Journal of anesthesia
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Journal of anesthesia · Jun 2019
ReviewInfraclavicular brachial plexus block in adults: a comprehensive review based on a unified nomenclature system.
Over the last decade, considerable progress has been made regarding infraclavicular brachial plexus block (ICB) in adults, especially since the introduction of ultrasound guidance. The advancements in ICB have been attributed to the development of various approaches to improve the success rate and reduce complications. This has also necessitated a unified nomenclature system to facilitate comparison among different approaches. ⋯ For continuous ICB, the proximal approach is promising for reducing local anesthetic volume and increasing efficacy. Nevertheless, further studies are warranted in this direction. We provide practice advisories to maximize safety and minimize adverse events, and recommend designing future studies on ICB according to these findings based on the unified nomenclature system.
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Journal of anesthesia · Jun 2019
Review Meta Analysis Comparative StudyComparison of invasive and noninvasive blood hemoglobin measurement in the operating room: a systematic review and meta-analysis.
Noninvasive hemoglobin (Hb)-monitoring devices are new inventions in pulse oximeter systems that show hemoglobin levels continuously. The aim of this systematic review and meta-analysis was to evaluate the accuracy and precision of noninvasive versus standard central laboratory Hb measurements in the operating room. We systematically searched multiple databases. ⋯ A total of 28 studies on 2000 participants were included in the meta-analysis. Meta-analysis results of mean differences between noninvasive and the central laboratory Hb measurements in overall pooled random effects were - 0.27 (95% LoA (0.44, - 0.10); P value < 0.05). According to this meta-analysis, noninvasive hemoglobin measurement has acceptable accuracy in comparison with the standard invasive method.
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Journal of anesthesia · Jun 2019
Review Meta Analysis Comparative StudyComparison of invasive and noninvasive blood hemoglobin measurement in the operating room: a systematic review and meta-analysis.
Noninvasive hemoglobin (Hb)-monitoring devices are new inventions in pulse oximeter systems that show hemoglobin levels continuously. The aim of this systematic review and meta-analysis was to evaluate the accuracy and precision of noninvasive versus standard central laboratory Hb measurements in the operating room. We systematically searched multiple databases. ⋯ A total of 28 studies on 2000 participants were included in the meta-analysis. Meta-analysis results of mean differences between noninvasive and the central laboratory Hb measurements in overall pooled random effects were - 0.27 (95% LoA (0.44, - 0.10); P value < 0.05). According to this meta-analysis, noninvasive hemoglobin measurement has acceptable accuracy in comparison with the standard invasive method.
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Journal of anesthesia · Jun 2019
ReviewEmergent endotracheal intubation associated cardiac arrest, risks, and emergency implications.
Emergent endotracheal intubation (ETI)-related cardiac arrest (CA) is a life-threatening complication that is poorly documented. Definitions and risk factors for CA during or directly after emergent ETI have not been clearly established and may represent modifiable means of improving patient outcomes. We conducted a review of the literature to assess the incidence and risk factors associated with ETI-related CA in the Emergency Department (ED) as well as in the inpatient setting outside of the operating room. ⋯ Definitions of ETI-related CA also varied considerably ranging from within 5 min to within 60 min of intubation; however, the majority of ETI-related CA cases occurred within 10 min. Hemodynamic factors such as SI, hypotension, and hypoxemia were associated with increased rates of CA. ETI-related CA may represent a potentially modifiable complication that can improve patient outcomes in critically ill patients presenting in the ED.