BMC anesthesiology
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The new noninvasive Vitalstream (VS) continuous physiological monitor (Caretaker Medical LLC, Charlottesville, Virginia), allows continuous cardiac output by a low pump-inflated, finger cuff that pneumatically couples arterial pulsations via a pressure line to a pressure sensor for detection and analysis. Physiological data are communicated wirelessly to a tablet-based user interface via Bluetooth or Wi-Fi. We evaluated its performance against thermodilution cardiac output in patients undergoing cardiac surgery. ⋯ This study demonstrated that the agreement between the VS CO and TD CO was clinically acceptable with a percent error (PE) of 34.5 to 38% with and without external calibration. The threshold for an acceptable agreement between the VS and TD was considered to be below 40% which is below the threshold recommended by others.
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Observational Study
Tissue oxygen saturation is predictive of lactate clearance in patients with circulatory shock.
Tissue oxygen saturation (StO2) decrease could appear earlier than lactate alteration. However, the correlation between StO2 and lactate clearance was unknown. ⋯ Our results suggested that BSA-weighted StO2 was a strong predictor of 6-hour lactate clearance in patients with shock.
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The aim of the study was to evaluate the value of lung ultrasound (LUS) in patients with cardiogenic shock treated by venoarterial extracorporeal membrane oxygenation (VA-ECMO). ⋯ LUS is a promising tool for evaluating pulmonary changes in patients with cardiogenic shock undergoing VA-ECMO.
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Both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) have higher incidence and lower survival rates. Predictors of in-hospital mortality for intensive care unit (ICU) admitted cardiac arrest (CA) patients remain unclear. ⋯ The LASSO model enabled good prediction of in-hospital mortality in ICU admission CA patients, which may be widely used in clinical decision-making.
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The liberal use of remifentanil in spine surgery has been associated with an increased incidence of postoperative hyperalgesia. Nevertheless, controversies remain as the existing evidence is inconclusive to determine the relationship between remifentanil use and the development of opioid-induced hyperalgesia. We hypothesized that intraoperative infusion of higher dose remifentanil during scoliosis surgery is associated with postoperative hyperalgesia, manifesting clinically as greater postoperative morphine consumption and pain scores. ⋯ Intraoperative use of remifentanil as an adjuvant in AIS patients undergoing posterior spinal fusion surgery was not associated with postoperative hyperalgesia.