Journal of clinical anesthesia
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To investigate the association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury (SA-AKI). ⋯ Dexmedetomidine administration was associated with improvements in renal function recovery and in-hospital survival in critically ill patients with SA-AKI. The results need to be verified in further randomized controlled trials.
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Obesity, defined by the World Health Organization as body mass index (BMI) ≥ 30.0 kg/m2, is associated with adverse outcomes and challenges during surgery. Difficulties during endotracheal intubation, occur in 3-8% of procedures and are among the principal causes of anesthetic-related morbidity and mortality. Endotracheal intubation can be challenging in obese patients due to an array of anatomic and physiologic factors. Double lumen tubes (DLTs), the most commonly used airway technique to facilitate anatomic isolation of the lungs for one lung ventilation. However, DLTs can be difficult to properly position and are also more likely to cause airway injuries and bleeding when compared to conventional single lumen tubes. We investigated the association between BMI and difficult tracheal DLT intubation. ⋯ Difficult intubations with DLT remain common, but BMI is a weak predictor thereof. For example, an increase in BMI from 20 to 40 kg/m2 corresponds to an increase in average absolute risk for difficult intubation from 16 to 19%, which probably is not clinically meaningful.
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Observational Study
Clinical agreement of a novel algorithm to estimate radial artery blood pressure from the non-invasive finger blood pressure.
A new algorithm was developed that transforms the non-invasive finger blood pressure (BP) into a radial artery BP (B̂PRad), whereas the original algorithm estimated brachial BP (B̂PBra). In this study we determined whether this new algorithm shows better agreement with invasive radial BP than the original one and whether in the operating room this algorithm can be used safely. ⋯ In this cohort of non-cardiac surgery patients, we found good agreement between BPRad and B̂PRad. Compared to B̂PBra, B̂PRad shows better agreement although clinical implications are small. This trial was registered with ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03795831).