Journal of clinical anesthesia
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Residual neuromuscular block (NMB) after anesthesia poses significant risk to patients, which can be reduced by adhering to evidence-based practices for the dosing, monitoring, and reversal of NMB. Incorporation of best practices into routine clinical care remains uneven across providers and institutions, prompting the need for effective implementation strategies. ⋯ This initiative demonstrates successful large-scale integration of quantitative TOF monitoring and evidence based NMB management across a diverse medical center, while highlighting important barriers in implementation. These findings contribute to the broader discussion on translating evidence into practice, offering insights for improving patient care and safety through tailored implementation strategies.
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Observational Study
Cerebral oximetry index indicates delirium or stroke after carotid endarterectomy: An observational study.
The cerebral oximetry index (COx) uses near-infrared spectroscopy to estimate cerebral autoregulation during cardiac surgery. However, the relationship between intraoperative loss of cerebral autoregulation and postoperative delirium or stroke remains unclear in patients recovering from carotid endarterectomy (CEA). ⋯ COx is a promising metric for predicting postoperative delirium or new-onset overt stroke in patients having CEA. The optimal COx threshold was 0.7 in the pre-clamping phase and 0.4 in the post-clamping phase.
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Observational Study
Pressure support ventilation improves ventilation during inhalational induction of anesthesia in children: A pilot study.
To evaluate the impact of positive end-expiratory pressure (PEEP) with or without pressure support ventilation (PSV) on the lung volume and the ventilation distribution during inhalational induction of anesthesia in children. ⋯ The ventilator settings used during inhalational induction of anesthesia in children have an impact on lung ventilation. PSV during inhalational induction of anesthesia in children may restore the end-expiratory lung volume independently from the increase in TV.