BMC anesthesiology
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Stimulating catheters offer the possibility of delivering an electrical charge via the tip of the catheter. This may be advantageous as it allows verifying if the catheter tip is in close proximity to the target nerve, thereby increasing catheter performance. This prospective blinded cohort study was designed to investigate whether there is a correlation between the minimal electrical charge at the tip of the stimulating catheter, and the efficacy of the peripheral nerve block (PNB) catheter as determined by 24 h postoperative morphine consumption. ⋯ We conclude that there is no proportional relation between MEC at the tip of the blindly inserted stimulating catheter and 24 h postoperative morphine consumption.
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The impact of anesthetic equipment on clinical practice parameters associated with development of acute respiratory distress syndrome (ARDS) has not been extensively studied. We hypothesized a change in anesthesia machines would be associated with parameters associated with lower rates of ARDS. ⋯ In this study, a change in ventilator management was associated with an anesthesia machine exchange. The smaller Vt and lower PIP noted in the post group may imply a lower risk of volutrauma and barotrauma, which may be significant in at-risk populations. However, there was not a statistically significant reduction in the incidence of post-operative ARDS.
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Comparative Study
Clinical impact of intra-aortic balloon pump during extracorporeal life support in patients with acute myocardial infarction complicated by cardiogenic shock.
There is no available data on clinical outcome in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock who are supported by an intra-aortic balloon pump (IABP) in combination with extracorporeal life support (ECLS). ⋯ The combined use of ECLS and IABP did not improve in-hospital survival in patients with AMI complicated by cardiogenic shock.
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Prolonged storage of red blood cells (RBCs) leads to fundamental changes in both the RBCs and the storage media. We retrospectively evaluated the relationship between the RBC age and in-hospital and long-term postoperative outcomes in patients undergoing off-pump coronary artery bypass. ⋯ In patients undergoing off-pump coronary artery bypass, the oldest age of transfused RBCs were associated with a postoperative negative base excess, increased wound complications, and a longer hospital stay, but not with the other in-hospital or long-term outcomes.
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This retrospective, single centre study was conducted to investigate the efficacy of fibrinogen concentrate (FBNc) in decreasing blood requirements and reaching optimal fibrinogen level, in non-trauma, massively transfused, bleeding patients with coagulopathy. ⋯ In massively transfused, non-trauma patients with coagulopathy and refractory bleeding, late administration of low FBNc dosage was not associated with decreased blood transfusion or increased post-infusion fibrinogen level. Given that both fibrinogen upon admission and target fibrinogen levels were associated with decreased blood transfusion, earlier administration and higher doses of FBNc could be needed.