3,351 results match your criteria: "Departments of Anesthesiology and Critical Care Medicine; Mayo Clinic; Jacksonville[Affiliation]"

Introduction: Millions of persons with chronic pain across North America and Europe use opioids. While the immunosuppressive properties of opioids are associated with risks of infections, these outcomes could be mitigated through careful patient selection and monitoring practices when appropriate. It is important to recognise that some patients do benefit from a carefully tailored opioid therapy.

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Association Between Neuromuscular Blocking Agents and Outcomes of Emergency Tracheal Intubation: A Secondary Analysis of Randomized Trials.

Ann Emerg Med

January 2025

Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN; Division of Allergy, Pulmonary & Critical Care, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.

Study Objective: To examine the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt and severe complications during tracheal intubation of critically ill adults in an emergency department (ED) or ICU.

Methods: We performed a secondary analysis of data from 2 multicenter randomized trials in critically ill adults undergoing tracheal intubation in an ED or ICU. Using a generalized linear mixed-effects model with prespecified baseline covariates, we examined the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt (primary outcome) and severe complications during tracheal intubation (secondary outcome).

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Article Synopsis
  • Trauma can increase the risk of unhealthy alcohol use, and this study investigates how brain reward systems change after trauma exposure in humans.
  • The research involved 286 participants who were assessed for changes in alcohol use and brain activity through fMRI shortly after experiencing trauma.
  • Findings suggest that heightened brain activity in specific regions (like the VTA) and altered connections between brain areas may lead to increased alcohol consumption following traumatic events, indicating potential targets for early intervention.
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  • The study investigates how often to screen critically ill adults on ventilators and the best method for conducting spontaneous breathing trials (SBT) to successfully extubate them.
  • It involves a randomized clinical trial with 797 participants who required mechanical ventilation, comparing once-daily and more frequent screenings alongside two SBT techniques: pressure-supported and T-piece.
  • Results show no significant differences in the time to successful extubation based on screening frequency or SBT technique, indicating that both methods may be similarly effective.
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Wearable devices as part of postoperative early warning score systems: a scoping review.

J Clin Monit Comput

October 2024

Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126, Parma, Italy.

Article Synopsis
  • Postoperative deterioration can be indicated by changes in vital signs, but many hospitals lack resources for continuous monitoring outside of ICUs, prompting the use of wearable devices (WDs) for patient monitoring.
  • A Scoping Review was conducted using various databases to analyze the effectiveness of WDs as part of Continuous Remote Early Warning Score (CREWS) systems in monitoring patients after cardiac and non-cardiac surgeries, resulting in 10 studies featuring 11 CE/FDA approved devices.
  • The findings suggest that WDs are not only feasible and safe for monitoring but also help reduce the length of hospital stays and ICU admissions, leading to lower healthcare costs and better identification of potential complications post-surgery
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  • - Conscientious objection allows medical professionals to opt-out of patient care that conflicts with their personal values, but in anesthesiology, this raises unique ethical issues because they primarily support the performance of procedures by others rather than directly carrying them out themselves.
  • - There are established cases for conscientious objection in areas like abortion and futile treatments, but emerging procedures like gender-affirming surgery introduce complex ethical dilemmas for anesthesiologists regarding patient care.
  • - The review explores the legal, ethical, and practical aspects of conscientious objection in anesthesiology, the challenges faced by healthcare groups when this right is exercised, and potential strategies to navigate the resulting ethical tensions.
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Perioperative considerations in the paediatric patient with congenital and acquired coagulopathy.

BJA Open

December 2024

Divisions of Critical Care and Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.

Article Synopsis
  • * New ways to check for bleeding issues are being developed, like viscoelastic testing, but there aren’t enough age-specific guidelines for doctors to follow yet.
  • * Treatment for children with bleeding problems can include medications and blood products, and doctors are advised to use expert opinions until more research is done on how to best manage these situations in kids.
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Background Context: While some studies have demonstrated that ambulatory surgery centers (ASCs) are associated with reduced costs of orthopedic procedures, there is no consensus in the current literature as to the impact of ASCs versus hospital-based outpatient departments (HOPDs) on anterior cervical discectomies and fusions (ACDFs).

Purpose: This study sought to (1) compare immediate procedure reimbursements, patient out-of-pocket expenditures, and surgeon reimbursements for ACDFs performed at ASCs versus HOPDs and (2) identify factors predicting facility utilization.

Study Design: Retrospective cross-sectional study.

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Objective: Brain-Computer Interfaces (BCIs) hold significant promise for restoring communication in individuals with partial or complete loss of the ability to speak due to paralysis from amyotrophic lateral sclerosis (ALS), brainstem stroke, and other neurological disorders. Many of the approaches to speech decoding reported in the BCI literature have required time-aligned target representations to allow successful training - a major challenge when translating such approaches to people who have already lost their voice.

Approach: In this pilot study, we made a first step toward scenarios in which no ground truth is available.

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  • Many kids go to emergency rooms for help, especially those who can't easily see doctors regularly.
  • Police often work in these hospitals and can affect how care is given to these kids.
  • Doctors and nurses might not know the laws about how police should interact with young patients, which can cause problems and hurt the care these kids receive.
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  • * Recent efforts to stop smoking haven't been put into action yet, and it’s important to see what could happen if smoking rates stay the same or improve.
  • * Researchers used models to predict health outcomes by 2050 based on different scenarios of smoking rates, showing that cutting smoking could greatly improve health and life expectancy.
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Objectives: Although surgical site infection (SSI) is a commonly used quality metric after lower-limb revascularization surgery, outcomes associated with development of this complication are poorly characterized. We conducted a systematic review and meta-analysis of studies reporting associations between development of an SSI after these procedures and clinical outcomes and healthcare resource use.

Methods: We searched MEDLINE, Embase, CENTRAL, and Evidence-Based Medicine Reviews (inception to April 4th, 2023) for studies examining adjusted associations between development of an SSI after lower-limb revascularization surgery and clinical outcomes and healthcare resource use.

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Objective: This study measured the effect of renal function on the plasma concentrations of ceftazidime and avibactam in critically ill patients. We also sought to measure the concentration ratio of ceftazidime to avibactam.

Methods: This was a cohort study at a tertiary referral centre in Italy, on patients treated with continuous infusion of ceftazidime-avibactam (CAZ-AVI) between November 2019 and December 2023.

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Outpatient parenteral antimicrobial therapy with carbapenems: A systematic review.

J Infect

November 2024

UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, Australia. Electronic address:

Objective: To review the literature on parenteral carbapenems in OPAT and present comprehensive evidence on their safety, efficacy, and stability.

Methods: A systematic review following PRISMA guidelines was conducted through 17 January 2024, using PubMed, Embase, Web of Science, Scopus, and the Cochrane Library to find relevant articles.

Results: Ertapenem (1 g QD) in OPAT showed high clinical (81-97%) and microbiological (67-90.

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Article Synopsis
  • Spinal cord stimulation (SCS) is a treatment used when other options for pain relief haven't worked, but it can have problems and some patients stop following up with their doctors.
  • A study was done to find out why some patients didn't come back for their doctor visits after getting the SCS device, using phone surveys.
  • Out of 49 patients who were lost to follow-up, many said they stopped visiting because their pain got better or they had other health issues, while some just missed their appointments.
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  • Patients undergoing open radical cystectomy have a high risk of needing blood transfusions, and the study investigates the use of tranexamic acid (TXA) to potentially reduce this risk.
  • The TACT trial was a randomized, double-blind study conducted in 10 academic centers from 2013 to 2021, involving patients scheduled for this type of surgery due to bladder cancer.
  • Results showed no significant difference in RBC transfusion rates between the TXA group and the placebo group, with both groups needing transfusions at similar rates up to 30 days post-surgery.
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Background: Compared to intensive care unit patients with SARS-CoV-2 negative acute respiratory tract infections, patients with SARS-CoV-2 are supposed to develop more frequently and more severely neurologic sequelae. Delirium and subsequent neurocognitive deficits (NCD) have implications for patients' morbidity and mortality. However, the extent of brain injury during acute COVID-19 and subsequent NCD still remain largely unexplored.

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  • Emergency departments face significant risks for medical errors, prompting the development of a comprehensive ED Safety Checklist aimed at enhancing patient outcomes across various international settings.* -
  • The checklist was created through a modified Delphi consensus process involving experts from 34 countries, with initial items gathered from a systematic review, followed by rounds of evaluation to reach an 80% agreement for inclusion.* -
  • The final checklist consists of 86 items, which include a general ED Safety Checklist and five domain-specific checklists that focus on critical areas of care, improving communication, and preventing medical errors in emergency settings.*
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Endogenous orexin and hyperacute autonomic responses after resuscitation in a preclinical model of cardiac arrest.

Front Neurosci

September 2024

Departments of Neurology, Anesthesiology-Critical Care Medicine and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Article Synopsis
  • The study investigates how autonomic responses during the recovery from cardiac arrest (CA) are influenced by orexin, specifically examining whether the endogenous orexin promotes rapid cardiovascular sympathetic activity after resuscitation and how this is affected by the drug suvorexant, which blocks orexin receptors.
  • Using a rat model, the researchers monitored heart rate and blood pressure changes following CA, measuring the balance between sympathetic and parasympathetic activities through heart rate variability, while also assessing the levels of plasma orexin-A and neurological outcomes.
  • Findings showed that heart rate significantly increased shortly after resuscitation, correlating with better neurological outcomes, and this response was reduced when the rats were treated with suvore
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Background: Early detection of acute brain injury (ABI) at the bedside is critical in improving survival for patients with extracorporeal membrane oxygenation (ECMO) support. We aimed to examine the safety of ultra-low-field (ULF; 0.064-T) portable magnetic resonance imaging (pMRI) in patients undergoing ECMO and to investigate the ABI frequency and types with ULF-pMRI.

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  • Procedural sedation lacks standardized competencies and training programs across various practitioners and settings, leading to inconsistency in practices.
  • The International Committee for the Advancement of Procedural Sedation aimed to establish a consensus on the essential competencies required for practitioners, utilizing a framework focused on Competency-Based Medical Education.
  • Through literature review and iterative consensus-building, the committee identified core competencies related to knowledge, skills, and attitudes, and proposed a structured framework for training and credentialing in procedural sedation.
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