Anesthesiology
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Randomized Controlled Trial Multicenter Study Comparative Study
Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, A Randomized Controlled Trial.
Spinal anesthesia for neonatal hernia repair reduces the incidence of early post-operative apnea but has no effect on later apnea (30 min to 12 hours).
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Review Meta Analysis Comparative Study
Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis.
Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. ⋯ These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.
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Randomized Controlled Trial Observational Study
Effects of an Innovative Psychotherapy Program for Surgical Patients: Bridging Intervention in Anesthesiology-A Randomized Controlled Trial.
The stepped care program Bridging Intervention in Anesthesiology (BRIA) aims at motivating and supporting surgical patients with comorbid mental disorders to engage in psychosocial mental healthcare options. This study examined the efficacy of BRIA. ⋯ Among surgical patients with comorbid mental disorders, BRIA results in an increased engagement in subsequent therapy options and a decrease of general psychological distress. These data suggest that it is reasonable to integrate innovative psychotherapy programs into the context of interdisciplinary surgical care.
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Randomized Controlled Trial Comparative Study
A Randomized, Double-blinded Trial of a "Rule of Threes" Algorithm versus Continuous Infusion of Oxytocin during Elective Cesarean Delivery.
The administration of uterotonic agents during cesarean delivery is highly variable. The authors hypothesized a "rule of threes" algorithm, featuring oxytocin 3 IU, timed uterine tone evaluations, and a systematic approach to alternative uterotonic agents, would reduce the oxytocin dose required to obtain adequate uterine tone. ⋯ A "rule of threes" algorithm using oxytocin 3 IU results in lower oxytocin doses when compared with continuous-infusion oxytocin in women undergoing elective cesarean delivery.
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Comparative Study
Assessing and Comparing Anesthesiologists' Performance on Mandated Metrics Using a Bayesian Approach.
Periodic assessment of performance by anesthesiologists is required by The Joint Commission Ongoing Professional Performance Evaluation program. ⋯ Bayesian hierarchical multivariate methodology with covariate adjustment is better suited to faculty monitoring than the nonhierarchical frequentist approach.