Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2023
Hyperoxia Increases Kidney Injury During Renal Ischemia and Reperfusion in Mice.
Renal ischemia and reperfusion (IR) contribute to perioperative acute kidney injury, and oxygen is a key regulator of this process. We hypothesized that oxygen administration during surgery and renal IR would impact postoperative kidney function and injury in mice. ⋯ In this controlled preclinical study of oxygen treatment during renal IR surgery, hyperoxia and hypoxia impaired renal function, increased renal injury, and impacted expression of genes that affect mitochondrial biogenesis and antioxidant response. These results might have implications for patients during surgery when high concentrations of oxygen are frequently administered, especially in cases involving renal IR.
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Profound racial and ethnic disparities have been documented in health and health care outcomes in recent decades. Some researchers have erroneously ascribed these inequities to biological variations, prompting debate as to how, or even if, race and ethnicity should be included as an outcome variable. ⋯ Color consciousness, in contrast, approaches disparities with the knowledge that experiences related to one's race and ethnicity influence an individual's health and well-being. In this Pro-Con commentary article, we discuss the concept of color blindness and debate its use as an approach in medicine and research.
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Anesthesia and analgesia · Nov 2023
Associations Between Fresh Gas Flow and Duration of Anesthetic on the Maximum Potential Benefit of Anesthetic Gas Capture in Operating Rooms and in Postanesthesia Care Units to Capture Waste Anesthetic Gas.
Sevoflurane and desflurane are halogenated hydrocarbons with global warming potential. We examined the maximum potential benefit assuming 100% efficiency of waste gas capture technology used in operating rooms and recovery locations. ⋯ Simulations with Gas Man show a strong rationale based on agent uptake and distribution for using volatile anesthetic agent capture in operating rooms if the technology can be highly efficient at volatile agent recovery.
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Capnography is an essential tool used in the monitoring of patients during anesthesia and in critical care which, while required in most high-income countries, is unavailable in many low- and middle-income countries. Launched in 2020, the Smile Train-Lifebox Capnography Project aimed to find a "capnography solution" for resource-poor settings. The project was specifically interested in a capnography device that would meet the needs of the Smile Train partner hospitals to help monitor children requiring airway or cleft surgery. ⋯ These materials were piloted in Ethiopia, subsequently modified, and endorsed by the education team. The device is now ready for distribution, with the accompanying education package, to the Smile Train network and beyond. In addition, a study is being planned to measure the impact of capnography introduction into operating rooms in resource-constrained settings.