Anesthesiology
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Comparative Study
Strict glucose control does not affect mortality after aneurysmal subarachnoid hemorrhage.
The effects of both hyperglycemia and hypoglycemia are deleterious to patients with neurologic injury. ⋯ The initiation of a tight glucose control regimen lowered average glucose levels but had no effect on overall in-hospital mortality.
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Comparative Study
Intraoperative fraction of inspired oxygen is a modifiable risk factor for surgical site infection after spinal surgery.
Surgical site infections (SSI) after spinal surgery increase morbidity, mortality, length of hospital stay, and costs. Most previously identified risk factors for these infections, such as severity of illness and procedure duration, are not amenable to intervention. This study sought to identify modifiable risk factors associated with SSI after spinal surgery. ⋯ In addition to previously reported risk factors, this study identified intraoperative administered fraction of inspired oxygen of less than 50% as an independent, modifiable risk factor for SSI after spinal surgery. Intraoperative administration of at least 50% fraction of inspired oxygen should be tested prospectively as an intervention to prevent SSI after spinal surgery.
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Comparative Study
Anesthesiology trainees face ethical, practical, and relational challenges in obtaining informed consent.
Categorizing difficulties anesthesiologists have in obtaining informed consent may influence education, performance, and research. This study investigated the trainees' perspectives and educational needs through a qualitative analysis of narratives. ⋯ The ethical, practical, and relational challenges in obtaining informed consent colored trainees' views of patient care and affected their interactions with patients. Using participant narratives personalizes education and motivates participants. The richness of narratives may help anesthesiologists to appreciate the qualitative aspects of informed consent.