Anesthesiology
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Postoperative pulmonary complications (PPCs) can increase hospital length of stay, postoperative morbidity and mortality. Despite many factors can increase the risk of PPCs, it is not known whether intraoperative ventilation/perfusion (V/Q) mismatch can be associated with an increased risk of PPCs after major non-cardiac surgery. ⋯ In patients with intermediate/high risk of PPCs undergoing major non-cardiac surgery, intraoperative V/Q mismatch is associated with the development of PPCs. Increased high V/Q before extubation is independently associated with the occurrence of PPCs in the first 7 days after surgery.
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The best approaches to supplemental oxygen administration during surgery remain unclear, which may contribute to variation in practice. We aimed to assess determinants of oxygen administration and its variability during surgery. ⋯ Among adults undergoing surgery with anesthesia and tracheal intubation, supplemental oxygen administration was variable and appeared arbitrary. Most patient and procedure factors had statistical but minor clinical associations with oxygen administration. Medical center and anesthesia provider explained significantly more variability in oxygen administration than patient or procedure factors.
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Preventing emergence delirium is a clinical goal for pediatric anesthesia, yet there is no consensus on its prevention. This study investigated the hypothesis that a continuous infusion or a single bolus of remimazolam can reduce the incidence of emergence delirium in children. ⋯ Both continuous infusion and single bolus administration of remimazolam can effectively reduce the occurrence of emergence delirium in children.