Hemodynamic Effects of Methamphetamine and General Anesthesia.

Design: A retrospective analysis of all anesthetic records at our institution over a two-year period was performed. . Operating room cases under balanced anesthesia.

Succinylcholine Administration and Resultant Pulseless Ventricular Tachycardia: A Case Report of Communication Breakdown During an Emergent Intubation.

Poor communication continues to be one of the leading root causes of sentinel events in the United States annually. This case report documents a miscommunication that occurred during the management of a patient with Guillain-Barré syndrome (GBS) and acute respiratory failure requiring emergent intubation, which resulted in a transient hyperkalemia and subsequent cardiac arrest.

Safety and Efficacy of Hospital Utilization of Tranexamic Acid in Civilian Adult Trauma Resuscitation.

Introduction: Patients with trauma-induced coagulopathies may benefit from the use of antifibrinolytic agents, such as tranexamic acid (TXA). This study evaluated the safety and efficacy of TXA in civilian adults hospitalized with traumatic hemorrhagic shock.

Methods: Patients who sustained blunt or penetrating trauma with signs of hemorrhagic shock from June 2014 through July 2018 were considered for TXA treatment.

Preventing Mistransfusions: An Evaluation of Institutional Knowledge and a Response.

Background: Blood product mistransfusions occur when a process error causes transfusion of incompatible blood products. These events are known sources of negative patient outcomes. One such event demonstrated an institutional knowledge gap and an opportunity to reduce this source of transfusion errors.

An Assessment of Basic Patient Safety Skills in Residents Entering the First Year of Clinical Training.

Objectives: During safety rounds, we observed few residents demonstrating hand hygiene and patient identification as they began their postgraduate clinical training. We assessed baseline performance of these 2 basic safety skills in residents entering the first year of postgraduate clinical training (PGY1).

Methods: PGY1 residents beginning training on July 1, 2013, and July 1, 2014, at our institution were examined using a simulated scenario testing for hand hygiene and patient identification.

To do or not to do a preinduction check-up of the anesthesia machine.

The anesthesia machine check is an integral part of the anesthesiologist's daily routine. It is standard operating procedure to check the high- and low-pressure systems of the machine as well as other integral parts that are accessible. Many new anesthesia machines offer a self-testing capability, but older ones with fewer electronics on board are still widely used.

Management of an unusual complication during placement of a pulmonary artery catheter.

We describe an unusual complication during flotation of a pulmonary artery catheter through a preexisting percutaneous introducer sheath. A malfunctioning pulmonary artery catheter, which was placed through an introducer sheath in the right internal jugular vein, was removed. Attempts at repositioning a second pulmonary artery catheter met with resistance, and we were unable to either advance or withdraw it.

A laboratory evaluation of the level 1 rapid infuser (H1025) and the Belmont instrument fluid management system (FMS 2000) for rapid transfusion.

Unlabelled: In this investigation I compared the heating capabilities, infusion rates, and air management system of the new FMS 2000 and the Level 1 infusion systems. A rollerhead pump was placed at the position of the IV bag spikes on the Level 1 disposable set and used to match the flow of the rollerhead pump of the FMS 2000. Infusate temperature was measured at 250 and 500 mL/min by using packed red blood cells (PRBC) at the infusate supply and distal end of the disposable tubing.

Effect of site of venous protamine administration, previously alleged risk factors, and preoperative use of aspirin on acute protamine-induced pulmonary vasoconstriction.

Objective: To determine whether the incidence of protamine-induced pulmonary vasoconstriction (PIPV) is influenced by central venous versus peripheral venous infusion of protamine and whether aspirin ingestion within a week of surgery would decrease the incidence of PIPV.

Design: Single-institution, prospective, observational, randomized trial.

Setting: University teaching hospital.

Comparison of thermodilution bolus cardiac output and Doppler cardiac output in the early post-cardiopulmonary bypass period.

Objective: To evaluate the accuracy of measuring cardiac output (CO) in the early post-cardiopulmonary bypass (CPB) period by comparing thermodilution with Doppler methods.

Design: Prospective and blinded human trial.

Setting: Academic medical center.

Precardiopulmonary bypass right ventricular function is associated with poor outcome after coronary artery bypass grafting in patients with severe left ventricular systolic dysfunction.

Unlabelled: Patients with severe left ventricular systolic dysfunction (LVSD) undergoing coronary artery bypass grafting (CABG) have an increased risk for morbidity and mortality. The purpose of this study was to assess the association of pre-CABG right ventricular (RV) function with outcome for patients with severe LVSD. We performed a retrospective evaluation of 41 patients with severe LVSD (left ventricular ejection fraction [LVEF] < or =25%) scheduled for nonemergent CABG.

Polymerized bovine hemoglobin solution as a replacement for allogeneic red blood cell transfusion after cardiac surgery: results of a randomized, double-blind trial.

Background: Blood loss leading to reduced oxygen-carrying capacity is usually treated with red blood cell transfusions. This study examined the hypothesis that a hemoglobin-based oxygen-carrying solution can serve as an initial alternative to red blood cell transfusion.

Methods: In a randomized, double-blind efficacy trial of HBOC-201, a total of 98 patients undergoing cardiac surgery and requiring transfusion were randomly assigned to receive either red blood cell units or HBOC-201 (Hemopure; Biopure Corporation, Cambridge, Mass) for the first three postoperative transfusions.

Isoflurane does not further impair microvascular vasomotion in a rat model of subarachnoid hemorrhage.

Purpose: Since isoflurane is known to attenuate endothelium-dependent dilation (EDD) in normal cerebral arterioles, we examined whether the anesthetic has a similar effect and further impairs EDD in vessels exposed to SAH.

Methods: Autologous blood was introduced in the subarachnoid space and the parietal lobe harvested. Control animals were sacrificed without introduction of blood.