Articles: function.
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Curr Opin Anaesthesiol · Jun 2014
ReviewAnesthesia and ventilation strategies in children with asthma: part II - intraoperative management.
As asthma is a frequent disease especially in children, anesthetists are increasingly providing anesthesia for children requiring elective surgery with well controlled asthma but also for those requiring urgent surgery with poorly controlled or undiagnosed asthma. This second part of this two-part review details the medical and ventilatory management throughout the perioperative period in general but also includes the perioperative management of acute bronchospasm and asthma exacerbations in children with asthma. ⋯ To minimize the considerable risk of perioperative respiratory adverse events in asthmatic children, perioperative management should be based on two main pillars: the preoperative optimization of asthma treatment (please refer to the first part of this two-part review) and - the focus of this second part of this review - the optimization of anesthesia management in order to optimize lung function and minimize bronchial hyperreactivity in the perioperative period.
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Curr Opin Anaesthesiol · Jun 2014
ReviewPerioperative implications of the patient with autonomic dysfunction.
The autonomic nervous system functions to control heart rate, blood pressure, respiratory rate, gastrointestinal motility, hormone release, and body temperature on a second-to-second basis. Here we summarize some of the latest literature on autonomic dysfunction, focusing primarily on the perioperative implications. ⋯ Patients with dysautonomia often have unpredictable and paradoxical physiological responses to various perioperative stimuli. Knowledge of the underlying pathophysiology of their condition is required in order to reduce symptom exacerbation and limit morbidity and mortality during the perioperative period.
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Anesthesia and analgesia · Jun 2014
Randomized Controlled Trial Comparative StudyDehydration Enhances Pain-Evoked Activation in the Human Brain Compared with Rehydration.
Negative effects of dehydration on the human brain and cognitive function have been reported. In this study, we examined the effects of dehydration on pain thresholds and cortical activations in response to pain, compared with rehydration with an oral rehydration solution (ORS) by functional magnetic resonance imaging. ⋯ Our findings suggest that dehydration brings about increased brain activity related to painful stimuli together with enhanced thirst, whereas rehydration with ORS alleviates thirst and decreases brain activity related to painful stimuli.
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This retrospective observational study was performed to determine if the age of transfused units of red blood cells (RBCs) was related to mortality. The study included 31 transfused patients admitted to the intensive care unit during 1992 with severe sepsis (i.e., sepsis associated with organ dysfunction, hypoperfusion, or hypotension). ⋯ The authors concluded that the duration of storage of RBCs is directly related to the risk of mortality among transfused patients with severe sepsis. Recognizing the limitations of their small retrospective study that did not adjust for confounders, they also stated that further studies are needed to confirm or refute this association.
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Osteoarthr. Cartil. · Jun 2014
Comparative Study Observational StudyThe prevalence of erosive osteoarthritis in carpometacarpal joints and its clinical burden in symptomatic community-dwelling adults.
To estimate the prevalence of erosive disease in first carpometacarpal joints (CMCJs) and investigate its clinical impact compared with radiographic thumb base (TB) osteoarthritis (OA). ⋯ Erosive disease of first CMCJs was present in 2.2% of subjects with hand pain and was often not accompanied by erosions in IPJs. Erosive disease was associated with TB pain, but not with the level of pain, when compared with radiographic TB OA.