Therapeutics and clinical risk management
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Ther Clin Risk Manag · Jan 2018
The addition of capnography to standard monitoring reduces hypoxemic events during gastrointestinal endoscopic sedation: a systematic review and meta-analysis.
The use of capnography monitoring devices has been shown to lower the rates of hypoxemia via early detection of respiratory depression, and facilitate more accurate titration of sedatives during procedures. The aim of the current meta-analysis was to compare the incidence of hypoxemia associated with standard monitoring alone during gastrointestinal endoscopy to that associated with standard monitoring with the addition of capnography. ⋯ This study indicates that capnography monitoring is an important addition with regard to the detection of hypoxemia during gastrointestinal procedural sedation, and should be considered in routine monitoring during gastrointestinal endoscopy.
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Ther Clin Risk Manag · Jan 2018
The use of the C-MAC videolaryngoscope for awake intubation in patients with a predicted extremely difficult airway: case series.
The C-MAC videolaryngoscope was evaluated for intubation in patients with predicted extremely difficult airway. The presented cases are patients with neoplasm tumors in larynx. In all cases, awake intubation using C-MAC videolaryngoscope was performed in patients breathing spontaneously, under local anaesthesia, with oxygen administered via nasal catheter. ⋯ Based on my experience, I assume that C-MAC videolaryngoscope is a very useful tool for anaesthesiologists and can be applied not only for unexpected difficult intubation but also for predicted difficult airway. Moreover, it could be used as an additional diagnosis tool before larynx surgery. The view obtained with the C-MAC videlaryngoscope corresponds with larynx examination performed before surgery, and could potentially reveal more details.
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Ther Clin Risk Manag · Jan 2018
Long-term outcomes and predictors of survival after cardiopulmonary resuscitation for in-hospital cardiac arrest in a tertiary care hospital in Thailand.
There are limited data available regarding long-term survival and its predictors in cases of in-hospital cardiac arrest (IHCA) in which patients receive cardiopulmonary resuscitation. ⋯ Only 7.9% of patients with IHCA were alive 1 year following cardiac arrest. Prearrest serum HCO3<20 meq/L, asystole, urine <800 cc/d, postarrest coma, and absence of pupillary reflex were the independent factors that predicted long-term mortality.
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Ther Clin Risk Manag · Jan 2018
Effect of intrawound vancomycin application in spinal surgery on the incidence of surgical site infection: a meta-analysis.
Despite great advances in aseptic surgical techniques, surgical site infection (SSI) is still one of the main complications after spine surgery. SSI can bring tremendous physical, psychological, and economic challenges to patients. Intrawound vancomycin application is a much disputed method for the prevention of SSI after spine surgery. ⋯ SSI incidence after spinal surgery can be significantly reduced by intrawound application of vancomycin in most circumstances. This method can be applied in various spinal procedures involving instrumentation to prevent postoperative SSI.
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Ther Clin Risk Manag · Jan 2018
Videolaryngoscopy versus fiberoptic bronchoscope for awake intubation - a systematic review and meta-analysis of randomized controlled trials.
Awake intubation with videolaryngoscopy (VL) is a novel method that is drawing more and more attention as an alternative to awake intubation with fiberoptic bronchoscope (FOB). This meta-analysis is designed to determine the performance of VL compared to the FOB for awake intubation. ⋯ For awake intubation, VL with a shorter intubation time is as effective and safe as FOB. VL may be a useful alternative to FOB.