Current opinion in anaesthesiology
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Although little new has been specifically written in recent years regarding the anesthesia management of cardiovascular trauma, two specific areas have seen recent interest and progress, namely the endovascular management of blunt thoracic aortic trauma and commotio cordis, or sudden death following blunt precordial injury. ⋯ Although transesophageal echocardiography diagnosis of aortic trauma is very sensitive and specific, in general, the lack of immediate availability at all times of skilled echocardiographers and the immediate availability of spiral computed tomography scanners in trauma centers limits the use of transesophageal echocardiography as a first-line diagnostic tool. Endovascular repair of traumatic aortic injury is becoming routine. Commotio cordis is being increasingly recognized as a cause of acute post-traumatic sudden death.
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Curr Opin Anaesthesiol · Dec 2010
ReviewShaping the operating room and perioperative systems of the future: innovating for improved competitiveness.
To review the current state of anesthesiology for operative and invasive procedures, with an eye toward possible future states. ⋯ Anesthesiologists must create more headroom between costs and revenues in order to sustain the academic vigor and creativity required to create better clinical practice. We outline three areas in which technological and organizational innovation in anesthesiology can improve competitiveness and become a driving force in collaborative efforts to develop the operating rooms and perioperative systems of the future: increasing the profitability of operating rooms; increasing the efficiency of anesthesia; and technological and organizational innovation to foster improved patient flow, communication, coordination, and organizational learning.