A5052507237- Cardiac, Anesthesia and Surgical Outcomes
- Anesthesia and Sedative Agents
- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Hemodynamic Monitoring and Therapy
- Anesthesia and Pain Management
- Thermal Regulation in Medicine
- Anesthesia and Neurotoxicity Research
- Cardiac Arrest and Resuscitation
- Airway Management and Intubation Techniques
- Blood transfusion and management
- Obstructive Sleep Apnea Research
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Opioid Use Disorder Treatment
- Central Venous Catheters and Hemodialysis
- Nausea and vomiting management
- Climate Change and Health Impacts
- Thermoregulation and physiological responses
- Vitamin D Research Studies
- Antibiotics Pharmacokinetics and Efficacy
- Delphi Technique in Research
- Enhanced Recovery After Surgery
- Palliative Care and End-of-Life Issues
- Hospital Admissions and Outcomes
University of Michigan
2017-2023
Outcomes Research Consortium
2013-2023
Universitätsmedizin Göttingen
2019-2023
University of Göttingen
2021-2023
Michigan Medicine
2018-2022
Cleveland Clinic
2010-2021
Committee on Publication Ethics
2015-2020
American Society of Anesthesiologists
2019-2020
European Society of Radiology
2020
Wake Forest University
2020
Awareness during anesthesia is a serious complication with potential long-term psychological consequences. Use of the bispectral index (BIS), developed from processed electroencephalogram, has been reported to decrease incidence awareness when BIS value maintained below 60. In this trial, we sought determine whether BIS-based protocol better than based on measurement end-tidal anesthetic gas (ETAG) for decreasing in patients at high risk complication.We randomly assigned 2000 BIS-guided...
Low mean arterial pressure (MAP) and deep hypnosis have been associated with complications mortality. The normal response to high minimum alveolar concentration (MAC) fraction of anesthetics is hypotension low Bispectral Index (BIS) scores. MAP and/or BIS at lower MAC fractions may represent anesthetic sensitivity. authors sought characterize the effect triple state (low during a fraction) on duration hospitalization 30-day all-cause mortality.Mean intraoperative MAP, BIS, were determined...
Patients are often concerned about the effects of smoking on perioperative risk. However, effective advice may be limited by paucity information and Thus, our goal was to determine effect 30-day postoperative outcomes in noncardiac surgical patients.We evaluated 635,265 patients from American College Surgeons National Surgical Quality Improvement Program database; 520,242 met inclusion criteria. Of these patients, 103,795 were current smokers; 82,304 smokers propensity matched with...
<h3>Importance</h3> Postoperative delirium occurs in 10% to 60% of elderly patients having major surgery and is associated with longer hospital stays, increased costs, 1-year mortality. Emerging literature suggests that dexmedetomidine sedation critical care units reduced incidence delirium. However, intraoperative use for prevention has not been well studied. <h3>Objective</h3> To evaluate whether an infusion reduces postoperative <h3>Design, Setting, Participants</h3> This study was a...
Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed provide an international picture of the extent injuries and factors associated with ICU-acquired in adult ICU patients. International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors injury mortality were assessed by generalised linear mixed-effects regression analysis. Data from...
Five percent of adult patients undergoing noncardiac inpatient surgery experience a major pulmonary complication. The authors hypothesized that the choice neuromuscular blockade reversal (neostigmine vs. sugammadex) may be associated with lower incidence complications.
Core temperature patterns in patients warmed with forced air remain poorly characterized. Also unknown is the extent to which transient and mild intraoperative hypothermia contributes adverse outcomes broad populations.We evaluated esophageal (core) temperatures 58,814 adults having surgery lasting >60 min who were air. Independent associations between hypothermic exposure transfusion requirement duration of hospitalization evaluated.In every percentile subgroup, core decreased during first...
Abstract Background Despite the significant healthcare impact of acute kidney injury, little is known regarding prevention. Single-center data have implicated hypotension in developing postoperative injury. The generalizability this finding and interaction between baseline patient disease burden remain unknown. authors sought to determine whether association intraoperative injury varies by preoperative risk. Methods Major noncardiac surgical procedures performed on adult patients across...
BACKGROUND: Opioid-related adverse events are a serious problem in hospitalized patients. Little is known about patients who likely to experience opioid-induced respiratory depression on the general care floor and may benefit from improved monitoring early intervention. The trial objective was derive validate risk prediction tool for receiving opioids, as detected by continuous pulse oximetry capnography monitoring. METHODS: PRediction of Opioid-induced Depression In monitored capnoGraphY...
Persistent postoperative cognitive decline is thought to be a public health problem, but its severity may have been overestimated because of limitations in statistical methodology. This study assessed whether long-term occurred after surgery or illness by using an innovative approach and including participants with early Alzheimer disease overcome some limitations.In this retrospective cohort study, three groups were identified from tested annually at the Washington University Alzheimer's...
Transfers of patient care and responsibility among caregivers, "handovers," are common. Whether handovers worsen outcome remains unclear. The authors tested the hypothesis that intraoperative transitions anesthesia providers associated with postoperative complications.From records 138,932 adult Cleveland Clinic (Cleveland, Ohio) surgical patients, assessed association between total number during a case an adjusted collapsed composite in-hospital mortality major morbidities using...
BACKGROUND: Continuous infusions of norepinephrine to treat perioperative hypotension are typically administered through a central venous line rather than peripheral catheter avoid the risk localized tissue necrosis in case drug extravasation. There is limited literature estimate skin when used counteract anesthesia-associated elective surgical cases. This study aimed rate occurrence drug-related adverse effects, including requiring management extravasation occurs. METHODS: retrospective...
We investigated if the stress applied to lung during non-invasive respiratory support may contribute coronavirus disease 2019 (COVID-19) progression. Single-center, prospective, cohort study of 140 consecutive COVID-19 pneumonia patients treated in high-dependency unit with continuous positive airway pressure (n = 131) or ventilation 9). measured quantitative computed tomography, esophageal swings and total stress. Patients were divided five subgroups based on their baseline PaO2/FiO2 (day...
This study aimed at investigating the mechanisms underlying oxygenation response to proning and recruitment maneuvers in coronavirus disease 2019 (COVID-19) pneumonia.Twenty-five patients with COVID-19 pneumonia, variable times since admission (from 1 3 weeks), underwent computed tomography (CT) lung scans, gas-exchange lung-mechanics measurement supine prone positions 5 cmH2O during recruiting maneuver (supine, 35 cmH2O). Within non-aerated tissue, we differentiated atelectatic consolidated...
<h3>Importance</h3> Recent studies have investigated the effect of overlapping surgeon responsibilities or nurse to patient staffing ratios on outcomes, but association anesthesiologist with outcomes remains unexplored our knowledge. <h3>Objective</h3> To examine between different levels and surgical morbidity mortality. <h3>Design, Setting, Participants</h3> A retrospective, matched cohort study consisting major noncardiac inpatient procedures performed from January 1, 2010, October 31,...
Background There is insufficient prospective evidence regarding the relationship between surgical experience and prolonged opioid use pain. The authors investigated association of patient characteristics, procedure, perioperative anesthetic course with postoperative consumption pain 3 months postsurgery. hypothesized that characteristics intraoperative factors predict Methods Eleven U.S. one European institution enrolled patients scheduled for spine, open thoracic, knee, hip, or abdominal...
Background Optimal risk adjustment is a requisite precondition for monitoring quality of care and interpreting public reports hospital outcomes. Current risk-adjustment measures have been criticized including baseline variables that are difficult to obtain inadequately adjusting high-risk patients. The authors sought develop highly predictive models 30-day mortality morbidity based only on small number preoperative characteristics. They included the Procedural Terminology code corresponding...
In Brief BACKGROUND: General use of angiotensin-converting enzyme inhibitors (ACEIs) is associated with upper-airway complications such as cough, angioedema, and bronchospasm; furthermore, preoperative increased morbidity or mortality. Our primary goal in this study was thus to evaluate the association ACEI therapy perioperative respiratory adult noncardiac surgical patients. secondary goals were between 30-day mortality, well a composite outcome in-hospital mortality patients having general...
Anemia has been associated with increased postoperative morbidity and mortality. We used the American College of Surgeons National Surgical Quality Improvement Program database to retrospectively assess relationship between preoperative anemia 30-day mortality in noncardiac surgical patients, careful distinguish confounding variables from mediator variables.Each patient was matched one without using propensity matching on potentially baseline variables. Logistic regression evaluate...
Inflammation after cardiopulmonary bypass may contribute to postoperative delirium and cognitive dysfunction. The authors evaluated the effect of high-dose methylprednisolone suppress inflammation on incidence quality recovery cardiac surgery.Five hundred fifty-five adults from three hospitals enrolled in randomized, double-blind Steroids Cardiac Surgery trial were randomly allocated placebo or 250 mg at induction before bypass. Each completed Postoperative Quality Recovery Scale surgery...
<h3>Importance</h3> Overlapping surgery, in which more than 1 procedure performed by the same primary surgeon is scheduled so start time of one overlaps with end another, concern because potential adverse outcomes. <h3>Objective</h3> To determine association between overlapping surgery and mortality, complications, length surgery. <h3>Design, Setting, Participants</h3> Retrospective cohort study 66 430 operations patients aged 18 to 90 years undergoing total knee or hip arthroplasty; spine...