Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2024
Developments in Transfusion Medicine: Pulmonary Transfusion Reactions and Novel Blood Cell Labeling Techniques.
Staying updated on advancements in transfusion medicine is crucial, especially in critical care and perioperative setting, where timely and accurate transfusions can be lifesaving therapeutic interventions. This narrative review explores the landscape of transfusion-related adverse events, focusing on pulmonary transfusion reactions such as transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI). TACO and TRALI are the leading causes of transfusion-related morbidity and mortality; however, specific treatments are lacking. ⋯ Despite advancements, significant gaps remain in our understanding of what occurs during transfusions, highlighting the necessity for improved monitoring methods. To address this, the review also presents novel blood cell labeling techniques in transfusion medicine used for improving monitoring, quality assessment, and as a consequence, potentially reducing transfusion-related complications. This article aims to provide an update for anesthesiologists, critical care specialists, and transfusion medicine professionals regarding recent advancements and developments in the field of transfusion medicine.
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Anesthesia and analgesia · Sep 2024
Intrathecal Drug Delivery System in Prepontine Cistern for Patients with Intractable Craniofacial Cancer Pain: A Multicenter Retrospective Study.
Patients with craniofacial cancer frequently suffer from severe pain. The traditional intrathecal, oral, or intravenous analgesics could only provide insufficient pain relief with many side effects. Thus, a more effective analgesia approach is required. This study aimed to investigate the safety and efficacy of placing the catheter of an intrathecal morphine pump in the prepontine cistern for the treatment of craniofacial cancer pain. ⋯ Placing the catheter tip of an intrathecal morphine pump into the prepontine cistern could effectively relieve refractory craniofacial cancer pain with an extremely low total morphine dose requirement and few adverse events. This procedure could be considered in patients with severe refractory craniofacial cancer pain.
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Anesthesia and analgesia · Sep 2024
Pro-Con Debate: Anesthesiologists Should Be Responsible for Treating Preoperative Anemia.
In this Pro-Con commentary article, we discuss whether anesthesiologists should be responsible for treating preoperative anemia. This debate was proposed based on the article published in this issue of Anesthesia & Analgesia by Warner et al, which is an advisory on managing preoperative anemia endorsed by both the Society of Cardiovascular Anesthesiologists and the Society for Advancement of Patient Blood Management. ⋯ Even if we agree that preoperative anemia is worth treating before surgery, the question remains who should be responsible for doing so, and therein lies the reason for this Pro-Con debate. Should it be the responsibility of the anesthesiologist, or not? Let the readers decide.
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Anesthesia and analgesia · Sep 2024
The Case for the Role of Primary Care in Patient Blood Management.
Patient blood management (PBM) is a patient-centered evidence-based strategy designed to preserve a patient's own blood and improve health outcomes. The effectiveness of PBM programs is now well-established globally within tertiary and secondary sectors, with demonstrable outcome benefits and cost savings. However, the role of primary care and the general practitioner in PBM is poorly understood. ⋯ The skill set of general practitioners in integrating and continuing care through the transition period after hospitalization is especially important. General practitioners are well-suited to the roles of health promotion and prevention, and have the potential to deliver substantial population health benefits. Given the public health imperative of this condition, it is vital that policy-makers appropriately support the role of general practitioners with financing, education, and resources for PBM in primary care.
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Anesthesia and analgesia · Sep 2024
Evaluation of the Noninvasive Estimated Continuous Cardiac Output System for Pediatric Patients: A Prospective Observational Study.
The estimated continuous cardiac output (esCCO) system is a hemodynamic monitor that uses electrocardiograms and pulse oximeter waves to noninvasively estimate cardiac output. The coefficients for esCCO measurement have been established for adult patients, but the appropriate coefficients for pediatric patients are unclear. Therefore, this study determined esCCO coefficients for pediatric patients and validated the accuracy and tracking ability of a modified esCCO system. ⋯ Cardiac output measurement by esCCO with modified coefficients for pediatric patients showed high accuracy and tracking ability compared with cardiac output measurement by transthoracic echocardiography. This noninvasive cardiac output measurement could benefit perioperative hemodynamic monitoring in children.