Journal of clinical anesthesia
-
To assess the prevalence of preoperative acidosis and lactatemia in elderly patients having hip fracture surgery and their association with post-operative mortality. ⋯ Preoperative acidosis and lactatemia are common among patients ≥65 years having hip fracture surgery and are associated with 90-day all-cause mortality. Time from hospital admission to surgery is not an independent risk factor, once adjusted for metabolic indices. Future studies should evaluate whether the increased risk associated with preoperative metabolic disturbances is modifiable.
-
The use of entrustable professional activities (EPAs) as a basis for assessment may bridge the gap between the theory of competency-based education and clinical practice. The purpose of this study was to develop and validate EPAs for United States (US) first-year clinical anesthesia (CA-1) residents for anesthesiology residency programs to use as the basis for curriculum development and workplace assessment. ⋯ This study applied a construct validity lens to EPA development providing assurance that the EPAs adopted are appropriate for use in workplace-based assessment and entrustment decision-making.
-
Review Meta Analysis
The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.
To evaluate the effectiveness of supplemental oxygen therapy and high-flow nasal cannula (HFNC) therapy in patients with obstructive sleep apnea (OSA) in different clinical settings to assess its application to surgical patients in the postoperative setting. ⋯ Oxygen therapy effectively reduces AHI and increases SpO2 in patients with OSA. CPAP is more effective in reducing AHI than oxygen therapy. HFNC therapy is effective in reducing AHI. Although both oxygen therapy and HFNC therapy effectively reduce AHI, more research is needed to draw conclusions on clinical outcomes.
-
Meta Analysis
Airway nerve blocks for awake tracheal intubation: A meta-analysis of randomized control trials and trial sequential analysis.
This systematic review and meta-analysis aimed to assess the superiority of airway nerve blocks versus airway anesthesia without nerve blocks for awake tracheal intubation (ATI). ⋯ Based on current published evidence, airway nerve blocks provide better airway anesthesia quality for ATI with a shorter intubation time, better intubation conditions including higher no reaction to placement of the flexible scope and tracheal tube, lower cough or gag reflex during intubation, higher excellent patient satisfaction, and lower overall complications.