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Source: British Journal of Anaesthesia
Procedure: Anesthesia

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Total 66 results found since Jan 2013.

Is postspinal hypotension a sign of impaired cardiac performance in the elderly? An observational mechanistic study
Conclusions. A decrease in cardiac output from baseline before spinal anaesthesia and an inability to increase it after induction may be important features of postspinal hypotension in elderly patients.
Source: British Journal of Anaesthesia - October 10, 2017 Category: Anesthesiology Source Type: research

Novel method for intraoperative assessment of cerebral autoregulation by paced breathing
Conclusions. During surgery, cerebral autoregulation indices were similar to values determined before surgery. This indicates that CA can be quantified reliably and non-invasively using this novel method and confirms earlier evidence that CA is unaffected by sevoflurane anaesthesia.Clinical trial registration. NCT03071432.
Source: British Journal of Anaesthesia - October 6, 2017 Category: Anesthesiology Source Type: research

Lack of benefit of near-infrared spectroscopy monitoring for improving patient outcomes. Case closed?
Near-infrared spectroscopy (NIRS) monitoring of regional cerebral oxygen saturation (rSco2) during cardiac surgery has been available to clinicians for more than three decades.12 This monitoring is attractive because it is non-invasive, requires minimal user technical expertise, provides an intuitively important end point (oxygenation of the superficial cerebral cortex), and has a continuous output. As a result of these features, NIRS monitoring overcomes many of the limitations of existing monitors for judging adequacy of cerebral perfusion during surgery [(particularly, throughout cardiopulmonary bypass (CPB)], such as e...
Source: British Journal of Anaesthesia - September 8, 2017 Category: Anesthesiology Source Type: research

Comparison of two stroke volume variation-based goal-directed fluid therapies for supratentorial brain tumour resection: a randomized controlled trial
ConclusionsDuring GDFT for supratentorial brain tumour resection, fluid boluses targeting a lower SVV are more beneficial than a restrictive protocol.Clinical trial registrationNCT02113358.
Source: British Journal of Anaesthesia - July 17, 2017 Category: Anesthesiology Source Type: research

Some light in the grey zone?
Treatment of shock is not a new concern in intensive care medicine. The highest priority in patients with shock is the restoration of oxygen delivery. Fluid resuscitation is the very first goal of increasing cardiac output and oxygen delivery in patients with acute circulatory insufficiency. First, based on the simple physiology of the Frank –Starling mechanism, fluid loading should increase cardiac output (CO) by increasing preload and subsequently increasing left ventricular (LV) stroke volume.1 However, fluid overload, especially in patients with pre-existing or developing cardiac failure, can end in only a fractional...
Source: British Journal of Anaesthesia - June 28, 2017 Category: Anesthesiology Source Type: research

Predictor of fluid responsiveness in the ‘grey zone’: augmented pulse pressure variation through a temporary increase in tidal volume
Conclusion: In mechanically ventilated patients, our augmented PPV successfully predicted fluid responsiveness in the previously suggested grey zone.Clinical trial registration: ClinicalTrials.gov, NCT02653469.
Source: British Journal of Anaesthesia - June 28, 2017 Category: Anesthesiology Source Type: research

Elevated preoperative heart rate is associated with cardiopulmonary and autonomic impairment in high-risk surgical patients
Conclusions. Elevated preoperative heart rate is associated with impaired cardiopulmonary performance consistent with clinically unsuspected, subclinical cardiac failure.Clinical trial registration. ISRCTN88456378.
Source: British Journal of Anaesthesia - June 28, 2017 Category: Anesthesiology Source Type: research

Oesophageal Doppler guided goal-directed haemodynamic therapy in thoracic surgery - a single centre randomized parallel-arm trial
Conclusions: Compared to standard haemodynamic management, oesophageal Doppler monitor-guided GDT was associated with fewer postoperative pulmonary complications and a shorter hospital stay.Clinical trial registration. The study was registered in the German Clinical Trials Register (DRKS 00006961).https://drks-neu.uniklinik-freiburg.de/drks_web/
Source: British Journal of Anaesthesia - June 2, 2017 Category: Anesthesiology Source Type: research

Effects of arterial load variations on dynamic arterial elastance: an experimental study
Conclusions. Acute modifications of arterial load induced significant changes on Eadyn; vasodilatation increased Eadyn, whereas vasoconstriction decreased it. The Eadyn was associated with both arterial load and cardiac factors, suggesting that Eadyn should be more properly considered as a ventriculo-arterial coupling index.
Source: British Journal of Anaesthesia - June 2, 2017 Category: Anesthesiology Source Type: research

Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis
AbstractViscoelastic point-of-care tests are commonly used to provide prompt diagnosis of coagulopathy and allow targeted treatments in bleeding patients. We updated existing meta-analyses that have evaluated the clinical effectiveness of viscoelastic point-of-care testsvs the current standard of care for the management of cardiac surgery patients at risk of coagulopathic bleeding. Randomized controlled trials comparing viscoelastic point-of-care diagnostic testing with standard care in cardiac surgery patients were sought. All-cause mortality, blood loss, reoperation, blood transfusion, major morbidity, and intensive care...
Source: British Journal of Anaesthesia - May 14, 2017 Category: Anesthesiology Source Type: research

Comparison of bioreactance and echocardiographic non-invasive cardiac output monitoring and myocardial function assessment in primagravida women
Conclusions. Stroke volume and CO measurements obtained using NICOM® were comparable to those obtained using echocardiography, with acceptable limits of agreement. Increased maternal BMI negatively impacts LV diastolic function measured using tissue Doppler imaging.
Source: British Journal of Anaesthesia - April 8, 2017 Category: Anesthesiology Source Type: research

Meta-analyses of Bland–Altman-style cardiac output validation studies: good, but do they provide answers to all our questions?
No one would deny the need for safe, reliable, and non-invasive cardiac output (CO) monitoring in anaesthesia and acute medicine. Measuring CO, or better still stroke volume (SV), adds a further dimension to haemodynamic monitoring as it completes the circulatory equation BP=CO×PR, where BP is blood pressure, PR is peripheral resistance, CO=SV×HR, and HR is heart rate. Clinical use of the pulmonary artery thermodilution catheter has been in decline since the 1990s,<a href="#aew442-B1" class="reflinks">1</a> and newer, less invasive technologies have ...
Source: British Journal of Anaesthesia - February 15, 2017 Category: Anesthesiology Source Type: research

Effect of beta-blockers on perioperative outcomes in vascular and endovascular surgery: a systematic review and meta-analysis
Conclusions. Beta-blockers do not improve perioperative outcomes in vascular and endovascular surgery.
Source: British Journal of Anaesthesia - December 29, 2016 Category: Anesthesiology Authors: Hajibandeh, S., Hajibandeh, S., Antoniou, S. A., Torella, F., Antoniou, G. A. Tags: Review Articles Source Type: research

Non-invasive assessment of fluid responsiveness using CNAP™ technology is interchangeable with invasive arterial measurements during major open abdominal surgery
Conclusions. Non-invasive assessment of FR using PPVCNAP seems to be interchangeable with PPVPiCCO in patients undergoing major open abdominal surgery. Clinical trial registration. NCT02166580.
Source: British Journal of Anaesthesia - December 29, 2016 Category: Anesthesiology Authors: Renner, J., Gruenewald, M., Hill, M., Mangelsdorff, L., Aselmann, H., Ilies, C., Steinfath, M., Broch, O. Tags: Cardiovascular Source Type: research

Electrical impedance tomography for non-invasive assessment of stroke volume variation in health and experimental lung injury
Conclusions. EIT provides automated calculation of a dynamic preload index of fluid responsiveness (SVVEIT) that is non-invasively derived from a central haemodynamic signal. However, alterations in thoracic impedance induced by lung injury influence this method.
Source: British Journal of Anaesthesia - December 29, 2016 Category: Anesthesiology Authors: Trepte, C. J. C., Phillips, C., Sola, J., Adler, A., Saugel, B., Haas, S., Bohm, S. H., Reuter, D. A. Tags: Cardiovascular Source Type: research

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