Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study Observational Study
A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.
Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. ⋯ This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.
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Case Reports
Inferior vena cava filter migration during the prone position for spinal surgery: a case report.
Inferior vena cava (IVC) filters have been used as an alternative therapy for patients with a contraindication to anticoagulation. We present a case of an IVC filter migration to the right ventricle occurring while a trauma patient was undergoing spinal surgery in the prone position. The patient provided written consent to describe this case. ⋯ The prone position during surgery can induce anatomic and hemodynamic changes in the IVC. This may contribute to the migration of IVC filters--especially flexible retrievable filters. Careful handling and positioning of patients with IVC filters is recommended to avoid a sudden increase in IVC pressure that may predispose to IVC filter migration.
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Randomized Controlled Trial Comparative Study
Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position.
Positional change can displace an endotracheal tube (ETT) and change the ETT cuff pressure in a tracheally intubated patient. Endotracheal tubes with different cuff shapes may lead to different cuff pressures after positional change. We hypothesized that the intracuff pressure in the TaperGuard™ ETT with a tapered-shaped cuff would be higher than that in the conventional ETT with a cylindrical-shaped cuff after a change from the supine to the lateral flank position. ⋯ After the change from the supine to the lateral flank position, the ETT cuff pressure was significantly higher in the TaperGuard ETT than in the conventional ETT, although the extent of cephalad displacement of the ETT was comparable between the two groups. This trial was registered at Clinicaltrials.gov: NCT02165319.