Residual neuromuscular block (RNMB) remains a significant safety concern for patients throughout the perioperative period and is still widely under-recognized by perioperative healthcare professionals. Current literature suggests an association between RNMB and an increased risk of postoperative pulmonary complications, a prolonged length of stay in the post anesthesia care unit (PACU), and decreased patient satisfaction. The 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade provide guidance for the use of quantitative neuromuscular monitoring coupled with neuromuscular reversal to recognize and reduce the incidence of RNMB.
View Article and Find Full Text PDFSemin Cardiothorac Vasc Anesth
December 2015
Mechanical circulatory support devices have been approved as bridge to transplantation, as bridge to recovery, or as destination therapy to treat end-stage heart failure. The perioperative challenges for the anesthesiologist and the intensivist caring for these patients include device-related complications, hemodynamic instability, arrhythmias, right ventricular failure, and coagulopathy. Perioperative management in this high-risk population has a significant impact on patient outcomes.
View Article and Find Full Text PDFPurpose: Arterial blood gas (ABG) analysis is a useful tool to evaluate hypercapnia in the context of conditions and diseases affecting the lungs. Oftentimes, indications for ABG analysis are broad and nonspecific and lead to frequent testing without test results influencing patient management.
Materials And Methods: Electronic charts of 300 intensive care unit (ICU) patients at a single institution were reviewed retrospectively.
Objective: Several strategies have been used to reduce the incidence of right ventricular failure after left ventricular assist device (LVAD) placement, including pulmonary vasodilation. The inhaled prostacyclin, epoprostenol, selectively dilates the pulmonary vasculature of ventilated areas of the lung, but also has been shown to inhibit platelet aggregation.(1) The authors evaluated the impact of early initiation of epoprostenol administration during LVAD placement on pulmonary artery pressures, use of vasoactive drugs, and blood loss.
View Article and Find Full Text PDFVolatile anesthetics have been the major anesthetics used clinically for more than 150 years. They provide all components of general anesthesia and are easy to be applied and monitored with modern equipment and technology. In addition to having anesthetic property, volatile anesthetics have multiple other effects.
View Article and Find Full Text PDFBackground: Systemic arterial respiratory variation has been shown to be a reliable predictor of changes in cardiac output after fluid administration. Arterial respiratory variation is often estimated from visual examination of the arterial waveform tracing. Our goal in this study was to assess the ability of anesthesia providers to visually estimate systolic pressure variation (SPV) as a percentage of systolic blood pressure (SPV).
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