much less than expected based on proportional faculty size. While the increase is encouraging, the relatively poor engagement is concerning, representing not only a missed opportunity but also a possible threat to the academic standing of the profession. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 28, 2016 Category: Anesthesiology Source Type: research

Anesthesia considerations for patients with an implanted deep brain stimulator undergoing surgery: a review and update
ConclusionThe anesthesiologist plays an important role to ensure a safe operating environment for patients with an implanted DBS device. Pertinent issues include identifying the type of device, involving a DBS-trained physician, turning off the device intraoperatively, implementing precautions when using electrosurgical equipment, and checking the device postoperatively. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

Outcomes of elderly critically ill medical and surgical patients: a multicentre cohort study
ConclusionsIn this large sample of critically ill medical and surgical patients, the admission SOFA score and hospital lengths of stay were not different between the two groups, but medical patients had longer ICU lengths of stay and higher ICU and hospital mortality than surgical patients. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

Transforaminal migration of an epidural catheter
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

The effect of verbal and video feedback on learning direct laryngoscopy among novice laryngoscopists: a randomized pilot study
ConclusionThis pilot study establishes feasibility and provides a sample size estimate for a future RCT. Required modifications to the study protocol include wider hospital involvement and consideration regarding standardization of airway education, teaching, feedback, and patient characteristics. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

Con: Pure service delivery is no longer needed in global surgical missions
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

Glottic impersonation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

Preventing intravenous bag contamination
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 26, 2016 Category: Anesthesiology Source Type: research

Pro: Pure service delivery is still needed in global surgery missions
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 21, 2016 Category: Anesthesiology Source Type: research