Journal of anesthesia
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Cardiac surgery-associated acute kidney injury (AKI) is a major health problem that is extremely common and has a significant effect on cardiac surgical outcomes. AKI occurs in nearly 30 % of patients undergoing cardiac surgery, with about 1-2 % of these ultimately requiring dialysis. The development of AKI predicts a significant increase in morbidity and mortality independent of other risk factors. ⋯ Risk factors for AKI have been identified in several models, and these facilitate physicians to prognosticate and develop a strategy for tackling patients predisposed to developing renal dysfunction. Effective therapy of the condition is still suboptimal, and hence the accent has always been on risk factor modification. Thus, strategies for reducing preoperative anemia, perioperative blood transfusions and surgical re-explorations may be effective in attenuating the incidence and severity of this complication.
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Journal of anesthesia · Jun 2013
ReviewResuscitation after hemorrhagic shock: the effect on the liver--a review of experimental data.
The liver is currently considered to be one of the first organs to be subjected to the hypoxic insult inflicted by hemorrhagic shock. The oxidative injury caused by resuscitation also targets the liver and can lead to malfunction and the eventual failure of this organ. Each of the various fluids, vasoactive drugs, and pharmacologic substances used for resuscitation has its own distinct effect(s) on the liver, and the anesthetic agents used during surgical resuscitation also have an impact on hepatocytes. ⋯ The effect of a specific resuscitation agent on the liver is assessed mainly by measuring apoptotic pathway regulators and inflammation-induced indicators. Apart from a wide range of pharmacological substances, modifications of Ringer's Lactate, colloids, and pyruvate provide protection to the liver after hemorrhage and resuscitation. In this setting, it is of paramount importance that the treating physician recognize those agents that may attenuate liver injury and avoid using those which inflict additional damage.
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Journal of anesthesia · Jun 2013
Retraction Of PublicationRetraction note: Further notice of formal retraction of articles by Dr. Yoshitaka Fujii.
Retraction to: J Anesth (1997) 11:126–129DOI 10.1007/BF02480074,J Anesth (1996) 10:22–25DOI 10.1007/BF02482063,J Anesth (1996) 10:176–180DOI 10.1007/BF02471386,J Anesth (1995) 9:58–60DOI 10.1007/BF02482037,J Anesth (1995) 9:343–347DOI 10.1007/BF02479949,J Anesth (1994) 8:301–304DOI 10.1007/BF02514655. To readers of the Journal of Anesthesia: In addition to the articles listed in a retraction note in JAnesth (2013) 27:322, the following articles published by Dr. Yoshitaka Fujii in the Journal of Anesthesia also are hereby retracted as a result of: (1) overwhelming evidence of fabrication related to the fact that the distributions of many variables reported by Dr. ⋯ J Anesth. 1996;10:22–5.*Fujii Y, Toyooka H. Nicardipine inhibits amrinone-enhanced contractility in fatigued diaphragm. J Anesth.1997;11:126–9.
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialComparison of the use of the Valsalva maneuver and the eutectic mixture of local anesthetics (EMLA®) to relieve venipuncture pain: a randomized controlled trial.
Intravenous cannulation is a painful and stressful procedure. The objective of this study was to compare the analgesic efficacy of the eutectic mixture of local anesthetics (EMLA(®)) with that of the Valsalva maneuver in adult patients during i.v. cannulation. ⋯ The Valsalva maneuver yields similar results to the EMLA(®) in terms of pain reduction during venipuncture.