Issues
Table of Contents
Anesthesiology
Editorial Board
Anesthesiology
This Month in Anesthesiology
This Month In: Anesthesiology
Science, Medicine, and the Anesthesiologist
Science, Medicine, and the Anesthesiologist
Infographics in Anesthesiology
Complex Information for Anesthesiologists Presented Quickly and Clearly: Cardiac Arrest: Etiology and Outcomes across the Spectrum of Care
Anesthesiology CME Program
Instructions for Obtaining Anesthesiology Continuing Medical Education (CME) Credit
Editorial
Introduction to the Anesthesiology Cardiac Arrest and Resuscitation Issue
Estimating Maternal Cardiac Arrest Incidence and Outcomes: A Rare and Challenging Complication of Pregnancy That Behooves Preparedness
Epinephrine for Cardiac Arrest: Are We Doing More Harm Than Good?
Physiologically Based Pharmacokinetic–Pharmacodynamic Modeling to the Rescue: Understanding How Resuscitation from Local Anesthetic Overdose with Lipid Emulsions Works
The Risk versus Benefit of LUCAS: Is It Worth It?
No Monitor Is an Island: Depth of Anesthesia Involves the Whole Patient
Human Factors Engineering in Patient Safety
Leading Departmental Change to Advance Perioperative Quality
Perioperative Medicine: Clinical Science
Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011
In a review from the Nationwide Inpatient Sample of over 50 million hospitalizations for delivery from 1998 to 2011, cardiac arrest occurred in 8.5 per 100,000 hospitalizations, with no change in the rate over this time period. Nearly 60% of women survived to discharge, with an increase in survival over this time period.
Monitoring Depth of Anesthesia Utilizing a Combination of Electroencephalographic and Standard Measures
In a prospective study with 263 adult patients from 6 European centers undergoing surgery under general anesthesia, it was found that an index based on multimodal integration of electroencephalographic and standard monitoring parameters may more precisely assess depth of anesthesia than either standard monitoring or bispectral index monitoring alone.
Anesthesia-related Cardiac Arrest
As judged by an independent study commission, anesthesia-related cardiac arrest occurred in 37 out of 160 cardiac arrests within a 24-h perioperative period.
Patient Blood Management in Elective Total Hip- and Knee-replacement Surgery (Part 1): A Randomized Controlled Trial on Erythropoietin and Blood Salvage as Transfusion Alternatives Using a Restrictive Transfusion Policy in Erythropoietin-eligible Patients
In this prospective, randomized, controlled trial including 683 patients with a preoperative hemoglobin level between 10 and 13 g/dl undergoing hip and/or knee arthroplasty, erythropoietin was found to significantly reduce the number of patients requiring the use of erythrocyte transfusion, but not the amount of erythrocytes transfused. Costs due to erythropoietin were €7300 per avoided transfusion. Autologous blood salvage devices were not effective in sparing erythrocyte transfusion.
Patient Blood Management in Elective Total Hip- and Knee-replacement Surgery (Part 2): A Randomized Controlled Trial on Blood Salvage as Transfusion Alternative Using a Restrictive Transfusion Policy in Patients with a Preoperative Hemoglobin above 13 g/dl
In this prospective randomized controlled trial including 1,759 patients with a preoperative hemoglobin level greater than 13 g/dl (and therefore ineligible for erythropoietin) undergoing hip or knee arthroplasty, autologous intra- and postoperative blood salvage devices were not effective as transfusion alternatives. The use of these devices did not reduce erythrocyte use and increased costs.
Perioperative Medicine: Basic Science
Kidney Protection by Hypothermic Total Liquid Ventilation after Cardiac Arrest in Rabbits
As demonstrated by several renal biomarkers, ultrafast cooling induced by total liquid ventilation protects kidneys in a severe model of cardiac arrest in rabbits.
Supplemental Digital Content is available in the text.
Cardioprotection during Diabetes: The Role of Mitochondrial DNA
Using rat strains and ischemic injury, there was an inferred effect of mitochondrial genome and of mitochondrial function in determining the susceptibility to anesthetic preconditioning and ischemia–reperfusion injury in diabetes.
Beneficial Effects of Nitric Oxide on Outcomes after Cardiac Arrest and Cardiopulmonary Resuscitation in Hypothermia-treated Mice
Endothelial nitric oxide synthase derived nitric oxide is required for protection by therapeutic hypothermia after cardiopulmonary resuscitation; but inhaled nitric oxide remains beneficial even during therapeutic hypothermia. These results suggest that inhaled nitric oxide may be beneficial after cardiopulmonary resuscitation during disease states characterized by impaired nitric oxide bioavailability.
Cellular Registration without Behavioral Recall of Olfactory Sensory Input under General Anesthesia
The authors demonstrated that in ketamine–xylazine anesthetized rats, odor presentation resulted in histologically distinguishable registration of sensory process, suggesting that general anesthesia causes disintegration of information processing but may preserve cellular communication.
Critical Care Medicine: Clinical Science
Lung Ultrasound Predicts Interstitial Syndrome and Hemodynamic Profile in Parturients with Severe Preeclampsia
Lung and cardiac ultrasound were used to evaluate lung edema in parturients with severe preeclamspsia and lung edema was found in 5 of 20 women. The results from this preliminary study suggest hypotheses that need further investigation.
Supplemental Digital Content is available in the text.
Critical Care Medicine: Basic Science
Resuscitation with Lipid Emulsion: Dose-dependent Recovery from Cardiac Pharmacotoxicity Requires a Cardiotonic Effect
Intravenous lipid emulsions dose-dependently reversed bupivacaine-induced cardiovascular toxicity in rats. Using a physiologically based pharmacokinetic–pharmacodynamic model, the direct cardiotonic effect of the intravenous lipid emulsion and its associated volume effect were found to be primarily responsible for the rapid recovery from bupivacaine-induced cardiovascular toxicity, with contributions from the lipid sink.
Efficient Extra- and Intracellular Alkalinization Improves Cardiovascular Functions in Severe Lactic Acidosis Induced by Hemorrhagic Shock
A therapeutic strategy based on alkalinization with sodium bicarbonate, along with hyperventilation and calcium administration increases pH and improves cardiovascular function.
Supplemental Digital Content is available in the text.
Attenuation of Responses to Endotoxin by the Triggering Receptor Expressed on Myeloid Cells-1 Inhibitor LR12 in Nonhuman Primate
The triggering receptor expressed on myeloid cells-1 inhibitor LR12 mitigated endotoxin-associated clinical and biological, with no obvious side effects in experimental primates.
Effects of Various Modes of Mechanical Ventilation in Normal Rats
Anesthetized rats subjected to positive pressure or negative pressure ventilation with the breathing pattern occurring before mechanical ventilation did not experience ventilator-induced lung injury, unless marked chest distortion was produced, supporting the hypothesis that with normal lung expansion, there is a critical volume threshold to cause ventilator-induced lung injury.
Pain Medicine: Basic Science
Preclinical Toxicity Screening of Intrathecal Oxytocin in Rats and Dogs
Identification of a Novel Spinal Dorsal Horn Astroglial d-Amino Acid Oxidase–Hydrogen Peroxide Pathway Involved in Morphine Antinociceptive Tolerance
The results of these studies suggest that reactive oxygen species such as hydrogen peroxide are generated by spinal astrocytes and are involved in tolerance. The flavoprotein, d-amino acid oxidase, is an important astrocytic enzyme involved in this process.
Nociceptor-selective Peripheral Nerve Block Induces Delayed Mechanical Hypersensitivity and Neurotoxicity in Rats
After incisional hind paw surgery in rats, administration of lidocaine and QX-314 followed by capsaicin initially attenuated mechanical hypersensitivity, but led to a delayed onset of mechanical hypersensitivity and neurotoxicity.
Education: Case Scenario
Local Anesthetic Systemic Toxicity after Combined Psoas Compartment–Sciatic Nerve Block: Analysis of Decision Factors and Diagnostic Delay
Education: Images in Anesthesiology
Systemic Thrombus Formation in Cardiac Arrest: Manifestation of Cardiac Arrest-related Hypercoagulability Visualized by Transesophageal Echocardiography
Supplemental Digital Content is available in the text.
High-frequency Percussive Ventilation for Severe Inhalation Injury
Education: Original Investigations in Education
Effect of Simulation Training on Compliance with Difficult Airway Management Algorithms, Technical Ability, and Skills Retention for Emergency Cricothyrotomy
Using a prestudy–poststudy design with randomized follow-up, this study demonstrated cricothyrotomy high-fidelity simulation increases and serves to maintain compliance of difficult airway management algorithm during “cannot intubate cannot ventilate” scenarios in addition to retention of the improved skill for 1 yr in the third-year anesthesia residents.
Education: Clinical Concepts and Commentary
Cardiac Resuscitation and Coagulation
Cardiac arrest and its treatment options are frequently associated with significant derangements in coagulation. This review article highlights coagulopathies commonly encountered in cardiac arrest and during treatment with hypothermia, thrombolysis, and extracorporeal membrane oxygenation.
Education: Review Article
Vascular Access in Resuscitation: Is There a Role for the Intraosseous Route?
Intraosseous vascular access has a defined role in the American Heart Association Guidelines for Cardiopulmonary Resuscitation. Literature addressing the use of intraosseous access in resuscitation is presented.
Supplemental Digital Content is available in the text.
Education: Mind to Mind
Wishful Thinking?
“Red Fern”
Breakup Wine
Education: Case Reports
Fatal Pancreatic Injury due to Trauma after Successful Cardiopulmonary Resuscitation with Automatic Mechanical Chest Compression
Handheld Doppler to Improve Pulse Checks during Resuscitation of Putative Pulseless Electrical Activity Arrest
Successful Cardiopulmonary Resuscitation in the Lateral Position during Intraoperative Cardiac Arrest
Correspondence
Does High Oxygen Concentration Reduce Postoperative Infection?
Benefits and Risks of Intraoperative High Inspired Oxygen Therapy: Firm Conclusions Are Still Far Off
In Reply
Permanent Diaphragm Paralysis after Shoulder Rotator Cuff Repair: Interscalene Block Is Not the Only Factor
Interscalene Brachial Plexus Blocks and Phrenic Nerve Palsy
Postsurgical Inflammatory Neuropathy Should Be Considered in the Differential Diagnosis of Diaphragm Paralysis after Surgery
In Reply
In Reply
Reviews of Educational Material
Patient Safety in the Operating Room
Anesthesiology Reflections from the Wood Library-Museum
Erratum
Neuraxial Anesthesia in Parturients with Intracranial Pathology: A Comprehensive Review and Reassessment of Risk: Erratum
Announcements
Nominations Sought for the 2014 FAER Mentoring Excellence in Research Award
Advertisement