Anesthesiology clinics
-
Anesthesiology clinics · Sep 2011
ReviewClinical research using an information system: the multicenter perioperative outcomes group.
Clinical research using electronic medical record (EMR) data is an emerging source of scientific progress. Increasingly, researchers are using retrospective observational data acquired from EMRs as the substrate for their clinical research into comorbidities, procedures, situations, and outcomes that have historically presented significant challenges. Although EMR data collection is perceived to require fewer resources than manual chart review, there are many specific regulatory, privacy, data quality, and technique issues unique to clinical research using EMR data. This article discusses the use of EMRs for observational research.
-
Intelligent medical displays have the potential to improve patient outcomes by integrating multiple physiologic signals, exhibiting high sensitivity and specificity, and reducing information overload for physicians. Research findings have suggested that information overload and distractions caused by patient care activities and alarms generated by multiple monitors in acute care situations, such as the operating room and the intensive care unit, may produce situations that negatively impact the outcomes of patients under anesthesia. This can be attributed to shortcomings of human-in-the-loop monitoring and the poor specificity of existing physiologic alarms. Modern artificial intelligence techniques (ie, intelligent software agents) are demonstrating the potential to meet the challenges of next-generation patient monitoring and alerting.
-
Hydroxyethyl starch (HES) 130/0.4 (Voluven, Fresenius/Hospira, Germany) is indicated for the treatment and prophylaxis of hypovolemia. As the Voluven molecule is smaller than those of other available hydroxyethyl starch products, it is associated with less plasma accumulation and can be safely used in patients with renal impairment. Previous studies have demonstrated that Voluven has comparable effects on volume expansion and hemodynamics as other available HES products. Voluven is also associated with fewer effects on coagulation and may be an acceptable alternative to albumin for volume expansion in situations in which other starches are contraindicated secondary to risk of coagulopathy.
-
Amiodarone is an antiarrhythmic medication used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias. Amiodarone gained slow acceptance outside the specialized field of cardiac antiarrhythmic surgery because the side-effects are significant. ⋯ Its use is slowly expanding in the acute medicine setting of anesthetics. This article summarizes the use of Amiodarone by anesthesiologists in the operating room and during cardiopulmonary resuscitation.