Development and Pilot Testing of a Programmatic System for Competency Assessment in US Anesthesiology Residency Training.

Background: In 2018, a set of entrustable professional activities (EPAs) and procedural skills assessments were developed for anesthesiology training, but they did not assess all the Accreditation Council for Graduate Medical Education (ACGME) milestones. The aims of this study were to (1) remap the 2018 EPA and procedural skills assessments to the revised ACGME Anesthesiology Milestones 2.0, (2) develop new assessments that combined with the original assessments to create a system of assessment that addresses all level 1 to 4 milestones, and (3) provide evidence for the validity of the assessments.

Persistent Pain After Cardiac Surgery: Prevention and Management.

Persistent postoperative pain (PPP) after cardiac surgery is a significant complication that negatively affects patient quality of life and increases health care system burden. However, there are no standards or guidelines to inform how to mitigate these effects. Therefore, in this review, we will discuss strategies to prevent and manage PPP after cardiac surgery.

Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training.

Background: Modern medical education requires frequent competency assessment. The Accreditation Council for Graduate Medical Education (ACGME) provides a descriptive framework of competencies and milestones but does not provide standardized instruments to assess and track trainee competency over time. Entrustable professional activities (EPAs) represent a workplace-based method to assess the achievement of competency milestones at the point-of-care that can be applied to anesthesiology training in the United States.

Objective postoperative pain assessment using incentive spirometry values: a prospective observational study.

Determine if incentive spirometry (IS) values correlate with postoperative pain control. Prospective observational study. A total of 100 patients undergoing major abdominal procedures at the University of North Carolina Medical Center.

S-100 and Antioxidant Capacity in Cerebrospinal Fluid during and after Thoracic Endovascular Aortic Repair.

Background: Thoracic Endovascular Aortic Repair (TEVAR) has substantially decreased the mortality and major complications from aortic surgery. However, neurological complications such as spinal cord ischemia may still occur after TEVAR. S-100 is a biomarker of central nervous system injury, and oxidant injury plays an important role in neurological injury.

Assessment of circulating blood volume with fluid administration targeting euvolemia or hypervolemia.

Background: The occurrence of hypovolemia in the setting of cerebral vasospasm reportedly increases the risk for delayed ischemic neurologic deficits. Few studies have objectively assessed blood volume (BV) in response to fluid administration targeting normovolemia (NV) or hypervolemia (HV) and none have done so with crystalloids alone. The primary purpose was to evaluate the BV of patients with SAH receiving crystalloid fluid administration targeting NV or HV.

Interval vs massed training: how best do we teach surgery?

Objective: To compare 2 different training paradigms, massed vs interval training, when novice students learn a surgical procedure, myringotomy with ventilation tube insertion, on a validated surgical simulator.

Study Design: Medical students were randomized into 2 training groups: the interval group (n = 19) was trained to perform the procedure in 5 trials/d over 3 days, and the massed group (n = 21) was trained to perform the procedure in 15 trials all in 1 session. One week later, all students were tested in 5 additional final trials.

Differences in end-of-life care in the ICU across patients cared for by medicine, surgery, neurology, and neurosurgery physicians.

Background: Some of the challenges in the delivery of high-quality end-of-life care in the ICU include the variability in the characteristics of patients with certain illnesses and the practice of critical care by different specialties.

Methods: We examined whether ICU attending specialty was associated with quality of end-of-life care by using data from a clustered randomized trial of 14 hospitals. Patients died in the ICU or within 30 h of transfer and were categorized by specialty of the attending physician at time of death (medicine, surgery, neurology, or neurosurgery).

Validity of exchangeable solute balance as a measure of blood volume in neurologically injured adults.

Background: Daily weight (DW) and examination of fluid balances (FB) are commonly used in assessments of extracellular fluid (ECF) and circulating blood volume (BV). We hypothesized that a calculated total body exchangeable solute, the main determinant of the ECF, would have high agreement and correlation with actual BV.

Methods: The University of Washington IRB approved the study.

Preliminary report on cardiac dysfunction after isolated traumatic brain injury.

Objective: The aim of this study was to examine cardiac dysfunction during the first 2 weeks after isolated traumatic brain injury and its association with in-hospital mortality.

Design: Retrospective.

Setting: Level 1 regional trauma center.

Rat intubation and ventilation for surgical research.

Effective outcomes in cardiothoracic surgical research using rodents are dependent upon adequate techniques for intubation and mechanical ventilation. Multiple methods are available for intubation of the rat; however, not all techniques are appropriate for survival studies. This article presents a refinement of intubation techniques and a simplified mechanical ventilation setup necessary for intrathoracic surgical procedures using volatile anesthetics.