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BACKGROUND Variation in clinical practice in the perioperative environment and intensive care unit is a major challenge facing modern medicine. The objective of the present study was to analyse intraoperative crystalloid administration practices at two academic medical centres in the USA. METHODS We extracted clinical data from patients undergoing(More)
BACKGROUND Noninvasive hemoglobin (Hb) monitoring devices are available in the clinical setting, but their accuracy and precision against central laboratory Hb measurements have not been evaluated in a systematic review and meta-analysis. METHODS We conducted a comprehensive search of the literature (2005 to August 2013) with PubMed, Web of Science and(More)
BACKGROUND The present study aimed to compare myocardial protection, as assessed by cardiac troponin-I release, and short-term outcomes between two groups of neonates undergoing the arterial switch operation (ASO) with either Custodiol cardioplegia (Custodiol HTK, Köhler Chemie GmbH, Bensheim, Germany) or repeated oxygenated warm blood cardioplegia. (More)
OBJECTIVES High-fidelity simulation (HFS) calls heavily upon cognitive capacities and generates stress and anxiety. The objectives of this prospective, observational study were to assess trait anxiety and fear of negative evaluation (FNE) in anaesthesiology and critical care residents and appraise their state anxiety levels and cardiovascular responses(More)
OBJECTIVE Intraoperative haemodynamic optimization based on fluid management and stroke volume optimization (Goal Directed Fluid Therapy [GDFT]) can improve patients' postoperative outcome. We have described a closed-loop fluid management system based on stroke volume variation and stroke volume monitoring. The goal of this system is to apply GDFT protocols(More)
BACKGROUND In this randomized, prospective trial, we sought to determine the effective dose of hypobaric ropivacaine with sufentanil providing 95% success (ED95) in spinal anesthesia for traumatic femoral neck surgery in the elderly. METHODS Sixty-eight elderly patients with unilateral hip fracture randomly received 6, 8, 10, or 12 mg spinal hypobaric(More)
The feasibility and clinical utility of the endotracheal cardiac output monitor (ECOM) to optimize intraoperative hemodynamics and improve short-term outcome in off-pump coronary artery bypass grafting (OPCAB) is unknown. We aimed to compare ECOM with a standard of care in that specific surgical setting. Twenty consecutive adult ECOM-monitored patients(More)
BACKGROUND EtCO2 variation has been advocated replacing cardiac output measurements to evaluate fluid responsiveness (FR) during sepsis. The ability of EtCO2 variation after a fluid challenge to detect FR in the context of general anaesthesia has not been investigated. Forty patients were prospectively studied. They underwent general anaesthesia for major(More)
 Although surgery has become much safer, it has also becoming increasingly more complex and perioperative complications continue to impact millions of patients worldwide each year. Perioperative hemodynamic optimization utilizing Goal Directed Therapy (GDT) has attracted considerable interest within the last decade due to its ability to improve(More)
OBJECTIVE The present study aimed to assess the usefulness of routine monitoring of cardiac troponin I concentrations within 24 hours of surgery (cTn-I<24h) in neonates and infants undergoing cardiac surgery. METHODS The added predictive ability of a high peak cTn-I<24h (within the upper quintile per procedure) for a composite outcome, including 30-day(More)