Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Massive transfusion has recently been given a dynamic definition, namely, the replacement of more than four red cell concentrates within an hour. The purpose of this continuing professional development module is to review the pathophysiology of hemorrhagic shock in the trauma patient and the current management strategies of the massively bleeding trauma patient. ⋯ After reading this module, the reader should be able to: 1. Enumerate the complications associated with massive transfusion in the trauma context; 2. Understand how the coagulopathy present in the trauma patient differs from that seen in the elective setting; 3. Identify the modifications suggested by the recent literature for the management of massive transfusion in the trauma setting; 4. Appreciate the evidence for the institution of massive transfusion protocols.
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Postoperative acute kidney injury (AKI) following arthroplasty has not been well studied. Our aim was to identify factors associated with increased risk of AKI. ⋯ In this case-control investigation, we identified several factors associated with the development of postoperative AKI. Recognition of these risk factors could allow for the adoption of perioperative renal protective strategies in patients undergoing arthroplasty.
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Retraction Of Publication
Retraction note to: Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle. Can J Anaesth 1997; 44: 489-93, DOI 10.1007/BF03011936.
Further to the Expression of Concern posted online on March 13th, 2012, it is with considerable regret that the Canadian Journal of Anesthesia hereby retracts the above-cited article by Dr. Yoshitaka Fujii as a result of:(1) overwhelming evidence of fabrication relating to the fact that the distributions of many variables reported by Dr. ⋯ We extend our sincere appreciation to Toride Kyodo General Hospital for their review of the status of Dr. Fujii’s research and to the investigating committee for their review of his research findings.
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Case Reports
Cardiac output monitoring during Cesarean delivery in a patient with palliated tetralogy of Fallot.
Tetralogy of Fallot (TOF) is one of the most common causes of cyanotic congenital heart disease. The anesthetic management of parturients with uncorrected TOF is challenging and controversial, especially for Cesarean delivery (CD). We describe the use of noninvasive cardiac output (CO) monitoring to assist the management of CD for a woman with palliated TOF under general anesthesia. ⋯ Balanced general anesthesia and careful titration of uterotonic agents provided stable hemodynamic conditions during CD in a patient with a palliated TOF, as assessed by a continuous noninvasive CO monitor. Noninvasive CO monitoring may improve our understanding of the hemodynamic implications of various anesthetic techniques for CD in cardiac patients.