Articles: function.
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Randomized Controlled Trial Multicenter Study
Early diaphragm pacing in patients with amyotrophic lateral sclerosis (RespiStimALS): a randomised controlled triple-blind trial.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder associated with respiratory muscle weakness and respiratory failure. Non-invasive ventilation alleviates respiratory symptoms and prolongs life, but is a palliative intervention. Slowing the deterioration of diaphragm function before respiratory failure would be desirable. We aimed to assess whether early diaphragm pacing could slow down diaphragm deterioration and would therefore delay the need for non-invasive ventilation. ⋯ Hospital Program for Clinical Research, French Ministry of Health; French Patients' Association for ALS Research (Association pour la Recherche sur la Sclérose Latérale Amyotrophique); and Thierry de Latran Foundation.
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Spinal bupivacaine is used for day-case surgery but the appropriate dose that guarantees hospital discharge is unknown. ⋯ Ambulatory surgery is possible under spinal anaesthesia with bupivacaine although the dose range that ensures reliable anaesthesia with duration short enough to guarantee ambulatory management is narrow.
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Anesthesia and analgesia · Nov 2016
Multicenter Study Observational StudyMetabolic Acidosis Assessment in High-Risk Surgeries: Prognostic Importance.
Metabolic acidosis frequently is present in surgical patients; however, different types of metabolic acidosis (hyperlactatemia, hyperchloremia, and others) may have different relationships to perioperative outcomes. We hypothesized that in postoperative surgical patients, distinctive types of metabolic acidosis would correlate differently with the outcomes of high-risk surgeries. ⋯ We found that among patients with different types of acidosis, patients who developed hyperlactatemic metabolic acidosis postoperatively showed greater rates of renal dysfunction within 7 days and hyperlactatemic acidosis represented an independent factor on 30-day mortality in high-risk surgical patients.
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Acta Anaesthesiol Scand · Nov 2016
Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort.
Capnocytophaga canimorsus is a gram-negative rod capable of causing severe sepsis or septic shock. We studied the characteristics of patients with C. canimorsus bacteremia treated in intensive care unit (ICU). ⋯ Capnocytophaga canimorsus infection may present with severe sepsis or septic shock with organ dysfunction, most frequently coagulopathy and acute kidney injury. Previously recognized risk factors are not always present. A dog in a household may be a sufficient exposure for developing a severe form of the disease. The possibility of C. canimorsus infection should be considered in patients with any contact with dogs, even in immunocompetent patients.
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Inferior outcomes for medial unicompartmental knee arthroplasty (UKA) patients with preoperative medial tibial bone marrow lesions (BMLs) were recently reported. The purpose of this study was to compare the location and severity of BML on postoperative outcomes after medial UKA and TKA using a larger sample size and more rigorous magnetic resonance imaging (MRI) evaluation. ⋯ Medial tibial BMLs were not associated with inferior outcomes. Clinically, these results suggest that BMLs should not be considered a contraindication for medial UKA.