Результаты поиска

Propofol/dexmedetomidine and propofol/ketamine combinations for anesthesia in pediatric patients undergoing transcatheter atrial septal defect closure: a prospective randomized study.

BACKGROUND: Children undergoing cardiac catheterization usually need general anesthesia or deep sedation. OBJECTIVE: This study was performed to compare the effects of propofol/dexmedetomidine and propofol/ketamine combinations on recovery time and hemodynamic parameters in pediatric patients undergoing transcatheter atrial septal defect (ASD) closure. METHODS: This was a prospective randomized study. Pediatric patients with ASD were randomly assigned into 2 groups to receive propofol/dexmedetomidine or propofol/ketamine. The dexmedetomidine group received an infusion over 10 minutes of dexm…

Protocol for a prospective cohort study to determine the multimodal biomarkers of delirium and new dementia after acute illness in older adults: ORCHARD-PS.

INTRODUCTION: Delirium is common in the older hospital population and is often precipitated by acute illness. Delirium is associated with poor outcomes including subsequent cognitive decline and dementia and may therefore be a modifiable risk factor for dementia. However, the mechanisms underpinning the delirium-dementia relationship and the role of coexisting acute illness factors remain uncertain. Current biomarker studies of delirium have limitations including lack of detailed delirium characterisation with few studies on neurodegenerative or neuroimaging biomarkers especially in the acute

[Methohexital for treatment of intracranial hypertension].

BACKGROUND: Barbiturate coma therapy is a useful method to control increased intracranial pressure (ICP) in patients with severe brain damage if standard measures have failed to lower ICP. Pentobarbital (not available in Germany) and thiopental (in Germany only approved for induction of anesthesia) have frequently been used in patients with intracranial hypertension and the effects and side-effects are well-described. However, little is known about the effect of methohexital (the only barbiturate in Germany approved for maintaining anesthesia) in lowering increased ICP. Therefore, the effect o

Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient.

OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill pati … edative drugs should be used prior to and during neuromuscular blockade, with the goal of achieving deep sedation. 4) Optimal clinical practice suggests that clinicians at the bedside implement measure to attenuate the risk of unintended extubation in patients receiving neuromuscular-blocking agents. 5) Optimal clinical practice suggests that a reduced dose of …

Trophoblastic microcirculation occlusion as an adjunct to electric vacuum aspiration for the treatment of endogenous cesarean scar pregnancy.

OBJECTIVE: To describe a simple adjunct treatment option, trophoblastic microcirculation occlusion (TMO), which could change subsequent high … fter TMO treatment to remove the products of conception completely. Surgical safety was enhanced by deep sedation and concurrent transabdominal ultrasound guidance. The levels of β-human chorionic gonadotropin (β-hCG) were measured weekly until a nonpregnant level was achieved. A follow-up ultrasound then was performed to confirm that the treatment was complete …

Искусственный интеллект в педиатрической нейрорадиологии: текущий ландшафт, проблемы и будущие направления.

В настоящем обзоре содержится информация о нынешнем ландшафте искусственного интеллекта (АИ) в области педиатрической и эмбриональной нейрорадиологии, критическая оценка текущей практики, барьеров на пути к клиническому усыновлению и будущего потенциала. Мы искали рецензированные исследования за последнее десятилетие, сфокусировавшись на сегментации изображений, обнаружении повреждений, классификации, прогнозировании и поддержке клинического решения при педиатрической съемке мозга. Особое внимание было уделено уникальным педиатрическим факторам, таким, как развитие мозга и нехватка данных. Мет

Оптимальный выбор способа управления лекарствами в отношении внутримышечной и подкожной инъекции.

Внутримышечное (IV), внутримышечное (IM) и подкожное (SC) three - наиболее часто используемые пути инъекции для лечения лекарств. Время от времени проводились сравнительные исследования СК по отношению к IV, IM по отношению к IV, или IM по сравнению с СК, и некоторые новые выводы совершенно отличаются от рекомендаций в отношении дозировки, описанных в предписаниях в отношении информации. Однако врачи, возможно, до сих пор не знают о таких новых фактах при выборе методов лечения. Поиск литературы MetodsA был проведен с использованием PubMed, MedLINE и Web of Sciences TM Core Collection для анал

Сексуальная дисфункция при расстройствах движения: распространенность, клинические особенности, связанные с этим факторы и управление.

Сексуальная дисфункция является распространенным, но недостаточно изученным симптомом немоторного расстройства движения. В то время как болезнь Паркинсона (PD) чаще всего исследуется, сексуальная дисфункция также отмечается в болезни Хантингтона, диспропорции и других расстройствах движения. Клинические представления являются разнородными и включают в себя сокращение желания, эректильную дисфункцию, эякуляционные и оргазмические расстройства, трудности с смазкой, диспаревинию и гиперсексуальность. В ДИ оценки распространенности заболеваний в различных исследованиях сильно различаются, главным

Barriers to Mobility in the ICU: Insights from Severe COVID-19 and Implications for Improving Patient Outcomes.

ObjectiveTo evaluate mobility outcomes of patients with severe COVID-19 during their intensive care unit (ICU) stay compared to non-COVID-19 critically ill counterparts and assess factors impacting mobility status.DesignA retrospective, single-center case-control study.SettingThis investigation was conducted at a large tertiary care center at the epicenter of the COVID-19 pandemic between April 2019 and July 2020 to capture a prepandemic baseline and the initial surge.ParticipantsA total of 3275 ICU cases were analyzed. Analysis was conducted at the ICU visit level rather than the patient leve

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… This is consistent with the results of the COVID-D study which found that more than 80% of patients with severe COVID-19 underwent prolonged periods of deep sedation. 40 In addition, we found that patients with COVID-19 were a staggering 11.64 times more likely to be proned than non-COVID-19 patients … Patients with severe COVID-19 requiring mechanical ventilation faced substantial barriers to mobilization, primarily because of higher rates of mobilization contraindications in this cohort such as deep sedation and prone positioning. …

Effect of modified ShengYangYiwei decoction on painless gastroscopy and gastrointestinal and immune function in gastric cancer patients.

BACKGROUND: Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice. It is of great significance in the clinical diagnosis, treatment, follow-up review and other aspects of gastric cancer patients. The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort. In clinical work, the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose; the application of opioid drugs often c

Ultrasound-Guided Interscalene Brachial Plexus Block for Pathological Humerus Fracture due to Multiple Myeloma with Systemic Manifestation: Useful Option for Management in Low-Income Countries.

Anesthetic management of pathological fracture due to multiple myeloma with systemic manifestation poses a perioperative challenge especially in low-resource setups like Nepal. Regional anesthesia using ultrasound-guided block can improve the accuracy, reduce complications, and improve overall perioperative management of pathological fractures due to malignancy with systemic spread in resource-deprived setups. We present a case of a 53-year-old lady with pathological fracture of left humerus shaft, a diagnosed case of multiple myeloma with compression fracture of multiple lumbar spine with che

Management of patients with an electrical storm or clustered ventricular arrhythmias: a clinical consensus statement of the European Heart Rhythm Association of the ESC-endorsed by the Asia-Pacific Heart Rhythm Society, Heart Rhythm Society, and Latin-American Heart Rhythm Society.

Electrical storm (ES) is a state of electrical instability, manifesting as recurrent ventricular arrhythmias (VAs) over a short period of time (three or more episodes of sustained VA within 24 h, separated by at least 5 min, requiring termination by an intervention). The clinical presentation can vary, but ES is usually a cardiac emergency. Electrical storm mainly affects patients with structural or primary electrical heart disease, often with an implantable cardioverter-defibrillator (ICD). Management of ES requires a multi-faceted approach and the involvement of multi-disciplinary teams, but

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… Deep sedation and mechanical ventilation 8.2.4.1. Agents used for (deep) sedation 8.2.5. Pharmacotherapy for the acute management of electrical storm 8.2.5.1. Structural heart disease 8.2.5.2. Primary electrical disease 8.2.6. Mechanical circulatory support 8.2.6.1. … Conscious patients require deep sedation or anaesthesia before delivering synchronized CV (see Section 8.2.4 .). …

Indian Society of Periodontology Good Clinical Practice Recommendations for dental pain management and use of analgesics.

Pain is one of the most frequent reasons for seeking dental care and significantly influences patient comfort, treatment acceptance, and clinical outcomes. Effective management of dental pain requires accurate diagnosis, timely intervention, and the rational use of analgesics supported by evidence-based clinical decision-making. Recognizing the need for structured guidance for everyday dental practice, the Indian Society of Periodontology has developed Good Clinical Practice Recommendations on Pain Management and the Use of Analgesics in Dental Clinics. These recommendations were formulated by

An exploration of person-centred approach in end-of-life care policies in England and Japan.

BackgroundIncreasing evidence has suggested that a person-centred approach (PCA) is beneficial not only for improving care outcomes but also for mitigating the pressure on public health systems. However, policy implementation gaps have prevented the translation of this complex framework into useful practical, ethical and moral stances for end-of-life care (EOLC). This article aims to explore the meaning and implications of person-centredness in EOLC policy discourses.MethodsBy perceiving policy documents as a medium embodied with socio-political and cultural norms, we analysed how PCA in EOLC

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… Hence, it can be suggested that ED has been inadequately envisaged in EOLC in England as compared to Netherlands, where decisions on continuous deep sedation in EOLC can be taken on the basis of the extent of existential suffering of the patients [ 45 ]. …

Резюме МКАРЕ 2023 77th Национальный конгресс " СИААРТИ "

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

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… We obtained, with an onset of 20-25', a moderate-deep sedation (RASS - 3/ - 5) which allowed the positioning of the venous access and the subsequent procedures without restraint. … MRI was started when subjects reached a deep sedation, according to University of Michigan Sedation Scale (UMSS). We included only good or excellent image quality, with no or almost absent motion artifacts. …

Resistant Ventricular Arrhythmia and the Role of Overdrive Pacing in the Suppression of the Electrical Storm.

Ventricular arrhythmia storm is a state of cardiac instability characterized by multiple ventricular arrhythmias or multiple ICD therapies within a 24-hour duration. Management of this life-threatening state depends on the reversal of the cause besides either electrical or medical management of the arrhythmia. We report a case of a 54-year-old male who underwent a percutaneous coronary intervention following massive acute myocardial infarction. Afterwards, he developed frequent life-threatening ventricular arrhythmias that required multiple shocks and antiarrhythmic medications. Despite all th

Rediscovering trazodone for the treatment of major depressive disorder.

Trazodone is a triazolopyridine derivative that belongs to the class of serotonin receptor antagonists and reuptake inhibitors (SARIs). The drug is approved and marketed in several countries worldwide for the treatment of major depressive disorder (MDD) in adult patients. In clinical studies, trazodone has demonstrated comparable antidepressant activity to other drug classes, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline (norepinephrine) reuptake inhibitors (SNRIs). Moreover, the SARI action of trazodone may overcome the

Delirium in Critically Ill Cancer Patients With COVID-19.

BackgroundCOVID-19 has been a devastating pandemic with little known of its neuropsychiatric complications. Delirium is one of the most common neuropsychiatric syndromes among hospitalized cancer patients with incidence ranging from 25% to 40% and rates of up to 85% in the terminally ill. Data on the incidence, risk factors, duration, and outcomes of delirium in critically ill cancer patients with COVID-19 are lacking.ObjectiveTo report the incidence, risks and outcomes of critically ill cancer patients who developed COVID-19.MethodsThis is a retrospective single-center study evaluating deliri

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… The novelty of the disease, anecdotal experience from critical care providers communicating throughout the world, and the basic pathophysiological knowledge from respiratory insufficiency led to the initial treatment of COVID-19 with early intubation, MV, and deep sedation. …

Bortezomib-induced painful neuropathy in patients with multiple myeloma.

Neurotoxicity towards the peripheral nervous system which appears clinically in the form of painful neuropathy is an essential dose-limiting factor during the treatment of multiple myeloma. In this review article different forms of this painful neuropathy are presented together with currently available diagnostic tools which are usually applied to confirm the diagnosis. Also, the most often used neurological scales estimating neurological deficit are presented. Special attention is paid to the management of the reversibility of bortezomib-induced neuropathic pain.

37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3) : Brussels, Belgium. 21-24 March 2017

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.