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Anesthesiology Jun 2019Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily... (Review)
Review
Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic support, and return to the preoperative state. The current work provides a review of classic physiology and emphasizes features important to the anesthesiologist. The material is divided in two main sections, gas exchange and respiratory mechanics; each section presents the physiology as the basis of abnormal states. We review the path of oxygen from air to the artery and of carbon dioxide the opposite way, and we have the causes of hypoxemia and of hypercarbia based on these very footpaths. We present the actions of pressure, flow, and volume as the normal determinants of ventilation, and we review the resulting abnormalities in terms of changes of resistance and compliance.
Topics: Anesthesia, General; Anesthesiologists; Carbon Dioxide; Humans; Hypercapnia; Hypoxia; Pulmonary Gas Exchange; Respiration, Artificial; Respiratory Mechanics; Tidal Volume
PubMed: 30998510
DOI: 10.1097/ALN.0000000000002666 -
Anesthesiology Feb 2024
Topics: Humans; Neuromuscular Blockade; Anesthesiologists; Wakefulness; Anesthetics
PubMed: 38193736
DOI: 10.1097/ALN.0000000000004808 -
Cardiac Arrest in the Operating Room: Resuscitation and Management for the Anesthesiologist: Part 1.Anesthesia and Analgesia Mar 2018Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate... (Review)
Review
Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate evaluation and management of these causes require modification of traditional cardiac arrest algorithms. There is a small but growing body of literature describing the incidence, causes, treatments, and outcomes of circulatory crisis and perioperative cardiac arrest. These events are almost always witnessed, frequently known, and involve rescuer providers with knowledge of the patient and their procedure. In this setting, there can be formulation of a differential diagnosis and a directed intervention that treats the likely underlying cause(s) of the crisis while concurrently managing the crisis itself. Management of cardiac arrest of the perioperative patient is predicated on expert opinion, physiologic rationale, and an understanding of the context in which these events occur. Resuscitation algorithms should consider the evaluation and management of these causes of crisis in the perioperative setting.
Topics: Anesthesiologists; Cardiopulmonary Resuscitation; Disease Management; Heart Arrest; Humans; Operating Rooms; Physician's Role
PubMed: 29135598
DOI: 10.1213/ANE.0000000000002596 -
Brazilian Journal of Anesthesiology... 2021
Topics: Anesthesiologists; Humans; Patient Satisfaction
PubMed: 33716005
DOI: 10.1016/j.bjane.2021.02.028 -
Journal of Cardiothoracic and Vascular... Jul 2022
Topics: Anesthesiologists; Humans; Physicians
PubMed: 35595584
DOI: 10.1053/j.jvca.2022.04.015 -
Anesthesiology Clinics Jun 2021The anesthesiologist, upon completion of their training, is expected to be the liaison to the operating room and the patient. Key components of the anesthesiologist's... (Review)
Review
The anesthesiologist, upon completion of their training, is expected to be the liaison to the operating room and the patient. Key components of the anesthesiologist's training and daily routine make them an ideal participant and leader when it comes to their potential involvement in a mass casualty event. Airway expertise, vascular access, ongoing triage, hemodynamic vigilance, resuscitation, and real-time adaptation to a changing and critical care environment are a few of the skills that encompass the daily routine and value the anesthesiologist brings to an emergency management team.
Topics: Anesthesiologists; Critical Care; Emergency Medical Services; Humans; Mass Casualty Incidents; Triage
PubMed: 34024433
DOI: 10.1016/j.anclin.2021.03.001 -
Current Opinion in Anaesthesiology Jun 2020Surgery poses major threats to functional independence. Prehabilitation is a preoperative conditioning intervention that aims to prevent or attenuate surgery-related... (Review)
Review
PURPOSE OF REVIEW
Surgery poses major threats to functional independence. Prehabilitation is a preoperative conditioning intervention that aims to prevent or attenuate surgery-related functional decline and its consequences. The present review is to summarize most recent evidence on the effectiveness of prehabilitation on key topics in cancer care, such as perioperative functional capacity, surgical and oncologic outcomes.
RECENT FINDINGS
Recent studies predominantly focus on functional outcomes, demonstrating a positive effect of prehabilitation on perioperative physical fitness.
SUMMARY
Prehabilitation prevents functional decline associated with major cancer surgery. Evidence is still needed to support its effectiveness in relation to postoperative complication, length of hospital stay, tumor progression, response to medical treatment, and survival. Ongoing and future research is essential to prompt the role of perioperative medicine in cancer care.
Topics: Anesthesiologists; Humans; Length of Stay; Physical Fitness; Postoperative Complications; Preoperative Care; Preoperative Period; Recovery of Function; Surgical Procedures, Operative
PubMed: 32371632
DOI: 10.1097/ACO.0000000000000854 -
Paediatric Anaesthesia Dec 2022
Topics: Humans; Anesthesiologists; Virtual Reality; Pain Management
PubMed: 36352521
DOI: 10.1111/pan.14464 -
Journal of Cardiothoracic and Vascular... Jan 2023
Topics: Humans; Anesthesiologists; Heart
PubMed: 36273945
DOI: 10.1053/j.jvca.2022.09.095 -
Anesthesiology Clinics Sep 2020This article discusses modernizing the education of pediatric anesthesiologists in the United States. First, the current education requirements to become an American... (Review)
Review
This article discusses modernizing the education of pediatric anesthesiologists in the United States. First, the current education requirements to become an American Board of Anesthesiology certified pediatric anesthesiologist are detailed and then, through a historical lens, the development of the subspecialty is examined. Gaps and challenges in the current training system are identified and interventions for improvement discussed. Additionally, suggestions are made and questions posed on how to move from a time-based model towards a competency-based curriculum.
Topics: Anesthesiologists; Anesthesiology; Fellowships and Scholarships; Humans; Pediatrics; United States
PubMed: 32792183
DOI: 10.1016/j.anclin.2020.06.005