Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2019
Comparative StudyNational Trends and Factors Associated With Inpatient Mortality in Adult Patients With Opioid Overdose.
The prevalence of opioid misuse and opioid-related mortality has increased dramatically over the past decade. There is limited evidence on factors associated with mortality from opioid overdose in the inpatient setting. The primary objective was to report national trends in opioid overdose and mortality. The secondary objectives were to explore factors associated with inpatient mortality and report differences in prescription opioid overdose (POD) versus illicit opioid overdose (IOD) cohorts. ⋯ The increase in mortality provides a strong basis for further risk reduction strategies and intervention program implementation. Medical management of not only the opioid overdose but also the comorbidities calls for a multidisciplinary approach that involves policy makers and health care teams.
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Anesthesia and analgesia · Jan 2019
Intraoperative Hemodynamic and Echocardiographic Measurements Associated With Severe Right Ventricular Failure After Left Ventricular Assist Device Implantation.
Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF. ⋯ Post-chest closure values of CVP and PAPi were significantly associated with severe RVF. Echocardiographic assessment of RV function post-CPB was weakly associated with severe RVF.
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Anesthesia and analgesia · Jan 2019
Comparative StudyTrainability of Cricoid Pressure Force Application: A Simulation-Based Study.
Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP. ⋯ At baseline, performance was poor at achieving target forces specified by national guidelines. Simulation-based training improved the success rate, but no participant achieved the predefined threshold for proficiency.
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Gender inequity is still prevalent in today's medical workforce. Previous studies have investigated the status of women in academic anesthesiology. The objective of this study is to provide a current update on the status of women in academic anesthesiology. We hypothesized that while the number of women in academic anesthesiology has increased in the past 10 years, major gender disparities continue to persist, most notably in leadership roles. ⋯ Gender disparities continue to exist at the upper levels of leadership in academic anesthesiology, most importantly in the roles of full professor, department chair, and journal editors. However, there are some indications that women may be on the path to leadership parity, most notably, the growth of women in anesthesiology residencies and faculty positions and increases in major research grants awarded to women.