Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2017
Massive Transfusion Protocols: A Survey of Academic Medical Centers in the United States.
Massive transfusion protocols (MTPs) have been adopted in many hospitals, and they may improve outcomes, as well as decrease the number of blood products transfused. However, there are no specific guidelines regarding the number and types of products that should be included in these protocols. MTPs may vary from hospital to hospital. ⋯ One-hundred percent of survey respondents had an MTP in place. Despite a lack of published guidelines regarding MTPs, the survey results demonstrated substantial uniformity in numbers of products and target transfusion ratios.
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Anesthesia and analgesia · Jan 2017
The Need to Apply Medical Device Informatics in Developing Standards for Safe Interoperable Medical Systems.
Medical device and health information technology systems are increasingly interdependent with users demanding increased interoperability. Related safety standards must be developed taking into account these systems' perspective. In this article, we describe the current development of medical device standards and the need for these standards to address medical device informatics. ⋯ These examples illustrate the clinical implications of the failure to capture important signals and device attributes. We provide recommendations relating to the coordination between historically separate standards development groups, some of which focus on safety and effectiveness and others focus on health informatics. We identify the need for a shared understanding among stakeholders and describe organizational structures to promote cooperation such that device-to-device interactions and related safety information are considered during standards development.
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Anesthesia and analgesia · Jan 2017
Comparative StudySevoflurane Abolishes Oxygenation Impairment in a Long-Term Rat Model of Acute Lung Injury.
Patients experiencing acute lung injury (ALI) often need mechanical ventilation for which sedation may be required. In such patients, usually the first choice an intravenously administered drug. However, growing evidence suggests that volatile anesthetics such as sevoflurane are a valuable alternative. In this study, we evaluate pulmonary and systemic effects of long-term (24-hour) sedation with sevoflurane compared with propofol in an in vivo animal model of ALI. ⋯ Long-term sedation with sevoflurane compared with propofol improves oxygenation and attenuates the inflammatory response in LPS-induced ALI. Our findings suggest that sevoflurane may improve lung function when used for sedation in patients with ALI.