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1.
PLoS One ; 14(5): e0215221, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31120888

RESUMO

Poor reporting quality may contribute to irreproducibility of results and failed 'bench-to-bedside' translation. Consequently, guidelines have been developed to improve the complete and transparent reporting of in vivo preclinical studies. To examine the impact of such guidelines on core methodological and analytical reporting items in the preclinical anesthesiology literature, we sampled a cohort of studies. Preclinical in vivo studies published in Anesthesiology, Anesthesia & Analgesia, Anaesthesia, and the British Journal of Anaesthesia (2008-2009, 2014-2016) were identified. Data was extracted independently and in duplicate. Reporting completeness was assessed using the National Institutes of Health Principles and Guidelines for Reporting Preclinical Research. Risk ratios were used for comparative analyses. Of 7615 screened articles, 604 met our inclusion criteria and included experiments reporting on 52 490 animals. The most common topic of investigation was pain and analgesia (30%), rodents were most frequently used (77%), and studies were most commonly conducted in the United States (36%). Use of preclinical reporting guidelines was listed in 10% of applicable articles. A minority of studies fully reported on replicates (0.3%), randomization (10%), blinding (12%), sample-size estimation (3%), and inclusion/exclusion criteria (5%). Statistics were well reported (81%). Comparative analysis demonstrated few differences in reporting rigor between journals, including those that endorsed reporting guidelines. Principal items of study design were infrequently reported, with few differences between journals. Methods to improve implementation and adherence to community-based reporting guidelines may be necessary to increase transparent and consistent reporting in the preclinical anesthesiology literature.


Assuntos
Avaliação Pré-Clínica de Medicamentos/normas , Relatório de Pesquisa/normas , Analgésicos/uso terapêutico , Animais , Bases de Dados Factuais , Guias como Assunto , Dor/tratamento farmacológico
2.
Can J Anaesth ; 60(8): 803-7, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23681721

RESUMO

PURPOSE: We report a case of unrecognized cardiac tamponade diagnosed pre-induction by focused transthoracic echocardiography (TTE). The value of focused perioperative TTE, the anesthetic implications of Churg-Strauss syndrome, and the diagnosis of cardiac tamponade are discussed. CLINICAL FEATURES: A 58-yr-old man with a history of severe asymptomatic aortic stenosis presented for elective endoscopic sinus surgery for intractable nasal polyps with recurrent sinusitis. His cardiologist and cardiac surgeon had recommended proceeding with surgery, as aortic valve replacement was not indicated because he was asymptomatic. Prior to induction, a focused TTE was performed by anesthesia in order to document the degree of aortic stenosis, baseline ventricular function, and baseline volume status. This provided a baseline for comparison in case the patient's hemodynamic status should deteriorate intraoperatively. Unexpectedly, the TTE examination revealed cardiac tamponade. After confirmation of the diagnosis by cardiology, urgent pericardiocentesis was performed. A diagnosis of Churg-Strauss syndrome was ultimately made, and the patient was treated with high-dose prednisone therapy. CONCLUSION: Focused TTE has significant clinical utility for the diagnosis and assessment of hemodynamically significant cardiac conditions, particularly in the complex patient where clinical examination is challenging and echocardiographic findings can have immediate management implications.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Ecocardiografia Transesofagiana/métodos , Estenose da Valva Aórtica/diagnóstico por imagem , Função do Átrio Direito/fisiologia , Volume Cardíaco/fisiologia , Síndrome de Churg-Strauss/diagnóstico , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Pericardiocentese/métodos , Pericárdio/diagnóstico por imagem , Cuidados Pré-Operatórios , Disfunção Ventricular Direita/diagnóstico por imagem , Função Ventricular/fisiologia
3.
Can J Anaesth ; 55(11): 779-84, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19138919

RESUMO

PURPOSE: The Combitube has been shown to be effective in many airway management scenarios. We describe its use as a rescue device in a "cannot intubate cannot ventilate" (CICV) situation that was encountered during a Cesarean delivery (CD) followed by transient cranial nerve dysfunction. CLINICAL FEATURES: A 24-yr-old gravida 4 para 1 (weight 112 kg, body mass index 44 kg.m(-2)) at 34 weeks gestation, with pregnancy induced hypertension and a prior history of uneventful airway management, presented for urgent CD. She refused regional anesthesia and attempts at awake laryngoscopy and intubation. Following rapid sequence induction, attempts at direct laryngoscopy and intubation failed. Ventilation via facemask and laryngeal mask also failed. A Combitube was inserted and inflated according to manufacturer's instructions and resulted in successful ventilation of the patient. The Combitube was in place for approximately three hours and then removed uneventfully. The following day, the patient presented with signs and symptoms consistent with bilateral glossopharyngeal and unilateral hypoglossal nerve dysfunction. Three months later the patient's nerve dysfunction had completely resolved. CONCLUSION: Although this patient's transient nerve dysfunction was most likely due to the Combitube, we believe its inclusion as part of any difficult airway armamentarium should be encouraged. Training in its use should be promoted. It has an important role in emergency airway management and can be effective when other non-surgical ventilation techniques fail. Despite this, clinicians must remain vigilant for complications following its use.


Assuntos
Anestesia por Inalação/efeitos adversos , Anestesia Obstétrica/efeitos adversos , Cesárea , Traumatismos do Nervo Glossofaríngeo , Traumatismos do Nervo Hipoglosso , Intubação Intratraqueal/efeitos adversos , Feminino , Humanos , Faringite/etiologia , Gravidez , Língua/patologia , Adulto Jovem
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