1
|
Daly Guris RJ, George P, Gurnaney HG. Simulation in pediatric anesthesiology: current state and visions for the future. Curr Opin Anaesthesiol 2024; 37:266-270. [PMID: 38573191 DOI: 10.1097/aco.0000000000001375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
PURPOSE OF REVIEW Simulation is a well established practice in medicine. This review reflects upon the role of simulation in pediatric anesthesiology in three parts: training anesthesiologists to care for pediatric patients safely and effectively; evaluating and improving systems of care for children; and visions for the future. RECENT FINDINGS Simulation continues to prove a useful modality to educate both novice and experienced clinicians in the perioperative care of infants and children. It is also a powerful tool to help analyze and improve upon how care is provided to infants and children. Advances in technology and computational power now allow for a greater than ever degree of innovation, accessibility, and focused reflection and debriefing, with an exciting outlook for promising advances in the near future. SUMMARY Simulation plays a key role in developing and achieving peak performance in the perioperative care of infants and children. Although simulation already has a great impact, its full potential is yet to be harnessed.
Collapse
Affiliation(s)
- Rodrigo J Daly Guris
- Children's Hospital of Philadelphia, Pennsylvania
- University of Pennsylvania, Philadelphia
| | - Preeta George
- Division of Pediatric Anesthesiology, Department of Anesthesiology, St. Louis Children's Hospital, Washington University, Missouri, USA
| | - Harshad G Gurnaney
- Children's Hospital of Philadelphia, Pennsylvania
- University of Pennsylvania, Philadelphia
| |
Collapse
|
2
|
Dundaru-Bandi D, Antel R, Ingelmo P. Advances in pediatric perioperative care using artificial intelligence. Curr Opin Anaesthesiol 2024; 37:251-258. [PMID: 38441085 DOI: 10.1097/aco.0000000000001368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE OF THIS REVIEW This article explores how artificial intelligence (AI) can be used to evaluate risks in pediatric perioperative care. It will also describe potential future applications of AI, such as models for airway device selection, controlling anesthetic depth and nociception during surgery, and contributing to the training of pediatric anesthesia providers. RECENT FINDINGS The use of AI in healthcare has increased in recent years, largely due to the accessibility of large datasets, such as those gathered from electronic health records. Although there has been less focus on pediatric anesthesia compared to adult anesthesia, research is on- going, especially for applications focused on risk factor identification for adverse perioperative events. Despite these advances, the lack of formal external validation or feasibility testing results in uncertainty surrounding the clinical applicability of these tools. SUMMARY The goal of using AI in pediatric anesthesia is to assist clinicians in providing safe and efficient care. Given that children are a vulnerable population, it is crucial to ensure that both clinicians and families have confidence in the clinical tools used to inform medical decision- making. While not yet a reality, the eventual incorporation of AI-based tools holds great potential to contribute to the safe and efficient care of our patients.
Collapse
Affiliation(s)
| | - Ryan Antel
- Department of Anesthesia, McGill University
| | - Pablo Ingelmo
- Department of Anesthesia, McGill University
- Division of Pediatric Anesthesia
- Edwards Family Interdisciplinary Center for Complex Pain. Montreal Children's Hospital
- Research Institute, McGill University Health Center
- Alan Edwards for Research on Pain. McGill University, Montreal, Quebec, Canada
| |
Collapse
|
3
|
Shiraishi-Zapata CJ. Recent trends in the density of Peruvian physician anesthesia providers and their regional distribution. Int J Obstet Anesth 2024; 58:103972. [PMID: 38508959 DOI: 10.1016/j.ijoa.2023.103972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/10/2023] [Accepted: 12/17/2023] [Indexed: 03/22/2024]
Affiliation(s)
- C J Shiraishi-Zapata
- Service of Anesthesiology and Surgical Center "Telésforo León Velasco", Hospital III José Cayetano Heredia, EsSalud Piura, Peru.
| |
Collapse
|
4
|
Christensen E, Morabito J, Kowalsky M, Tsai JP, Rooke D, Clendenen N. Year in Review 2022: Noteworthy Literature in Cardiac Anesthesiology. Semin Cardiothorac Vasc Anesth 2023; 27:123-135. [PMID: 37126462 PMCID: PMC10445401 DOI: 10.1177/10892532231173074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Last year researchers made substantial progress in work relevant to the practice of cardiac anesthesiology. We reviewed 389 articles published in 2022 focused on topics related to clinical practice to identify 16 that will impact the current and future practice of cardiac anesthesiology. We identified 4 broad themes including risk prediction, postoperative outcomes, clinical practice, and technological advances. These articles are representative of the best work in our field in 2022.
Collapse
Affiliation(s)
- Elijah Christensen
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | | | | | | | | | | |
Collapse
|
5
|
Martinez-Simon A, Honorato-Cia C, Cacho-Asenjo E, Aquerreta I, Panadero-Sanchez A, Núñez-Córdoba JM. COVID-19 publications in anaesthesiology journals: a bibliometric analysis. Br J Anaesth 2022; 128:e239-e241. [PMID: 34955168 PMCID: PMC8654585 DOI: 10.1016/j.bja.2021.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Antonio Martinez-Simon
- Department of Anaesthesia and Critical Care, Clínica Universidad de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Cristina Honorato-Cia
- Department of Anaesthesia and Critical Care, Clínica Universidad de Navarra, Pamplona, Spain
| | - Elena Cacho-Asenjo
- Department of Anaesthesia and Critical Care, Clínica Universidad de Navarra, Pamplona, Spain
| | - Irene Aquerreta
- Pharmacy Service, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - Jorge M Núñez-Córdoba
- Research Support Service, Central Clinical Trials Unit, Clínica Universidad de Navarra, Pamplona, Spain; Institute of Data Science and Artificial Intelligence, University of Navarra, Pamplona, Spain.
| |
Collapse
|
6
|
Yánez Benítez C, Ribeiro MAF, Alexandrino H, Koleda P, Baptista SF, Azfar M, Di Saverio S, Ponchietti L, Güemes A, Blas JL, Mesquita C. International cooperation group of emergency surgery during the COVID-19 pandemic. Eur J Trauma Emerg Surg 2021; 47:621-629. [PMID: 33047158 PMCID: PMC7550249 DOI: 10.1007/s00068-020-01521-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/26/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE The COVID-19 pandemic has changed working conditions for emergency surgical teams around the world. International surgical societies have issued clinical recommendations to optimize surgical management. This international study aimed to assess the degree of emergency surgical teams' adoption of recommendations during the pandemic. METHODS Emergency surgical team members from over 30 countries were invited to answer an anonymous, prospective, online survey to assess team organization, PPE-related aspects, OR preparations, anesthesiologic considerations, and surgical management for emergency surgery during the pandemic. RESULTS One-hundred-and-thirty-four questionnaires were returned (N = 134) from 26 countries, of which 88% were surgeons, 7% surgical trainees, 4% anesthetists. 81% of the respondents got involved with COVID-19 crisis management. Social media were used by 91% of the respondents to access the recommendations, and 66% used videoconference tools for team communication. 51% had not received PPE training before the pandemic, 73% reported equipment shortage, and 55% informed about re-use of N95/FPP2/3 respirators. Dedicated COVID operating areas were cited by 77% of the respondents, 44% had performed emergency surgical procedures on COVID-19 patients, and over half (52%), favored performing laparoscopic over open surgical procedures. CONCLUSION Surgical team members have responded with leadership to the COVID-19 pandemic, with crisis management principles. Social media and videoconference have been used by the vast majority to access guidelines or to communicate during social distancing. The level of adoption of current recommendations is high for organizational aspects and surgical management, but not so for PPE training and availability, and anesthesiologic considerations.
Collapse
Affiliation(s)
- Carlos Yánez Benítez
- General and GI Surgery Department, Royo Villanova Hospital, SALUD, Av. de San Gregorio s/n. 50015, Zaragoza, Spain
| | - Marcelo A. F. Ribeiro
- Department of General Surgery and Trauma Surgery, Catholic University of São Paulo PUC-Sorocaba and Hospital Moriah, Avenida Victor Civita, Sao Paulo, 235 Brazil
| | - Henrique Alexandrino
- Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045 Coimbra, Portugal
| | - Piotr Koleda
- Department of Medical Simulation, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | | | - Mohammad Azfar
- Department of General Surgery, Al Rahba Hospital, Abu Dhabi, UAE
| | - Salomone Di Saverio
- Department of General Surgery, Varese University Hospital, ASST Sette Laghi, University of Insubria, Regione Lombardia, Varese, Italy
| | - Luca Ponchietti
- Department of General Surgery, San Jorge University Hospital, Av. Martínez de Velasco, 36, 22004 Huesca, Spain
| | - Antonio Güemes
- Department of General Surgery, Lozano Blesa University Hospital, Av. San Juan Bosco, 15, 50009 Zaragoza, Spain
| | - Juan L. Blas
- General and GI Surgery Department, Royo Villanova Hospital, SALUD, Av. de San Gregorio s/n. 50015, Zaragoza, Spain
| | - Carlos Mesquita
- Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045 Coimbra, Portugal
| |
Collapse
|
7
|
Wu J, Chen X, Chen X, Yao S, Liu R. The Initial Response to a Pandemic: Anesthesiology Experiences from China at the Onset of COVID-19. Anesthesiol Clin 2021; 39:255-264. [PMID: 34024429 PMCID: PMC7877230 DOI: 10.1016/j.anclin.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jing Wu
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Xueyin Chen
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Xiangdong Chen
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Shanglong Yao
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei 430022, China.
| | - Renyu Liu
- Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Center of Penn Global Health Scholar, 336 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA 19104, USA.
| |
Collapse
|
8
|
Abstract
The demographics of the United States is changing with 51% of the population being female, and 32% of the population identifying as an underrepresented minority (URM, ie, African American/black, Hispanic/Latino, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). Women and URMs have been historically underrepresented in medicine and in academic anesthesiology. This article provides an overview of the current status of women and URM faculty in academic anesthesiology and provides a framework for academic advancement. Throughout the text, the terms woman/women are used, as opposed to female, as the terms woman/women refer to gender, and female refers to biological sex.
Collapse
Affiliation(s)
- Paloma Toledo
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron Street, F5-704, Chicago, IL 60611, USA; Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Choy R Lewis
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron Street, F5-704, Chicago, IL 60611, USA
| | - Elizabeth M S Lange
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron Street, F5-704, Chicago, IL 60611, USA
| |
Collapse
|
9
|
Rajan S, Bebawy J, Avitsian R, Lee CZ, Rath G, Luoma A, Bilotta F, Pierce JT, Kofke WA. The Impact of the Global SARS-CoV-2 (COVID-19) Pandemic on Neuroanesthesiology Fellowship Programs Worldwide and the Potential Future Role for ICPNT Accreditation. J Neurosurg Anesthesiol 2021; 33:82-86. [PMID: 33075035 DOI: 10.1097/ana.0000000000000738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic is an international crisis placing tremendous strain on medical systems around the world. Like other specialties, neuroanesthesiology has been adversely affected and training programs have had to quickly adapt to the constantly changing environment. METHODS An email-based survey was used to evaluate the effects of the pandemic on clinical workflow, clinical training, education, and trainee well-being. The impact of the International Council on Perioperative Neuroscience Training (ICPNT) accreditation was also assessed. RESULTS Responses were received from 14 program directors (88% response rate) in 10 countries and from 36 fellows in these programs. Clinical training was adversely affected because of the cancellation of elective neurosurgery and other changes in case workflow, the introduction of modified airway and other protocols, and redeployment of trainees to other sites. To address educational demands, most programs utilized online platforms to organize clinical discussions, journal clubs, and provide safety training modules. Several initiatives were introduced to support trainee well-being during the pandemic. Feelings of isolation and despair among trainees varied from 2 to 8 (on a scale of 1 to 10). Fellows all reported concerns that their clinical training had been adversely affected by the coronavirus disease 2019 (COVID-19) pandemic because of decreased exposure to elective subspecialty cases and limited opportunities to complete workplace-based assessments and training portfolio requirements. Cancellation of examination preparation courses and delayed examinations were cited as common sources of stress. Programs accredited by the ICPNT reported that international networking and collaboration was beneficial to reduce feelings of isolation during the pandemic. CONCLUSION Neuroanesthesia fellowship training program directors introduced innovative ways to maintain clinical training, educational activity and trainee well-being during the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - John Bebawy
- Department of Anesthesiology & Neurological Surgery, Northwestern University Feinberg School of Medicine
| | - Rafi Avitsian
- General Anesthesiology, Cleveland Clinic, Cleveland, OH
| | - Chanhung Z Lee
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA
| | - Girija Rath
- Department of Neuroanaesthesiology & Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
| | - Astri Luoma
- Department of Neuroanaesthesia and Neurocritical Care, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
| | - Federico Bilotta
- Department of Anesthesiology and Critical Care, Sapienza University of Rome, Rome, Italy
| | - John T Pierce
- Department of Anesthesiology, Chicago Medical School, North Chicago, IL
| | - William A Kofke
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
10
|
Abstract
Patients with frailty experience substantial physical and emotional distress related to their condition and face increased morbidity and mortality compared with their nonfrail peers. Palliative care is an interdisciplinary medical specialty focused on improving quality of life for patients with serious illness, including those with frailty, throughout their disease course. Anesthesiology providers will frequently encounter frail patients in the perioperative period and in the intensive care unit (ICU) and can contribute to improving the quality of life for these patients through the provision of palliative care. We highlight the opportunities to incorporate primary palliative care, including basic symptom management and straightforward goals-of-care discussions, provided by the primary clinicians, and when necessary, timely consultation by a specialty palliative care team to assist with complex symptom management and goals-of-care discussions in the face of team and/or family conflict. In this review, we apply the principles of palliative care to patients with frailty and synthesize the evidence regarding methods to integrate palliative care into the perioperative and ICU settings.
Collapse
Affiliation(s)
- Rita C. Crooms
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Laura P. Gelfman
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
11
|
Affiliation(s)
- Elizabeth L. Whitlock
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - Robert A. Whittington
- Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
12
|
Zhang HF, Bo L, Lin Y, Li FX, Sun S, Lin HB, Xu SY, Bian J, Yao S, Chen X, Meng L, Deng X. Response of Chinese Anesthesiologists to the COVID-19 Outbreak. Anesthesiology 2020; 132:1333-1338. [PMID: 32195704 PMCID: PMC7155904 DOI: 10.1097/aln.0000000000003300] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019, named COVID-19 officially by the World Health Organization (Geneva, Switzerland) on February 12, 2020, has spread at unprecedented speed. After the first outbreak in Wuhan, China, Chinese anesthesiologists encountered increasing numbers of infected patients since December 2019. Because the main route of transmission is via respiratory droplets and close contact, anesthesia providers are at a high risk when responding to the devastating mass emergency. So far, actions have been taken including but not limited to nationwide actions and online education regarding special procedures of airway management, oxygen therapy, ventilation support, hemodynamic management, sedation, and analgesia. As the epidemic situation has lasted for months (thus far), special platforms have also been set up to provide free mental health care to all anesthesia providers participating in acute and critical caring for COVID-19 patients. The current article documents the actions taken, lesson learned, and future work needed.
Collapse
Affiliation(s)
- Hong-Fei Zhang
- From the Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, Guangzhou, China (H.F.Z., F.X.L., H.B.L., S.Y.X.) Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China (L.B., J.B., X.D.) Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Y.L., S.S., X.C., S.Y.) Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (L.M.)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Affiliation(s)
- Melissa R Kenevan
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. https://twitter.com/KenevanMelissa
| | - Bhargavi Gali
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| |
Collapse
|
14
|
Fisler N, Sweitzer BJ, Wurz J, Kleiman AM, Stueber F, Luedi MM. Achieving Gender Parity in Acute Care Medicine Requires a Multidimensional Perspective and a Committed Plan of Action. Anesth Analg 2019; 129:1778-1783. [PMID: 31743201 DOI: 10.1213/ane.0000000000004451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Nadja Fisler
- From the Department of Anaesthesiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Jeannie Wurz
- From the Department of Anaesthesiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amanda M Kleiman
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Frank Stueber
- From the Department of Anaesthesiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus M Luedi
- From the Department of Anaesthesiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
15
|
Chandrakantan A, Adler AC, Stayer S, Roth S. National Institutes of Health-Funded Anesthesiology Research and Anesthesiology Physician-Scientists: Trends, Promises, and Concerns. Anesth Analg 2019; 129:1761-1766. [PMID: 31743198 DOI: 10.1213/ane.0000000000004341] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With a difficult National Institutes of Health (NIH) funding climate, the pipeline of physician-scientists in Anesthesiology is continuing to get smaller with fewer new entrants. This article studies current NIH funding trends and offers potential solutions to continue the historical trend of academic innovation and research that has characterized academic Anesthesiology. Using publicly available data, specifically the NIH REPORTeR and Blue Ridge Institute for Medical Research, we examined NIH trends in funding in academic Anesthesiology departments that have Anesthesiology residency training programs. When adjusted for inflation, median NIH funding of departments of Anesthesiology declined approximately 15% between 2008 and 2017. The majority (55%) of NIH funding to academic Anesthesiology departments, including R01 and K-series grants, went to 10 departments in the United States. This trend has remained relatively constant for the 9-year period we studied (2009-2017). There is an inequitable distribution of NIH funding to Anesthesiology departments. Arguably, this may be a case of the "rich get richer," but the implications for those who are trying to become or remain NIH-funded investigators are that success may depend, in part, on securing a faculty position in one of these well-funded departments.
Collapse
Affiliation(s)
- Arvind Chandrakantan
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Adam C Adler
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Stephen Stayer
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | | |
Collapse
|
16
|
Koch BE. Waking Up Safer? An Anesthesiologist's Record. AANA J 2019; 87:15-16. [PMID: 31587731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
|
17
|
Tan TK. Disruptive innovators in anaesthesia: data and devices. Singapore Med J 2019; 60:108-109. [PMID: 30997516 PMCID: PMC6441683 DOI: 10.11622/smedj.2019024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Affiliation(s)
- Tong Khee Tan
- Correspondence: A/Prof Tan Tong Khee, Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore 169608.
| |
Collapse
|
18
|
Abstract
Clinical hypnosis is a skill of using words and gestures (frequently called suggestions) in particular ways to achieve specific outcomes. It is being increasingly recognised as a useful intervention for managing a range of symptoms, especially pain and anxiety. We surveyed all 317 South Australian Fellows and trainees registered with ANZCA to determine their use, knowledge of, and attitudes towards positive suggestion, hypnosis and hypnotherapy in their anaesthesia practice. The response rate was 218 anaesthetists (69%). The majority of respondents (63%) rated their level of knowledge on this topic as below average. Forty-eight per cent of respondents indicated that there was a role for hypnotherapy in clinical anaesthesia, particularly in areas seen as traditional targets for the modality, i.e. pain and anxiety states. Nearly half of the anaesthetists supported the use of hypnotherapy and positive suggestions within clinical anaesthesia. Those respondents who had experience of clinical hypnotherapy were more likely to support hypnosis teaching at undergraduate or postgraduate level when compared with those with no experience.
Collapse
Affiliation(s)
- J C Coldrey
- Department of Anaesthesia, Women's and Children's Hospital, Adelaide, South Australia
| | | |
Collapse
|
19
|
Science and Clinical Potpourri for Your Life and Your Practice. AANA J 2018; 86:345-6. [PMID: 31584403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
|
20
|
Abstract
In population health medicine, often it is not primary care, but rather the specialists' care teams that are responsible for the most overall spending for health care. Engaging specialists in population health medicine is a prerequisite to be successful in improving the quality of care by reducing complications, unnecessary utilization, avoidable Emergency Department visits/readmissions, and total cost of care. Creating patient-centric, physician-lead, interdisciplinary care teams to redesign the delivery of care across the continuum of the episode of care (eg, shadow bundle) is a successful approach to commercial or Centers for Medicare and Medicaid Services value-based payments.
Collapse
Affiliation(s)
- Mike Schweitzer
- Population Health, Premier Inc, PSH Learning Collaborative, Clearwater, FL, USA.
| |
Collapse
|
21
|
|
22
|
Abstract
The European Academy of Anaesthesiology was founded in 1978 as a means of meeting the challenges resulting from the introduction of the Medical Directives permitting the free movement of doctors within the European Community. The Academy is a scientific forum for anaesthetists throughout Europe -not just the EC countries - and has established its own English-language journal and multi-lingual Diploma examination. It is now embarking on a system of hospital recognition linked to intraining examinations. With the help of industry and a professional communications organization, it is also exploring the production of multi-lingual educational packages. It is believed that for effective evolution of hospital practice in Europe, medical specialties need to have their own academic organizations which will develop specialist training and which are in a position to provide appropriate advice to relevant national and European bodies.
Collapse
|
23
|
Connors NJ, Nelson LS. The Evolution of Recommended Naloxone Dosing for Opioid Overdose by Medical Specialty. J Med Toxicol 2016; 12:276-81. [PMID: 27271032 PMCID: PMC4996792 DOI: 10.1007/s13181-016-0559-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/10/2016] [Accepted: 05/19/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Opioid abuse and opioid overdose deaths have increased significantly over the past decade. Naloxone is a potentially life-saving medication that can reverse opioid-induced respiratory depression, though precipitated opioid withdrawal can pose acute risks to the patient and medical personnel. The optimal naloxone dose is unclear and few studies address this question. METHODS A convenience sample of commonly available references were queried for the recommended IV naloxone dose. When dosing recommendations were different for opioid-tolerant patients these were also recorded. RESULTS Twenty-five references were located. 48% recommended a starting dose ≤ 0.05 mg while 36% recommend a dose ten-fold higher. More than half of medical toxicology and general medical sources recommended a low-dose strategy with a starting dose lower than 0.05 mg IV. CONCLUSION There are variations in the recommended doses for naloxone with ranges spanning an order of magnitude. Further exploration is needed to determine the dose that balances reversal of respiratory depression with mitigation of withdrawal.
Collapse
Affiliation(s)
- Nicholas J Connors
- Division of Emergency Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Lewis S Nelson
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA
| |
Collapse
|
24
|
Jordan L, Tselentis H, Quraishi J. Developing a Health Services Research Agenda in Nurse Anesthesia Using a Modified Delphi Method. AANA J 2016; 84:234-238. [PMID: 30501148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The authors sought to formalize a process and ascertain research priorities for nurse anesthesia, which resulted in a new Health Services Research (HSR) Agenda. After formation of an 8-member ad hoc committee (representing different stakeholders from the American Association of Nurse Anesthetists [AANA]), a modified Delphi technique was used to determine the top 3 HSR research priorities for the 2016 fiscal year. The committee identified 24 high-priority HSR questions/topics specific to policy, education, or practice. An anonymous, web-based survey was distributed to the committee to rank and prioritize the 24 identified research questions using a 5-point Likert scale. Two consensus meetings and a second anonymous, web-based survey were conducted to prioritize the top 3 HSR questions. Through this systematic method, an HSR agenda was created based on the research questions initially submitted by the committee. The method used ensured that the new research agenda is relevant and reflects the priorities of Certified Registered Nurse Anesthetists. This agenda was incorporated into the updated AANA and AANA Foundation Joint Research Program as suggested areas of research. This agenda is intended to focus investigators and funding organizations on highest priority areas in nurse anesthesia research.
Collapse
|
25
|
Kulikov AS, Lubnin AY. [FAST TRACK CONCEPT IN MODERN NEUROANESTHESIOLOGY]. Anesteziol Reanimatol 2016; 61:130-137. [PMID: 27468505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The concept of fast-track is one of the most discussed trends in the development of modern surgery. According to supporters of this ideology, the use of fast-track leads to the reduction ofhospital stay without increasing in readmission, reducing the frequency of postoperative complications, which is reflected in the decrease in the cost of the treatment and social expenses, due to earlier return of patients to normal life. The authors of this review discuss different anesthetic issues of fast-track approach (early awakening, postoperative analgesia, prevention of PONV; neuromuscular block reversion). The paper contains also valuable reasons for using fast-track in neurosurgery, as well as contraindications to the use of this approach.
Collapse
|
26
|
Cavaliere F, Allegri M, Calderini E, Carassiti M, Coluzzi F, Di Marco P, Piastra M, Rossi M. A year in review in Minerva Anestesiologica 2015. Minerva Anestesiol 2016; 82:243-254. [PMID: 26822820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Franco Cavaliere
- Istituto di Anestesia e Rianimazione, Università Cattolica del Sacro Cuore, Policlinico "A. Gemelli", Rome, Italy -
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Affiliation(s)
- P Kranke
- Klinik und Poliklinik für Anästhesiologie, Zentrum Operative Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
| |
Collapse
|
28
|
Versyck B, Van Houwe P. A survey of obstetric anesthesia practices in Flanders - 10 year update. Acta Anaesthesiol Belg 2016; 67:101-111. [PMID: 29873465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We assessed the practice of obstetric anesthesia in Flanders through an on-line enquiry form and investigated the advancements by comparing the results with those of the 2004 survey. 54 (86%) structured forms were completed, representative for 94% of the accredited maternity beds in Flanders. Obstetric anesthesia is provided in all Flemish acute hospitals and 7/10 deliveries are performed nowadays with neuraxial analgesia. For labor analgesia, classical epidural remains the main neuraxial technique (62%) whereas CSE is used as default technique in 17% of the hospitals and upon indication in 21%. In half of the departments a test dose is used to validate the correct placement of the catheter, with lidocaine as the most (68%) commonly used test drug; this practice is comparable to 10 years ago. Ropivacaine (84%) with or without sufentanil is typically used as loading dose and ropivacaine with sufentanil (83%) to maintain the epidural analgesia. Patient-controlled epidural analgesia is the preferred maintenance mode (76%) for labor analgesia. CSE with hyperbaric bupivacaine and sufentanil is the most used anesthesia protocol when caesarean section is required (47%). There is no clear preference for postoperative analgesia after cesarean section as both epidural/regional and parenteral/per os analgesia regimens are almost equally used in Flemish obstetric care.
Collapse
|
29
|
Cavaliere F, Biancofiore G, Bignami EG, DE Robertis E, Giannini A, Grasso S, Scolletta S, Taccone FS, Terragni P. A Year In Review In Minerva Anestesiologica 2015. Critical Care. Experimental and clinical studies. Minerva Anestesiol 2016; 82:125-138. [PMID: 26818030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Franco Cavaliere
- Istituto di Anestesia e Rianimazione, Università Cattolica del Sacro Cuore, Policlinico "A. Gemelli", Roma, Italia -
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Katz JD. Advances in Anesthesiology. Conn Med 2015; 79:565-566. [PMID: 26630711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
31
|
Osipova NA. [CRITERIA FOR THE QUALITY OF RESEARCH AND PUBLICATIONS IN MODERN ANAESTHESIOLOGY]. Anesteziol Reanimatol 2015; 60:54-56. [PMID: 26415299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
32
|
Abstract
Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail. Some OR-specific management challenges are worked out. From this it becomes clear that the economic logic of the most efficient implementation possible is not a contradiction of medical ethics, enabling the most effective treatment possible for patients while safeguarding the highest possible levels of safety and quality. The article aims to build a bridge for medical specialists to the language and world of commerce, emphasizing the profession-based competence and hopefully to arouse interest to go into more detail.
Collapse
Affiliation(s)
- O Tschudi
- Klinik für Anästhesiologie, Intensivmedizin, Rettungs- und Schmerzmedizin, Stab Medizin/OP-Management, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz
| | | |
Collapse
|
33
|
Affiliation(s)
- R Kasch
- Klinik und Poliklinik für Orthopädie und Chirurgische Orthopädie, Universitätsmedizin Greifswald Ernst-Moritz-Arndt-Universität, Ferdinand-Sauerbruchstr., 17475, Greifswald, Deutschland,
| | | | | | | |
Collapse
|
34
|
Chiumello D, Allegri M, Cavaliere F, De Cosmo G, Iohom G, Langeron O, Apan A, Spieth P, Capogna G. A year in review in Minerva Anestesiologica 2014. Minerva Anestesiol 2015; 81:238-249. [PMID: 25650560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- D Chiumello
- Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del dolore, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italia
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Drábková J. [Trajectory of anaesthesiology and intensive medicine--history, presence and prospects]. Cas Lek Cesk 2015; 154:239-243. [PMID: 26612333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Anaesthesia has been practised in a very simple way in ancient ages already, nevertheless its real progress started during last 50 years, supported with recent neurophysiological achievements, technical development, digital evaluation and telemedicine. Since the end of the 20th century close relations exist with CPR and with contemporary complex features of perioperative medicine. They form fundamental pillars for modern surgery encl. intensive medicine and care. Changing demography and efficient support of vital functions in intensive medicine create new phenomena and postulates: safety, chronic critical illness, long-term mechanical ventilation, palliative intensive care, patients preferences for own active end of life. Vital and global importance of anaesthesia equal to surgery has been accepted for the first time in their global history during the meeting of World Health Assembly (WHA) in the year 2015. Brief survey of development and trends in anaesthesiology and intensive medicine in our country completes the historical text.
Collapse
|
36
|
Vyzhigina MA, Parshin VD, Titov VA, Alekseev AV. [Actual respiratory technologies in thoracic surgery: traditional problems and innovative solutions]. Khirurgiia (Mosk) 2015:20-32. [PMID: 26753198 DOI: 10.17116/hirurgia20158220-32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The problem of efficient gas exchange maintenance is always actual in anesthetic management of thoracic surgery and determines the selection of appropriate method of anesthesia. The article presents an experience of anesthesia during operations on lungs, trachea, bronchi and mediastinal structures performed from 1963 to 2015. Current concept of safety and efficacy of anesthetic management in thoracic surgery is presented. The role of actual current respiratory technologies and methods of anesthesia per se to maximize the efficiency of gas exchange in all stages of thoracicsurgery is emphasized. Absolute coherence of anesthesiologist and surgeon based on correct interaction is the most important condition of successful surgery. Effectiveness of special respiratory technologies for thoracic surgery associated with one-lung ventilation and prolonged wide dissection of airways is described. The research results and pathophysiological rationale for the use of special respiratory technologies including different variants of differentiated independent lung ventilation especially important for patients with concomitant cardiorespiratory pathology are presented. We reported experience of effective gas exchange maintenance in reconstructive surgery of trachea and main bronchi including traditional mechanical ventilation with "shunt-breath" system, use of jet high-frequency ventilation and relatively new respiratory technology such as flow apnoeic oxygenation.
Collapse
Affiliation(s)
- M A Vyzhigina
- acad. B.V. Petrovskiy Russian Scientific Center for Surgery, Moscow; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - V D Parshin
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - V A Titov
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - A V Alekseev
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| |
Collapse
|
37
|
Chiumello D, Albaiceta GM, Caironi P, Donatelli F, Gabrielli A, Grasso S, Guarracino F, Mascia L, Rossi M, Taccone FS, Terragni P. A year in review in Minerva Anestesiologica 2014. Critical care. Experimental and clinical studies. Minerva Anestesiol 2015; 81:94-107. [PMID: 25582789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- D Chiumello
- Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del Dolore, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milano, Italia -
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
The introduction of laparoscopy in the surgeon’s armamentarium was in fact a “revolution in the history of surgery”. Since this technique involves insufflation of carbon dioxide it produces several pathophysiological changes which have to be understood by the anaesthesiologist who can modify the anaesthesia technique accordingly. Advantages of laparoscopy include reduced pain, small scars and early return to work. Certain complications specific to laparoscopic surgery are due to carboperitoneum and increased intra-abdominal pressure. Venous air embolism, although very rare, can be lethal if not managed promptly. Other complications include subcutaneous emphysema, haemodynamic compromise and arrhythmias. Although associated with minimal postoperative morbidity, postoperative pain, nausea and vomiting can be quite problematic. The limitations of laparoscopy have been overcome by the introduction of robotic surgery. There are important implications for the anaesthesiologist during robotic surgeries which have to be practiced accordingly. Robotic surgery has a learning curve for both the surgeon and the anaesthesiologist. The robot is bulky, and cannot be disengaged after docking. Therefore it is important that the anaesthetized patient remains immobile throughout surgery and anaesthesia is reversed only after the robot has been disengaged at the end of surgery. Advances in laparoscopy and robotic surgery have modified anaesthetic techniques too.
Collapse
|
39
|
Bristle TJ, Collins S, Hewer I, Hollifield K. Anesthesia and critical care ventilator modes: past, present, and future. AANA J 2014; 82:387-400. [PMID: 25842654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Mechanical ventilators have evolved from basic machines to complicated, electronic, microprocessing engines. Over the last 2 decades, ventilator capabilities and options for critical care and anesthesia ventilators have rapidly advanced. These advances in ventilator modalities--in conjunction with a better understanding of patient physiology and the effects of positive pressure ventilation on the body--have revolutionized the mechanical ventilation process. Clinicians today have a vast array of mechanical ventilator mode options designed to match the pulmonary needs of the critically ill and anesthetized patient. Modes of mechanical ventilation continue to be based on 1 of 2 variances: volume-based or pressure-based. The wording describing the standard ventilatory modes on select present-day ventilators has changed, yet the basic principles of operation have not changed compared with older ventilators. Anesthesia providers need to understand these ventilator modes to best care for patients. This literature review encompasses a brief history of mechanical ventilation and current modes available for anesthesia and critical care ventilators, including definitions of each mode, definitions of the various descriptive labels given each mode, and techniques for optimizing and meeting the ventilator needs of the patient while avoiding complications in the surgical and critical care patient.
Collapse
|
40
|
Matsuki A. [Background for governmental accreditation of "anesthesiology" as a specially approved medical specialty]. Masui 2014; 63:706-711. [PMID: 24979871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In 1960, "Anesthesiology" was accredited as a "specially approved medical specialty" for approving registered anesthesiologists. Exclusive training for more than two years of anesthesia under an adequate mentor is required for candidates to be qualified as registered anesthesiologists. In 1963, the Japan Society of Anesthesiology (JSA) established the system to qualify board certificated anesthesiologists as proper mentors responsible for the training of the candidates. This ranks as one of the most significant events in the JSA history and the society launched the first qualification system in the history of medical practice in Japan. Every member of the present society should fully understand the hidden background of the qualification system of the specialty for achieving greater social recognition of anesthesiologists in this country.
Collapse
|
41
|
Gupta D. Anesthesia care providers' based interdisciplinary peri-operative cross-over post-market--safety-surveillance: is it futuristic patient safety idea? Running title: post-hire PMSS for interventionists. Middle East J Anaesthesiol 2014; 22:527-530. [PMID: 25137872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
42
|
Salvo M. In support of teaching basic diagnostics. Am J Pharm Educ 2014; 78:64. [PMID: 24761025 PMCID: PMC3996396 DOI: 10.5688/ajpe78364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Marissa Salvo
- School of Pharmacy, University of Connecticut, Storrs, Connecticut
| |
Collapse
|
43
|
Putzer G, Ausserer J, Wenzel V, Pehböck D, Widmann T, Lindner K, Hamm P, Paal P. [Publication performances of university clinics for anesthesiology: Germany, Austria and Switzerland from 2001 to 2010]. Anaesthesist 2014; 63:287-93. [PMID: 24718414 DOI: 10.1007/s00101-014-2298-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 12/17/2013] [Accepted: 01/13/2014] [Indexed: 10/25/2022]
Abstract
AIM This study assessed the publication performance of university departments of anesthesiology in Austria, Germany and Switzerland. The number of publications, original articles, impact factors and citations were evaluated. MATERIAL AND METHODS A search was performed in PubMed to identify publications related to anesthesiology from 2001 to 2010. All articles from anesthesiology journals listed in the fields of anesthesia/pain therapy, critical care and emergency medicine by the "journal citation report 2013" in Thomson Reuters ISI web of knowledge were included. Articles from non-anaesthesiology journals, where the stem of the word anesthesia (anes*, anaes*, anäst*, anast*) appears in the affiliation field of PubMed, were included as well. The time periods 2001-2005 and 2006-2010 were compared. Articles were allocated to university departments in Austria, Germany and Switzerland via the affiliation field. RESULTS A total of 45 university departments in Austria, Germany and Switzerland and 125,979 publications from 2,863 journals (65 anesthesiology journals, 2,798 non-anesthesiology journals) were analyzed. Of the publications 23 % could not be allocated to a given university department of anesthesiology. In the observation period the university department of anesthesiology in Berlin achieved most publications (n = 479) and impact points (1,384), whereas Vienna accumulated most original articles (n = 156). Austria had the most publications per million inhabitants in 2006-2010 (n=50) followed by Switzerland (n=49) and Germany (n=35). The number of publications during the observation period decreased in Germany (0.5 %), Austria (7 %) and Switzerland (8 %). Tables 2 and 4-8 of this article are available at Springer Link under Supplemental. CONCLUSIONS The research performance varied among the university departments of anesthesiology in Germany, Austria and Switzerland whereby larger university departments, such as Berlin or Vienna published most. Publication output in Germany, Austria and Switzerland has decreased. Data processing in PubMed should be improved.
Collapse
Affiliation(s)
- G Putzer
- Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Gentili ME, Lentschener C. Do not stop publishing case reports. Acta Anaesthesiol Scand 2014; 58:499-500. [PMID: 24588284 DOI: 10.1111/aas.12284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
45
|
Schwartz AJ, Andropoulos DB, Davidson A. A review of key topics in pediatric anesthesia patient care. Anesthesiol Clin 2014; 32:xiii-xiv. [PMID: 24491662 DOI: 10.1016/j.anclin.2013.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Alan Jay Schwartz
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Room 9327, Philadelphia, PA 19104-4399, USA.
| | | | - Andrew Davidson
- Royal Children's Hospital, Flemington Road, Parkville, Melbourne, Victoria, 3052 Australia.
| |
Collapse
|
46
|
Staikou C, Paraskeva A, Karmaniolou I, Mani A, Chondrogiannis K. Current practice in obstetric anesthesia: a 2012 European survey. Minerva Anestesiol 2014; 80:347-354. [PMID: 24193179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND New scientific findings are gradually implemented into daily clinical routine. The present questionnaire survey investigated the current practice in obstetric anesthesia in Europe. METHODS A 19-point questionnaire on obstetric anesthesia practices, regarding the techniques, drugs, fluids, vasopressors and safety measures, was uploaded on the site of the European Society of Anaesthesiology (21/12/2011 to 21/12/2012). RESULTS Three hundred and forty-one (341) completed questionnaires were analyzed. Single-shot subarachnoid anesthesia is preferred by 225 (66%) respondents in uncomplicated Cesarean deliveries and by 190 (55.7%) in preeclampsia. Most anaesthesiologists (N.=133, 39%) perform neuraxial techniques if platelet count exceeds 80000/mm3. In anticipated hemorrhage, general anesthesia is administered by 165 (48.4%) respondents. Anesthesia is induced with thiopental/succinylcholine by 193 (56.6%) survey participants, usually under cricoid pressure (N.=201, 58.8%). For prevention of the hypotension associated with regional anesthesia, coloading with 1L of crystalloid represents the most popular measure undertaken by 80 (40.2%) respondents, while vasopressors are not favored (N.=260, 76.2%). For hypotension treatment, ephedrine is preferred over phenylephrine by 124 (36.4%) versus 79 (23.2%) anesthesiologists. Supplemental oxygen is routinely administered to parturients receiving regional anesthesia by 176 (51.6%) respondents. The standard dose of oxytocin is 5IU, according to most answers (N.=160, 46.9%). CONCLUSION Subarachnoid anesthesia is mostly favored among European anesthesiologists, while general anesthesia is reserved only for cases with anticipated hemorrhage. Fluid coloading and phenylephrine have gained popularity, in line with current knowledge. Conversely, cricoid pressure, standard supplemental oxygen and high oxytocin doses ‑ though strongly questioned ‑ are still advocated by most anaesthesiologists.
Collapse
Affiliation(s)
- C Staikou
- Department of Anesthesia, Aretaieio Hospital, Medical School, University of Athens, Athens, Greece -
| | | | | | | | | |
Collapse
|
47
|
Kawamae K. [Future of anesthesiology in Japan]. Masui 2014; 63:127. [PMID: 24601101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
48
|
Chiumello D, Allegri M, Cavaliere F, De Cosmo G, Iohom G, Langeron O, Apan A, Spieth P, Capogna G. A year in review in Minerva Anestesiologica 2013. Minerva Anestesiol 2014; 80:266-280. [PMID: 24500141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. METHODS The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were successful in both groups, with patients in each group being equally satisfied with the procedures. CONCLUSION This study highlights the importance of a structured FOI training program, demonstrating that it is possible to learn to perform FOI proficiently by practicing on dummies.
Collapse
Affiliation(s)
- D Chiumello
- Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del dolore, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italia -
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Waeschle RM, Michels P, Jipp M, Riech S, Schulze T, Schmidt CE, Bauer M. [Quality assurance at the interface between anesthesia and transfusion medicine]. Anaesthesist 2014; 63:154-62. [PMID: 24469248 DOI: 10.1007/s00101-013-2284-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The current situation in hospitals is characterized by financial limitations and simultaneously by increasing demands on quality and safety. The operative interface between anesthesia and transfusion medicine affects both factors. AIM A detailed analysis was performed to evaluate the process quality at this operative interface at the University Hospital of Göttingen. The aim of the project was to revise und develop the structures and responsibilities at this interface, to dispose of weak points and to realize the optimization potential in the supply of blood products. MATERIAL AND METHODS A databank-based electronic data processing solution was established with the clear definition of responsibilities for the various workflow procedures and the written documentation of these definitions in standard operating protocols. In order to guarantee the necessary transparency a routine reporting system to the department of surgery was established. In addition, a continuous further development of the blood supply standard based on electronic report data was implemented. RESULTS By implementing the above named measures the rate of supplied to transfused blood products could be increased from 43.1 % to 55.7 %. The compliance with the blood supply standard improved continually over the first 18 months from 60.3 % to 92.3 %. The rate of supplied blood product deliveries without subsequent operation could be reduced from 9.0 % to 4.6 %. As a result of this optimization the supply costs in the internal cost allocation were reduced from 9,406 <euro> to 3,544 <euro>. CONCLUSION The measures described are appropriate to cost-effectively improve quality and patient safety. The optimization measures presented in this article can be implemented in other hospitals to increase quality and safety after individual adjustment to the local circumstances.
Collapse
Affiliation(s)
- R M Waeschle
- Zentrum Anästhesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Deutschland,
| | | | | | | | | | | | | |
Collapse
|
50
|
Fiadjoe JE, Kovatsis P. Videolaryngoscopes in pediatric anesthesia: what's new? Minerva Anestesiol 2014; 80:76-82. [PMID: 24002465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Anesthesiologists are increasingly turning to videolaryngoscopes (VLs) for normal and difficult endotracheal intubations. As children grow the airway is in constant transition. This means that a device that works well in an older child may fail in an infant. Are VLs ideal in all children? What are the pitfalls and strengths of these devices? When are they indicated? How should their efficacy be assessed? Can they play a role in teaching standard laryngoscopy? This article explores these questions and reviews the literature relating to VLs use in children.
Collapse
Affiliation(s)
- J E Fiadjoe
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA -
| | | |
Collapse
|