Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial Article: Howard Dittrick: curator to the McMechans' legacy journal.
A noted medical historian and museum curator, Canadian American Howard Dittrick was a Cleveland gynecologist who served as Directing Editor of Current Researches in Anesthesia and Analgesia (1940-1954). In the aftermath of World War II, even after Congresses of Anesthetists had resumed, Dittrick and his editorial board allowed their yellow, then tan-covered journal, the so-called "yellow peril," to languish into near irrelevance.
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Anesthesia and analgesia · Dec 2012
Case ReportsCase report: an unforeseen peril of parental presence during induction of anesthesia.
Parental presence during induction of anesthesia is a common practice to allay perioperative anxiety in the pediatric population. We present the first documented case in the anesthesia literature of parental interruption of induction of anesthesia. The report is to inform practitioners of the need for perioperative screening, education, and contingency planning to prepare for the possibility of familial disruption during pediatric inductions, cesarean deliveries, and other practice settings that may have lay people present.
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Anesthesia and analgesia · Dec 2012
The accuracy of noninvasive hemoglobin monitoring using the radical-7 pulse CO-Oximeter in children undergoing neurosurgery.
The most common method for determining the hemoglobin concentration is to draw blood from a patient. However, the Radical-7 Pulse CO-Oximeter (Masimo Corporation, Irvine, CA) can noninvasively provide continuous hemoglobin concentration (SpHb). In our study we compared noninvasive measurements of SpHb with simultaneous laboratory measurements of total hemoglobin in arterial blood samples taken from children (tHb). ⋯ The Radical-7 Pulse CO-Oximeter can be useful as a trend monitor in children during surgery even immediately after intravascular volume expanders are administered. However, it is advisable to confirm the baseline hemoglobin level and to consider the influence of tHb level on the bias. In addition, one should be cautious with regard to using SpHb alone when making transfusion decisions.
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Anesthesia and analgesia · Dec 2012
A case series of recombinant platelet factor 4 for heparin reversal after cardiopulmonary bypass.
Platelet factor 4 (PF4) is released by activated platelets and has a strong affinity for heparin. Recombinant PF4 (rPF4) has been previously considered as an alternative to protamine for heparin reversal. However, it has been demonstrated that antibodies directed against the PF4/heparin moiety are important in the pathophysiologic development of heparin-induced thrombocytopenia, a prothrombotic complication for which cardiac bypass patients are at increased risk. ⋯ Our case series demonstrates that heparin anticoagulation was effectively reversed by the administration of rPF4 without serious complications. Additional studies are needed to further validate the safety and efficacy of exogenous rPF4 administration.
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial article: Francis Hoeffer McMechan, MD: creator of modern anesthesiology?
If one person can be credited with the creation of the infrastructure of modern anesthesiology, that individual would be Francis Hoeffer McMechan. He has been largely forgotten since his death in 1939 despite his remarkable and enduring accomplishments. ⋯ His accomplishments are even more amazing given the severe arthritis that left him wheelchair-bound for almost his entire professional life and denied him the ability to practice anesthesia. Our specialty owes an incredible debt to this largely unknown and unsung hero.