Journal of clinical anesthesia
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The global COVID-19 pandemic highlighted the importance of protecting frontline healthcare workers from novel respiratory infections while also exposing the limited instruction that medical students receive on proper donning of personal protective equipment (PPE) and more importantly the safe doffing of contaminated PPE to minimize their risk of nosocomial infection. The best methods of providing this kind of instruction have not yet been determined. ⋯ While best methods for providing instruction regarding topics such as PPE donning and doffing have not yet been determined, we have demonstrated that the underlying knowledge base from medical school regarding proper donning and doffing for respiratory isolation is insufficient for preventing self-contamination, and that Miller's pyramid-based training using both video and in-person instruction combined with task execution by learners can improve compliance with PPE donning and doffing protocols and more importantly decrease skin contamination among a group of early training anesthesiology residents.
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Randomized Controlled Trial
Effect of ultrasound-guided lung recruitment manoeuvre on perioperative atelectasis during laparoscopy in young infants: A randomised controlled trial.
Pneumoperitoneum is a risk factor for perioperative atelectasis in infants. This research aimed to investigate whether lung recruitment manoeuvres guided by ultrasound are more effective for young infants (<3 months) during laparoscopy under general anaesthesia. ⋯ Ultrasound-guided alveolar recruitment reduced the perioperative incidence of atelectasis in infants <3 months during laparoscopy under general anaesthesia.
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Alpha Gal Syndrome (AGS) is an emerging immune response to mammalian products (MP) containing the oligosaccharide galactose-α-1,3 galactose (α-Gal) which includes meats and inactive ingredients in certain medications. This becomes clinically important in the perioperative realm as MPs are commonly found in the operating room, and pre- and post-operative settings, and can trigger responses as severe as anaphylaxis. ⋯ Additionally, strategies are explored in order to screen and prevent exposure to MP with a multidisciplinary approach. While this emerging allergy is still not fully understood, it is of paramount importance that all anesthesia providers recognize the implications of MP exposure in AGS patients and ultimately prevent harm in this highly vulnerable population.
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Randomized Controlled Trial
Effect of intraoperative dexmedetomidine on long-term survival in older patients after major noncardiac surgery: 3-year follow-up of a randomized trial.
To assess the impact of intraoperative dexmedetomidine on long-term outcomes of older patients following major noncardiac surgery mainly for cancer. ⋯ In older patients having major noncardiac surgery mainly for cancer, intraoperative dexmedetomidine did not improve overall survival but was associated with improved recurrence-free and event-free survivals.
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Observational Study
A new formula based on height for determining endotracheal intubation depth in pediatrics: A prospective study.
The main objective was to devise an endotracheal intubation formula based on pediatric patients' strongly correlated growth parameters. The secondary objective was to compare the accuracy of the new formula to the age-based formula from Advanced Pediatric Life Support Course (APLS formula) and the middle finger length-based formula (MFL-based formula). ⋯ The prediction accuracy for intubation depth of the new formula 1 was higher than the other formulae. The new formula based on height: D (cm) = 4 + 0.1 × Height (cm) was preferable to APLS formula and MFL-based formula with a high incidence of appropriate endotracheal tube position.