BMC anesthesiology
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Randomized Controlled Trial
Maintaining intraoperative normothermia reduces blood loss in patients undergoing major operations: a pilot randomized controlled clinical trial.
Inadvertent intraoperative hypothermia (core temperature < 36 °C) is a common but preventable adverse event. This study aimed to determine whether active intraoperative warming reduced bleeding in patients undergoing major operations: open thoracic surgery and hip replacement surgery. ⋯ Intraoperative active warming is associated with less blood loss than passive warming in open thoracic and hip replacement operations in this pilot study.
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Randomized Controlled Trial Comparative Study
Hemodynamic responses to tracheal intubation with Bonfils compared to C-MAC videolaryngoscope: a randomized trial.
Direct laryngoscopy (DL) produce tachycardia and hypertension that could be fatal in a patient with a brain injury. Bonfils fiberscope and C-MAC videolaryngoscope are associated with little hemodynamic instability compared to DL. Scientific evidence comparing these two alternatives does not exist. We conducted this study to determine the hemodynamic effects of Bonfils compared to C-MAC in patients undergoing elective surgery. ⋯ Hemodynamic responses to tracheal intubation using the Bonfils fiberscope is comparable to the C-MAC videolaryngoscope among patients scheduled for an elective surgery. In light of these findings, using either technique appears to be a reasonable course of action.
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Propofol is an excellent hypnotic drug for use in repeated radiation procedures in young children. To date, tolerance to propofol generally does not develop in pediatric patients undergoing radiation therapy. However, several studies have suggested that there may be potential for development of tolerance to propofol. The aim of this study was to evaluate the development of a tolerance to propofol used for repeated deep sedation in children undergoing proton radiation therapy (PRT). ⋯ Repeated prolonged deep sedation for PRT elicited multiple times over several weeks in young children using propofol did not develop tolerance in 74% of patients. Although the incidence of 26% tolerance to propofol may still be present, the increase in propofol dose was minimal. Therefore, the use of repeated propofol for children was safe.
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Comparative Study Observational Study
Procalcitonin kinetics after burn injury and burn surgery in septic and non-septic patients - a retrospective observational study.
Early sepsis diagnosis is crucial for the correct management of burn patients, and it clearly influences outcomes. The systemic inflammatory response triggered by burns mimics sepsis presentation and complicates early sepsis diagnosis. Biomarkers were advocated to aid the diagnosis of early sepsis. Serum procalcitonin (PCT) exhibits fair accuracy and good correlation with sepsis severity, being used in diverse clinical settings. However, few studies have evaluated perioperative changes in PCT levels in burn patients. The present study evaluated PCT kinetics during the first days after burn injury and subsequent surgical interventions to assess PCT utility in distinguishing septic from non-septic inflammatory responses. ⋯ PCT kinetics coupled with a clinical examination may be helpful for sepsis diagnosis during the first days after burn injury and burn surgery.
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Observational Study
Incidence and cost of perioperative red blood cell transfusion for elective spine fusion in a high-volume center for spine surgery.
Spine fusion is a surgical procedure characterized by a significant perioperative bleeding, which often requires red blood cell (RBC) transfusion. ⋯ Several surgical and patient factors may contribute to the perioperative blood loss. An accurate patient blood management, may efficiently decrease transfusion requirements and ultimately healthcare costs.