Journal of clinical anesthesia
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Clinical Trial
Performance and customization of 4 prognostic models for postoperative onset of nausea and vomiting in ear, nose, and throat surgery.
To evaluate the performance of 4 published prognostic models for postoperative onset of nausea and vomiting (PONV) by means of discrimination and calibration and the possible impact of customization on these models. ⋯ The original models were not well validated in our study. An antiemetic therapy based on the results of these scores seems therefore unsatisfactory. Customization improved the accuracy of the prediction in our specialized patient population, more so for the Sinclair et al model and the Junger et al model than for the Koivuranta et al model and the Apfel et al model.
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To evaluate changes in cardiac troponin-I levels after major vascular surgery and their association with early and late postoperative cardiac complications. ⋯ Myocardial infarction after major noncardiac vascular surgery occurs in up to 12% of cases. Perioperative monitoring of troponin-I plasma levels may help to identify patients at increased risk for cardiac morbidity not only early after surgery but also during the first postoperative month.
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Comparative Study
A comparison of anesthesiology resident and faculty electronic evaluations before and after implementation of automated electronic reminders.
To develop an automated e-mail reminder system to contact residents and faculty regarding incomplete evaluations. DESIGN, SETTING, INTERVENTION, AND MEASUREMENTS: In the retrospective study, two 9-month periods were evaluated representing pre- and post-introduction of the automated e-mail reminder system. Data collected contained the number of evaluations completed and the rating of residents and faculty at the University of Michigan Health System in 5 different categories on a 5-point scale. ⋯ An automated e-mail reminder system implemented to contact residents and faculty regarding incomplete evaluations for residents and faculty dramatically enhanced participation in the evaluation process.
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Postoperative nausea and vomiting (PONV) continues to be a "big little problem" despite recent advances in anesthesia. Because of an increased interest in, and the abundant publications on this topic, guidelines for the management of PONV were published in 2003. ⋯ The application of these antiemetics in clinical practice has raised questions regarding the role of the 5-HT3 receptor antagonists in the treatment of postdischarge nausea and vomiting and opioid-induced nausea and vomiting. A brief overview of the incidence, risk factors and current management recommendations for PONV and current controversies with special emphasis on the 5-HT3 receptor antagonists, is discussed.
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Clinical Trial
Peripheral venous pressure as a predictor of central venous pressure during orthotopic liver transplantation.
To assess the reliability of peripheral venous pressure (PVP) as a predictor of central venous pressure (CVP) in the setting of rapidly fluctuating hemodynamics during orthotopic liver transplant surgery. ⋯ Our study confirms that PVP correlates with CVP even under adverse hemodynamic conditions in patients undergoing liver transplantation.