Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Amniotic fluid embolism (AFE) is a leading cause of obstetrical cardiac arrest and maternal morbidity. The pathogenesis of hemodynamic collapse is thought to be from right ventricular (RV) failure; however, there is a paucity of data documenting echocardiography findings in this population. We undertook a systematic review of the literature to evaluate the echocardiography findings in patients with AFE. ⋯ PROSPERO (CRD42021271323); registered 1 September 2021.
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Randomized Controlled Trial
Occupational therapist-guided cognitive interventions in critically ill patients: a feasibility randomized controlled trial.
Intensive care unit (ICU) delirium is a common complication of critical illness requiring a multimodal approach to management. We assessed the feasibility of a novel occupational therapist (OT)-guided cognitive intervention protocol, titrated according to sedation level, in critically ill patients. ⋯ gov (NCT03604809); registered 18 June 2018.
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The Guidelines to the Practice of Anesthesia Revised Edition 2023 (the Guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. The Guidelines are subject to revision and updated versions are published annually. ⋯ Anesthesiologists should exercise their own professional judgment in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.
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Randomized Controlled Trial
Comparison of the efficacy of costoclavicular space brachial plexus blockade with 0.5% versus 0.375% ropivacaine: a randomized, double-blind, single-centre, noninferiority clinical trial.
Recently, more attention has been given to the costoclavicular space (CCS) as an alternative pathway for ultrasound-guided brachial plexus block (BPB). While 0.5% ropivacaine was used in most related studies, research has shown effective ultrasound-guided supraclavicular BPB using lower local anesthetic concentrations, and our preliminary data have indicated that 0.375% ropivacaine may be effective when given in the CCS. Hence, we hypothesized that the efficacy of 0.375% ropivacaine would be noninferior compared with 0.5% in ultrasound-guided BPB via the CCS. ⋯ chictr.org.cn (ChiCTR20000306570); registered 8 March 2020.
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Awake tracheal intubation (ATI) is recommended in airway management guidelines when significant difficulty is predicted with airway management. Use of the technique may be declining, which may have implications for patient safety or for skills acquisition and maintenance. This historical cohort database study sought to determine if the use of ATI was decreasing in our adult tertiary care center. ⋯ In this single-center historical cohort study, the use of ATI decreased significantly from 2014 to 2020. Whether this decrease will result in morbidity or mortality related to airway management is currently unclear. Regardless, it has implications for training opportunities and maintenance of competence in performing the procedure.