Articles: cations.
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The knowledge required to manage surgical patients has expanded considerably over the past 40 years. Simultaneously, the cost of medical education has increased substantially. Surgical trainees are at particular disadvantage due to the time demands of training. We aim to determine whether surgeon compensation over time has adequately accounted for increasing student debt burden. ⋯ The rate of debt accumulation has outpaced the rate of salary growth for general surgeons to a significant degree.
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Airway management is often a life-saving procedure for patients. However, during airway management, difficult ventilation and difficult intubation are not always predictable. Preoxygenation, a crucial technique to improve oxygen reserves, plays a vital role in preventing hypoxemia during anesthesia induction. Preoxygenation technology and equipment are not monolithic. With the development of preoxygenation equipment and technology, the effect of preoxygenation has been improved, and it can be applied to different clinical settings. ⋯ Preoxygenation is really effective, and different preoxygenation equipment and technology can be applied in different clinical settings to improve the oxygen reserve of patients, thereby ensuring patient safety and improving patient outcome.
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While acute myocardial infarction (AMI) is widely recognized as the primary cause of Cardiogenic Shock (CS), Non-AMI related CS has been excluded from the majority of CS studies. Information on its prognostic factors remains largely understudied, and it is necessary to focus on these patients to identify the specific risk factors. In this study, we aimed to build and validate a predictive nomogram and risk classification system. ⋯ For non-AMI associated CS, a predictive nomogram and risk classification system were developed and validated, and the nomogram demonstrated good performance in prognostic prediction and risk stratification.
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There remains clinical equipoise regarding the preference for upfront appendectomy or nonoperative management for patients with complicated appendicitis. However, the natural history of the appendix following nonoperative management and pending interval appendectomy in children is not well characterized, and the risk of recurrent appendicitis as a function of time from index admission not known. ⋯ The highest likelihood of recurrent appendicitis or complications following nonoperative management of complicated appendicitis occurs in the first 50 days following index admission. This information will help surgeons during shared decision-making conversations regarding timing of interval appendectomy.
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Minerva anestesiologica · Dec 2024
Awake veno-venous extracorporeal membrane oxygenation: practical aspects and considerations.
Veno-venous extracorporeal membrane oxygenation (ECMO) is a life-saving technique in the armamentarium of critical care medicine. It involves extracorporeal blood circulation outside the body, providing temporary respiratory support while allowing the lungs to heal. ⋯ The "awake ECMO" concept emerged as a promising strategy to mitigate sedation-related complications and facilitate early mobilization in critically ill patients. In this article, we describe the potential advantages of awake ECMO and its role in preserving respiratory muscle function, enhancing rehabilitation prospects, and improving patient outcomes.