Articles: operative.
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Anesthesia and analgesia · Dec 2022
Randomized Controlled TrialHypobaric Unilateral Spinal Anesthesia Versus General Anesthesia for Hip Fracture Surgery in the Elderly: A Randomized Controlled Trial.
Hypotension during surgery is frequent in the elderly population and is associated with acute kidney and myocardial injury, which are, themselves, associated with increased 30-day mortality. The present study compared the hemodynamic effects of hypobaric unilateral spinal anesthesia (HUSA) to general anesthesia (GA) in patients ≥70 years of age undergoing hip fracture surgery. ⋯ HUSA leads to fewer episodes of severe intraoperative hypotension compared to GA in an elderly population undergoing hip fracture surgery.
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Curr Opin Crit Care · Dec 2022
ReviewLung transplantation in patients with lung disease secondary to coronavirus disease 2019 infection.
In this article, we describe preoperative patient selection and outcomes of patients with lung disease secondary to infection from COVID-19 who receive lung transplantation. ⋯ Patients with respiratory failure secondary to COVID-19 infection that require a lung transplant generally have a complicated preoperative course and the operations are more complex, but the long-term outcomes are excellent.
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Minerva anestesiologica · Dec 2022
Research progress of goal-directed fluid therapy in prone position surgery.
Goal-directed fluid therapy (GDFT) is currently recognized as a scientific and reasonable method of perioperative capacity management. However, most of the studies on GDFT are carried out in the supine position, while there are few studies on applying GDFT in the prone position. ⋯ Although it is controversial whether the GDFT strategy can improve the clinical outcome of patients undergoing prone position surgery, it is still the mainstream choice of fluid therapy. In the future, we need to explore further the method of predicting the fluid responsiveness of patients in the prone position, improve the GDFT strategy, and guide the perioperative fluid therapy of patients in the prone position.
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Anesthesia and analgesia · Dec 2022
Identification of Preanesthetic History Elements by a Natural Language Processing Engine.
Methods that can automate, support, and streamline the preanesthesia evaluation process may improve resource utilization and efficiency. Natural language processing (NLP) involves the extraction of relevant information from unstructured text data. We describe the utilization of a clinical NLP pipeline intended to identify elements relevant to preoperative medical history by analyzing clinical notes. We hypothesize that the NLP pipeline would identify a significant portion of pertinent history captured by a perioperative provider. ⋯ In this proof-of-concept study, we demonstrated that utilization of NLP produced an output that identified medical conditions relevant to preanesthetic evaluation from unstructured free-text input. Automation of risk stratification tools may provide clinical decision support or recommend additional preoperative testing or evaluation. Future studies are needed to integrate these tools into clinical workflows and validate its efficacy.
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Thomas Dent Mütter, a Philadelphia plastic surgeon in the 1840s, boldly championed anesthesia when few physicians were convinced of its virtues. He was an early advocate of handwashing and hygienic wound care and helped pioneer the concept of postoperative recovery units. ⋯ In 1863, this vast collection would serve as the basis for the Mütter Museum, which remains active today. Mütter exemplified expertise by tirelessly pursuing new knowledge and methods for the benefit of his patients and students.