Search results for "anesthesiology"
showing 10 items of 1218 documents
Hemodynamic Monitoring in Patients With Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
2020
Aneurysmal subarachnoid hemorrhage (aSAH) often causes cardiopulmonary dysfunction. Therapeutic strategies can be guided by standard (invasive arterial/central venous pressure measurements, fluid balance assessment), and/or advanced (pulse index continuous cardiac output, pulse dye densitometry, pulmonary artery catheterization) hemodynamic monitoring. We conducted a systematic review and meta-analysis of the literature to determine whether standard compared with advanced hemodynamic monitoring can improve patient management and clinical outcomes after aSAH. A literature search was performed for articles published between January 1, 2000 and January 1, 2019. Studies involving aSAH patients …
Die emotionale Zufriedenheit von Patienten mit der anästhesiologischen Betreuung
2003
Objective The evaluation of services by patients is an integral part of continuous quality improvement in anaesthesia. Patient satisfaction is affected by various objective and subjective variables. Individual experiences, impressions and needs represent an important part of overall patient satisfaction. Methods Data of 519 patients were collected in a standardised anonymous questionnaire independent of the post-anaesthetic visit. Results Anaesthesia staff appeared to be friendly to 97 % of patients asked, 95 % of patients wanted to be treated by the same staff in case of another anaesthesia, nearly 87 % felt relaxed and satisfied after anaesthesia. Up to 26 % of patients felt tense after p…
Opioid tolerance and dependence -- do they matter?
2004
The use of opioids has long been accepted as the standard of care in patients with cancer and acute pain. Opioids can further be used effectively in specific subgroups of patients with chronic nonmalignant pain states. While the development of tolerance and physical dependence are known effects of opioids in cancer and noncancer pain populations, these patients can not be regarded as addicted. However, long-term therapy with short-acting opioids predisposes to tolerance and addiction. Recent research has confirmed the important role of psychopathologic and psychosocial conditions as predictors of failed opioid effectiveness in a significant number of noncancer pain subgroups. The clinical p…
Consideraciones preoperatorias y manejo neuroanestesiológico intraoperatorio
2012
The anesthesiological management of patients undergoing neurosurgery of the posterior fossa has a series of characteristics that should be known by anesthesiologists. Intraoperative management is guided by a series of factors that include the physiopathological changes secondary to the patient's position during surgery, the importance of appropriate patient positioning to facilitate the surgical approach, the lower tolerance to changes in the elastance of the infratentorial region, the limited therapeutic options in episodes of intraoperative edema-swelling, and the presence of complications such as a venous air embolism. This first contribution to the guidelines discusses the main evidence…
Transmission of arterial oxygen partial pressure oscillations to the cerebral microcirculation in a porcine model of acute lung injury caused by cycl…
2013
Cyclic recruitment and derecruitment (R/D) play a key role in the pathomechanism of acute lung injury (ALI) leading to respiration-dependent oscillations of arterial partial pressure of oxygen (Pa(O(2))). These Pa(O(2)) oscillations could also be forwarded to the cerebral microcirculation.In 12 pigs, partial pressure of oxygen was measured in the thoracic aorta (Pa(O(2))) and subcortical cerebral tissue (Pbr(O(2))). Cerebral cortical haemoglobin oxygen saturation (Sbr(O(2))), cerebral blood flow (CBF), and peripheral haemoglobin saturation (Sp(O(2))) were assessed by spectroscopy and laser Doppler flowmetry. Measurements at different fractions of inspired oxygen (F(I(O(2)))) were performed …
Takotsubo Syndrome After Mitral Valve Replacement: Case Report and Brief Review of the Literature
2015
RANSIENT LEFT VENTRICULAR apical ballooningsyndrome, also known as Takotsubo or stress-inducedcardiomyopathy, is a cardiac disease characterized by transientleft ventricular dysfunction, electrocardiographic changes mim-icking an acute coronary syndrome, and release of myocardialcellular necrosis enzymes in the absence of significant lesionsof coronary arteries.
The anesthesiologist and end-of-life care
2012
Purpose of review Anesthesiologists may face problematic situations when patients are close to death, in which clinical problems, decision-making processes, and ethical issues are often interconnected and dependent on each of them. The aim of this review is to assess the recent literature regarding the anesthesiological role for advanced cancer patients. Recent findings Palliative sedation in the dying patients, end-of-life problems in the ICU, and pain control in advanced cancer patients have been the subject of recent research. All these issues have shown that anesthesiologist would be expert in the field of pain and symptom control at the end of life. End-of-life care problems are common…
Algoritmo diagnóstico-terapéutico de las microangiopatías trombóticas. A propósito de 2 casos
2022
Thrombotic microangiopathies (TMA) are a group of clinical syndromes associated with haemolytic anaemia, thrombocytopenia and organ dysfunction, mainly renal or neurological. They are associated with significant morbidity and mortality, so early diagnosis and treatment are essential. In this article we report two cases of TMA; a patient with thrombotic thrombocytopenic purpura (TTP) and a patient with atypical haemolytic uraemic syndrome (aHUS).
European guidelines on perioperative venous thromboembolism prophylaxis:Day surgery and fast-track surgery
2017
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient managem…
Elimination of hexamethylene diisocyanate cross-linked polypeptides in patients with normal or impaired renal function
1978
Infusions of 3.5% isocyanate cross-linked polypeptide solution 500 ml were given to 52 patients with normal or impaired renal function: glomerular filtration rate (GFR)=0–133 ml/min. The serum concentration and urinary excretion of hydroxyproline were measured and the equivalent polypeptide concentrations were calculated from the results. In patients with normal renal function (GFR>90 ml/min) the proportion of polypeptide excreted in the urine up to 12 h was 45.4±2.6% ( $$\bar X$$ ±SEM), up to 24 h 47.7±2.9% and up to 48 h 49.3±3.4%. In patients with moderate renal insufficiency (GFR=30–90 ml/min) there was no decrease in polypeptide excretion and even in patients with more serious impairme…