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Anesthesiology Clinics Dec 2021The authors provide a review of recent advances in the understanding of pathophysiology and perioperative management of preeclampsia and eclampsia, from the perspective... (Review)
Review
The authors provide a review of recent advances in the understanding of pathophysiology and perioperative management of preeclampsia and eclampsia, from the perspective of the anesthesiologist. This review includes aspects of assessment of severity of disease, hemodynamic monitoring, peripartum anesthesia care, and postpartum management. The perioperative management of patients with eclampsia is also discussed.
Topics: Anesthesiologists; Anesthesiology; Eclampsia; Female; Humans; Postpartum Period; Pre-Eclampsia; Pregnancy
PubMed: 34776105
DOI: 10.1016/j.anclin.2021.08.005 -
World Neurosurgery Jul 2018
Review
Topics: Anesthesia; Anesthesiologists; Humans; Neurosurgical Procedures; Patient Handoff; Perioperative Care; Treatment Outcome
PubMed: 29772360
DOI: 10.1016/j.wneu.2018.05.029 -
Journal of Cardiothoracic and Vascular... Nov 2020
Topics: American Heart Association; Anesthesiologists; Anesthesiology; Atrial Fibrillation; Humans
PubMed: 32690237
DOI: 10.1053/j.jvca.2020.05.036 -
Clinical Obstetrics and Gynecology Jun 2017Obstetric hemorrhage can bring significant challenges to the obstetrician and anesthestiologist. Optimal management requires a systems-based multidisciplinary and... (Review)
Review
Obstetric hemorrhage can bring significant challenges to the obstetrician and anesthestiologist. Optimal management requires a systems-based multidisciplinary and intraprofessinal approach, and implementation leadership is now the cornerstone of successful hemorrhage management. The National Partnership for Maternal Safety recently released a patient safety bundle for maternal hemorrhage. The bundle lists 13 resources that should be implemented in every delivery unit in the country to optimize readiness, recognition, response, and reporting and systems learning for obstetric hemorrhage. Anesthesiologists are expert in resuscitation and systems-based response, and can help lead both bundle implementation and clinical teams responding to obstetric hemorrhage.
Topics: Anesthesiologists; Clinical Protocols; Cooperative Behavior; Delivery, Obstetric; Female; Humans; Outcome and Process Assessment, Health Care; Patient Care Team; Patient Safety; Postpartum Hemorrhage; Pregnancy
PubMed: 28169855
DOI: 10.1097/GRF.0000000000000278 -
Journal of Clinical Anesthesia Aug 2021When the anesthesiologist does not individually perform the anesthesia care, then to make valid comparisons among US anesthesia departments, one must consider the... (Review)
Review
The anesthetizing sites supervised to anesthesiologist ratio is an invalid surrogate for group productivity in academic anesthesia departments when used without consideration of the corresponding managerial decisions.
When the anesthesiologist does not individually perform the anesthesia care, then to make valid comparisons among US anesthesia departments, one must consider the staffing ratio (i.e., how many cases each anesthesiologist supervises when working with Certified Registered Nurse Anesthetists [CRNAs] or Certified Anesthesiologist Assistants [CAA]). The staffing ratio also must be considered when accurately measuring group productivity. In this narrative review, we consider anesthesia departments with non-physician anesthesia providers and anesthesiology residents. We investigate the validity of such departments assessing the overall ratio of anesthetizing sites supervised per anesthesiologist as a surrogate for group clinical productivity. The sites/anesthesiologist ratio can be estimated accurately using the arithmetic mean calculated by anesthesiologist, the harmonic mean calculated by case, or the harmonic mean calculated by CRNA or CAA, but not by the arithmetic mean ratio by case. However, there is lack of validity to benchmarking the percentage time that anesthesiologists are supervising the maximum possible number of CRNAs or CAAs when some of the anesthesiologists also are supervising resident physicians. Assignments can differ in the total number anesthesiologists needed while every anesthesiologist is supervising as many sites as possible. Similarly, there is lack of validity to limiting assessment to the anesthesiologists supervising only CRNAs or CAAs. There also is lack of validity to limiting assessment only to cases performed by supervised CRNAs or CAAs. When cases can be assigned to anesthesiology residents or CRNAs or CAAs, increasing sites/anesthesiologist while limiting consideration to the CRNAs or CAAs creates incentive for the CRNAs or CAAs to be assigned cases, even when lesser productivity is the outcome. Decisions also can increase sites/anesthesiologist without increasing productivity (e.g., when one anesthesiologist relieves another before the end of the regular workday). A suitable alternative approach to fallaciously treating the sites/anesthesiologist ratio as a surrogate for productivity is that, when a teaching hospital supplies financial support, a responsibility of the anesthesia department is to explain annually the principal factors affecting productivity at each facility it manages and to show annually that decisions were made that maximized productivity, subject to the facilities' constraints.
Topics: Anesthesia Department, Hospital; Anesthesiologists; Anesthesiology; Efficiency; Humans; Nurse Anesthetists
PubMed: 33713934
DOI: 10.1016/j.jclinane.2021.110194 -
Anesthesiology Clinics Mar 2023
Topics: Humans; Anesthesiologists; Critical Care
PubMed: 36872010
DOI: 10.1016/j.anclin.2022.10.001 -
JAMA Surgery May 2023
Topics: Humans; Anesthesiologists; Surgeons
PubMed: 36811890
DOI: 10.1001/jamasurg.2022.8235 -
Anesthesia and Analgesia Aug 2023
Topics: Humans; Anesthesiologists; Anesthesiology; Anesthesia; Heart
PubMed: 37450907
DOI: 10.1213/ANE.0000000000006450 -
Annals of Cardiac Anaesthesia 2016With the growing requirement of echocardiography in the perioperative management, the anesthesiologists need to be well trained in transthoracic echocardiography (TTE).... (Review)
Review
With the growing requirement of echocardiography in the perioperative management, the anesthesiologists need to be well trained in transthoracic echocardiography (TTE). Lack of formal, structured teaching program precludes the same. The present article reviews the expanding domain of TTE, simulation-based TTE training, the advancements, current limitations, and the importance of simulation-based training for the anesthesiologists.
Topics: Anesthesiologists; Anesthesiology; Computer Simulation; Echocardiography; Humans; Manikins
PubMed: 27397457
DOI: 10.4103/0971-9784.185544 -
Anesthesia Progress Mar 2021
Review
Topics: Anesthesia; Anesthesiologists; Anesthesiology; Humans
PubMed: 33827120
DOI: 10.2344/anpr-68-01-11