Canadian journal of anaesthesia = Journal canadien d'anesthésie
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There is a paucity of evidence evaluating whether intensive care unit (ICU) discharge occupancy is associated with clinical outcomes. It is unknown whether increased discharge occupancy leads to greater afterhours discharges and downstream consequences. We explore the association between ICU discharge occupancy and afterhours discharges, 72-hr readmission, and 30-day mortality. ⋯ Greater ICU discharge occupancy was associated with a significant increase in afterhours discharges. Nevertheless, neither discharge occupancy nor afterhours discharge were associated with 72-hr readmission or 30-day mortality.
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Transcatheter aortic valve implantation (TAVI) has become a widely used technique for treating aortic stenosis. Subclavian access may be warranted in the presence of poor vasculature that precludes femoral access. Conscious sedation is increasingly being adopted with some evidence suggesting better outcomes compared with those of general anesthesia. We describe the use of two regional anesthetic techniques to facilitate subclavian access for TAVI. ⋯ The interscalene catheter in situ allowed for low-dose local anesthetic titration without further jeopardizing the pulmonary function throughout the procedure. Unlike other interfascial plane blocks, combined low-dose superficial cervical plexus and interscalene brachial plexus blocks offer surgical anesthesia and limb immobility, thus providing optimal condition for subclavian TAVI to be performed with minimal sedation.