A retrospective chart review was conducted on 241 oncology patients who received monitored anesthesia care for laparoscopy. A review of perioperative analgesic and sedative requirements, and perioperative complications is included. The authors conclude that laparoscopy for diagnostic and staging purposes can be accomplished successfully with monitored anesthesia care.
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Developing an EEG-based model to predict awakening after cardiac arrest using partial processing with the BIS Engine.
Anesthesiology
January 2025
Department of Anesthesiology, Brigham and Women's Hospital and Harvard Medical School, Boston MA, USA.
Introduction: Accurate prognostication in comatose survivors of cardiac arrest is a challenging and high-stakes endeavor. We sought to determine whether internal EEG subparameters extracted by the Bispectral Index (BIS) monitor, a device commonly used to estimate depth-of-anesthesia intraoperatively, could be repurposed to predict recovery of consciousness after cardiac arrest.
Methods: In this retrospective cohort study, we trained a 3-layer neural network to predict recovery of consciousness to the point of command following versus not based on 48 hours of continuous EEG recordings in 315 comatose patients admitted to a single US academic medical center after cardiac arrest (Derivation cohort: N=181; Validation cohort: N=134).
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December 2024
Weill Cornell Medicine, New York, NY, USA; St Vincent's Hospital, Melbourne, VIC, Australia.
Background: Postoperative delirium (POD) is a serious complication of surgery associated with prolonged hospitalisation, long-term cognitive decline, dementia and mortality. There is increasing evidence that electroencephalography (EEG) monitoring may reduce the incidence of POD, however, the best method for achieving this is unclear.
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Unravelling sources of variability on rocuronium pharmacokinetics: Implications for prolonged recovery in older patients.
Br J Clin Pharmacol
January 2025
Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics. College of Pharmacy, University of Florida, Orlando, FL, USA.
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View Article and Find Full Text PDFDynamic carotid compression arising from a change in patient position is a rare complication of goitre, with the potential for cerebral ischaemia and infarction. In this report, a 37-year-old woman presented with a multi-nodular goitre with clinical features concerning for transient cerebral ischaemia. The anaesthetic management and neurological monitoring used to mitigate the risk of cerebral ischaemia during thyroidectomy is described and the literature surrounding this rare complication is explored.
View Article and Find Full Text PDFValidation of the inadequate delivery of oxygen index in an adult cardiovascular intensive care unit.
JTCVS Open
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC.
Objective: Machine learning (ML) may allow for improved discernment of hemodynamics and oxygen delivery compared to standard invasive monitoring. We hypothesized that an ML algorithm could predict impaired delivery of oxygen (IDO) with comparable discrimination to invasive mixed venous oxygen saturation (SvO) measurement.
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