Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Thoracic endovascular aortic aneurysm repair (TEVAR) has become a mainstay of therapy for aneurysms and other disorders of the thoracic aorta. The purpose of this narrative review article is to summarize the current literature on the risk factors for and pathophysiology of spinal cord injury (SCI) following TEVAR, and to discuss various intraoperative monitoring and treatment strategies. ⋯ Further experimental and clinical research is needed to aid in the discovery of novel neuroprotective strategies for the protection and treatment of SCI following TEVAR.
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As simulator fidelity (i.e., realism) increases from low to high, the simulator more closely resembles the real environment, but it also becomes more expensive. It is generally assumed that the use of high-fidelity simulators results in better learning; however, the effect of fidelity on learning non-technical skills (NTS) is unknown. This was a non-inferiority trial comparing the efficacy of high- vs low-fidelity simulators on learning NTS. ⋯ This study suggests that low-fidelity simulators are non-inferior to the more costly high-fidelity simulators for teaching NTS to postgraduate medical trainees.
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As the use of recreational drugs increases, the likelihood of an anesthesiologist perioperatively encountering patients using or addicted to these drugs will also increase. ⋯ For optimal patient care through the perioperative period, it is critical to obtain information about patient drug use and other associated treatment in order to construct an appropriate anesthetic plan, including specific considerations during surgery, emergence, and in the postanesthesia care unit.
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Observational Study
The effect of pericardial incision on right ventricular systolic function: a prospective observational study.
Echocardiographic longitudinal markers of right ventricular (RV) systolic function are commonly depressed after coronary artery bypass graft surgery (CABG) despite an uncomplicated course and good clinical recovery. The exact timing and cause of these changes is unknown. The aim of this observational study was to monitor echocardiographic markers of RV systolic function intraoperatively during CABG. We used angle-independent speckle tracking to measure the primary endpoints of tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') before and after pericardiotomy. ⋯ Pericardial opening and suspension had no significant effect on the indices of RV systolic function derived from speckle tracking or colour tissue Doppler.