Journal of anesthesia
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Journal of anesthesia · Oct 2016
Switching therapy from intravenous beta blocker to bisoprolol transdermal patch for atrial fibrillation tachycardia.
Beta-blockers are important for severe-status patients with atrial fibrillation-related tachycardia. Beta 1-selective intravenous injection are routinely used, but long-term administration is difficult due to cost-performance- or management-related issues. A bisoprolol patch, a beta-blocker to be percutaneously absorbed, recently became commercially available in Japan. ⋯ After the completion of landiolol administration, there were also no significant changes in either parameter. There were no adverse events. In severe-status patients, switching therapy from landiolol injection to the bisoprolol patch can be conducted safely, and might be useful for heart-rate control.
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Journal of anesthesia · Oct 2016
Validity of ultrasonographic measurement of gastric volume in fasted pediatric patients without sedation.
Recently, gastric ultrasonography has been used as a noninvasive portable tool for evaluating gastric content and volume in adults and children. Pediatric patients are not always cooperative, especially younger ones, and it may be difficult to keep them in the appropriate scanning position without sedation. Hence, we modified the scanning method and position, and evaluated the efficacy of this alternative scanning technique in pediatric cases. ⋯ The gastric volume was then aspirated using a multi-orifice catheter under general anesthesia. Supine CSA measured via this gastric ultrasonography method was positively correlated with gastric volume (r = 0.56, p < 0.0001). We concluded that our alternative method of measuring antral CSA may be applicable for children minimal gastric contents.
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Journal of anesthesia · Oct 2016
Impact of aspirin use on morbidity and mortality in massively transfused cardiac surgery patients: a propensity score matched cohort study.
Aspirin may prevent organ dysfunction in critically ill patients and mitigate transfusion associated acute lung injury. We hypothesized that aspirin use might be associated with decreased morbidity and mortality in massively transfused cardiac surgery patients. ⋯ Preoperative aspirin use is not associated with decreased in-hospital mortality in massively transfused cardiac surgery patients, but may be associated with less mechanical lung ventilation time.
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The present study was to investigate if five values that are part of the hemogram analysis routinely checked before heart surgeries can be used as a high-quality, quick, low-cost, and easy-to-use outcome predictor. ⋯ The triple combination of parameters obtained as part of the hemogram, NLR-RDW-MPV, indicated a much more predictive power than two parameters coupled. This combination of three parameters, NLR-RDW-MPV, is to be considered as a sensitive, high-quality, low-cost outcome prediction marker for cardiac surgery patients that is less time consuming and easy to use.
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Journal of anesthesia · Oct 2016
The relationship between sedative drug utilization and outcomes in critically ill patients undergoing mechanical ventilation.
The objectives of this study were to describe current sedative drug utilization patterns in critically ill patients undergoing mechanical ventilation (MV) in intensive care units (ICUs) in Japanese hospitals and to elucidate the relationship of these utilization patterns with patient clinical outcomes. ⋯ This is the first study based on a large-scale analysis in Japan to elucidate sedative drug utilization patterns and their relationship with outcomes in critically ill patients. The most commonly used sedative was propofol, which was associated with favorable patient outcomes. Further prospective research must be conducted to discern effective sedative drug utilization.