BMC anesthesiology
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Observational Study
Early urea-to-creatinine ratio to predict rapid muscle loss in critically ill patients with sepsis: a single-center retrospective observational study.
Patients with sepsis in the intensive care unit (ICU) often experience rapid muscle loss. The urea-to-creatinine ratio (UCR) is thought to reflect muscle breakdown (creatinine) and catabolism (urea) and is commonly used to assess nutritional and metabolic status. This study aimed to investigate whether changes in UCR (ΔUCR) can predict the development of rapid muscle loss in patients with sepsis. ⋯ The results demonstrate that ΔUCR is independently associated with rapid muscle loss in patients with sepsis and the AUC of the ROC curve for the ability of ΔUCR to predict rapid muscle loss was 0.76. Though additional prospective data are needed, our results suggest that ΔUCR may be useful in the early identification of critically ill patients with sepsis at risk of rapid muscle loss.
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Case Reports
Nebulized dexmedetomidine in the treatment of obstetric post-dural puncture headache: two case reports.
Post-dural puncture headache (PDPH) is a debilitating complication of neuraxial anesthesia, particularly prevalent in obstetric patients, usually characterized by a postural headache. PDPH is hypothesized to result from cerebrospinal fluid leakage through a dural puncture, triggering symptoms like neck stiffness and subjective hearing changes. While conservative measures are common for treatment, more refractory cases may require invasive interventions such as an epidural blood patch (EBP). ⋯ Two case presentations illustrate the efficacy of nDEX in resolving PDPH symptoms rapidly and completely. These cases underscore the need for exploring novel therapeutic options, especially in obstetric patients where safe and prompt relief is essential for maternal and newborn well-being. While the EBP remains the gold standard, its limitations of accessibility and invasiveness highlight the significance of investigating alternatives like nDEX.
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Subarachnoid anesthesia is the primary anesthetic method for elective cesarean section surgery, characterized by rapidly taking effect and reliable analgesia. However, subarachnoid anesthesia is prone to cause a high block level, resulting in a high incidence of maternal hypotension. How to reduce the incidence of maternal hypotension under subarachnoid anesthesia is a practical problem that needs to be solved urgently in clinical practice. ⋯ Hyperbaric combined with hypobaric local anesthetic in subarachnoid anesthesia for cesarean section did not reduce the incidence of intraoperative hypotension in pregnant women.
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Randomized Controlled Trial
The C-MAC video laryngoscope helps presbyopic anesthetists to overcome difficulty in neonatal and infantile intubation: a randomized controlled trial.
Endotracheal intubation (ETI) is a life-saving procedure that must be accurately carried on to guard against complications. Presbyopia leads to difficulty in viewing close objects and may obstacle proper intubation even with the best hands. ⋯ The limitations of the study are the small sample size of anesthetists and the use of one type of VLs.
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It remains uncertain whether the utilization of methylprednisolone during surgery effectively mitigates the occurrence of adverse outcomes. To examine the association between perioperative methylprednisolone administration and postoperative pleural effusion and pneumonia in older patients with non-small cell lung cancer. ⋯ Perioperative methylprednisolone was associated with reducing the occurrence of postoperative pleural effusions in older patients with non-small volume lung cancer, but it was not associated with pneumonia or long-term survival outcomes.