Abstract:
BACKGROUND:Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. METHODS:This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods of 5 months, one before and one after elimination of daily-routine CXR. Chest CT and ultrasound studies were identified retrospectively by using the radiology department information system. Indications for and the diagnostic/therapeutic yield of chest CT and ultrasound studies were collected. RESULTS:Elimination of daily-routine CXR resulted in a decrease of CXRs per patient day from 1.1 +/- 0.3 to 0.6 +/- 0.4 (P < 0.05). Elimination did not affect duration of stay or mortality rates. Neither the number of chest CT studies nor the ratio of chest CT studies per patient day changed with the intervention: Before elimination of daily-routine CXR, 52 chest CT studies were obtained from 747 patients; after elimination, 54 CT studies were obtained from 743 patients. Similarly, chest ultrasound practice was not affected by the change of CXR strategy: Before and after elimination, 21 and 27 chest ultrasound studies were performed, respectively. Also, timing of chest CT and ultrasound studies was not different between the two study periods. During the two periods, 40 of 106 chest CT studies (38%) and 18 of 48 chest ultrasound studies (38%) resulted in a change in therapy. The combined therapeutic yield of chest CT and ultrasound studies did not change with elimination of daily-routine CXR. CONCLUSIONS:Elimination of daily-routine CXRs may not affect chest CT and ultrasound practice in a multidisciplinary intensive care unit.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Kröner A,Binnekade JM,Graat ME,Vroom MB,Stoker J,Spronk PE,Schultz MJdoi
10.1097/01.anes.0000296069.00566.16subject
Has Abstractpub_date
2008-01-01 00:00:00pages
40-5issue
1eissn
0003-3022issn
1528-1175pii
00000542-200801000-00009journal_volume
108pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Cortical acetylcholine originates in the basal forebrain and is essential for maintaining normal cognition and arousal. Morphine impairs these cholinergically mediated cortical functions. The current study tested the hypothesis that morphine decreases prefrontal cortical acetylcholine release by acting at th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200510000-00016
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Anesthesia during the synaptogenic period induces dendritic spine formation, which may affect neurodevelopment. The authors, therefore, evaluated whether changes in synaptic transmission after dendritic spine formation induced by sevoflurane were associated with long-term behavioral changes. The effects of s...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001470
更新日期:2017-02-01 00:00:00
abstract::The cerebral and systemic hemodynamic and metabolic effects of hypotension induced with desflurane were examined in 11 dogs. During a steady-state baseline period under 1 MAC desflurane (7.2%), the following were measured or derived: arterial, pulmonary artery, and pulmonary artery occlusion pressures; arterial, mixed...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199103000-00021
更新日期:1991-03-01 00:00:00
abstract::Ketamine is used clinically as a racemic mixture of optical isomers that differ in their analgesic properties and psychomimetic effects. Administered individually, or together as the racemate, ketamine enantiomers differ in their hepatic clearance and duration of anesthetic effect. S(+) ketamine exhibits a greater cle...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199212000-00022
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS:...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001504
更新日期:2017-03-01 00:00:00
abstract::Nonsteroidal antiinflammatory drugs (NSAIDs) are commonly combined with intravenous morphine patient-controlled analgesia to relieve postoperative pain. NSAIDs have a documented 30-50% sparing effect on morphine consumption. However, most of the studies have not demonstrated a decrease in morphine adverse effects. A m...
journal_title:Anesthesiology
pub_type: 杂志文章,meta分析
doi:10.1097/00000542-200506000-00027
更新日期:2005-06-01 00:00:00
abstract::Robert D. Dripps, M.D. (1911 to 1973), helped found academic anesthesiology. Newly reviewed teaching slides from the University of Pennsylvania (Philadelphia, Pennsylvania) contain six anesthesia records from 1965 to 1967 that involved Dripps. They illustrate the clinical philosophy he taught-to consider administratio...
journal_title:Anesthesiology
pub_type: 传,历史文章,杂志文章
doi:10.1097/ALN.0000000000001109
更新日期:2016-06-01 00:00:00
abstract::It is now well established that the pathophysiology of the malignant hyperthermia (MH) syndrome is related to a malfunction of intracellular calcium homeostasis. Magnesium plays important roles in the basic contractile properties of muscle, and many of its actions are antagonistic to those of calcium. The aim of this ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199007000-00016
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Mortality after noncardiac surgery has been associated with the "triple low state," a combination of low mean arterial blood pressure (<75 mmHg), low bispectral index (<45), and low minimum alveolar concentration of volatile anesthesia (<0.70). The authors set out to determine whether duration of a triple lo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000281
更新日期:2014-07-01 00:00:00
abstract::Isoflurane has protective properties during experimental global brain ischemia or hypoxia. However, this has not been evaluated in the more common case of focal ischemia, e.g., as caused by middle cerebral artery occlusion (MCAO). The authors therefore compared the effects of isoflurane, thiopental, and N2O/fentanyl a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198704000-00002
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Despite the fact that obesity is a known risk factor for cardiovascular disease, many studies have failed to demonstrate that obesity is independently associated with an increased risk of cardiovascular morbidity and mortality in nondiabetic patients undergoing coronary artery bypass graft surgery. The autho...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200603000-00010
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Propofol and isoflurane anesthesia were studied previously with functional brain imaging in humans to begin identifying key brain areas involved with mediating anesthetic-induced unconsciousness. The authors describe an additional positron emission tomography study of halothane's in vivo cerebral metabolic e...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199903000-00011
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:: Recent population studies have suggested that children with multiple exposures to anesthesia and surgery at an early age are at an increased risk of cognitive impairment. The authors therefore have established an animal model with single versus multiple exposures of anesthetic(s) in young versus adult mice...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182834d77
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 mg/kg propofol when administered intravenously after sevoflurane- compared with desflurane-b...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199810000-00007
更新日期:1998-10-01 00:00:00
abstract::Statin therapy is well established for prevention of cardiovascular disease. Statins may also reduce postoperative mortality and morbidity via a pleiotropic (non-lipid-lowering) effect. The authors conducted a meta-analysis to determine the influence of statin treatment on adverse postoperative outcomes in patients un...
journal_title:Anesthesiology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/00000542-200612000-00027
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Effects of volatile anesthetic agents on N-methyl-D-aspartate (NMDA) receptor-mediated excitatory synaptic transmission have not been well characterized. The authors compared effects produced by halothane and isoflurane on electrophysiologic properties of NMDA and non-NMDA receptor-mediated synaptic response...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200001000-00035
更新日期:2000-01-01 00:00:00
abstract::The influence of isoflurane on membrane currents, action potentials, and contraction was investigated in single cells isolated from guinea-pig ventricle. Isoflurane (1.65-4.45%) reduced the action potential duration at 20% and 90% repolarization times. When step depolarizations were applied under voltage-clamp conditi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198811000-00017
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Drugs that block spinal excitatory amino acid receptor activation may prevent pain after surgery. The authors previously studied the effect of excitatory amino acid receptor antagonists after incision. In the present study, we examined the role of N-methyl-d-aspartate (NMDA), non-NMDA, and metabotropic gluta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00029
更新日期:2000-08-01 00:00:00
abstract::Recovery from anesthesia was assessed in a controlled manner in 34 healthy student volunteers, using a psychomotor test battery 1 and 5 hours and a driving simulator 2, 4.5, and 7 hours after 3.5 minutes of anesthesia with halothane or enflurane combined with nitrous oxide and oxygen. Psychomotor performances remained...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197701000-00006
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Emergence delirium has been investigated in several clinical trials. However, no reliable and valid rating scale exists to measure this phenomenon in children. Therefore, the authors developed and evaluated the Pediatric Anesthesia Emergence Delirium (PAED) scale to measure emergence delirium in children. M...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200405000-00015
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Global cerebral ischemia is associated with delayed neuronal death. Given the role of caspases in apoptosis, caspase inhibitors may provide neuronal protection after cardiac arrest. To this end, the authors generated a transgenic rat line expressing baculovirus p35, a broad-spectrum caspase inhibitor, in cen...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200307000-00020
更新日期:2003-07-01 00:00:00
abstract::The neuromuscular and cardiovascular effects of mivacurium chloride (BW B1090U) were evaluated in 90 children (2-12 yr) during N2O:O2 halothane or N2O:O2 narcotic anesthesia. Neuromuscular response was evaluated by recording the force of contraction of the adductor of the thumb during train-of-four stimulation at 0.1 ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198902000-00010
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000809
更新日期:2015-10-01 00:00:00
abstract::The teratogenic potential of subanesthetic and anesthetic exposure to halothane was studied in Swiss/ICR mice. Two treatment regimens were employed: daily exposure of males and females for nine weeks prior to conception and on days 1 through 17 of pregnancy; and exposure of females only on days 6 through 15 of pregnan...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197912000-00010
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:There is little information concerning the carbon dioxide-related effects on respiratory mechanics in anesthetized, paralyzed subjects; however, hypocapnia or hypercapnia is often permitted in patients with severe brain injury or acute respiratory distress syndrome. Therefore, the carbon dioxide dependence o...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200104000-00013
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Phenotyping malignant hyperthermia (MH) by contracture testing has a low but quantifiable degree of inaccuracy, measured by its sensitivity and specificity. Quantifying the limitations inherent in diagnostic testing for MH can help resolve issues in clinical practice, such as the interpretation of a negative...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199803000-00007
更新日期:1998-03-01 00:00:00
abstract::The authors determined the effect of profound induced hypotension (i.e., mean arterial blood pressure less than 50 mmHg) during craniotomy for cerebral aneurysm on cerebral blood flow and cerebral metabolic rate for oxygen before, during, and after (20 min and 40 min after) the hypotensive period. The study was perfor...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198902000-00013
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Withdrawal thresholds in the paw are lower in younger animals, and incision further reduces these thresholds. The authors hypothesized that these differences result in part from changes in intrinsic electrophysiologic properties of large neurons. METHODS:Using isolated whole dorsal root ganglion, current cl...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31817c1ab9
更新日期:2008-07-01 00:00:00
abstract::The dose-response and plasma concentration-response relationships for pancuronium in man were studied during its intravenous administration to eight patients at a rate of 1.62 microgram/kg/min. The (log) dose-response relationships resulted in a sigmoid curve that was linear in its central range. At 20, 50 and 80 per ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197908000-00004
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Densities in dependent lung regions worsen oxygenation in patients with acute respiratory distress syndrome. Identification of these densities requires examination using computed tomography (CT). In this study, the authors evaluated the use of transesophageal echocardiography (TEE) to estimate densities in t...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200105000-00017
更新日期:2001-05-01 00:00:00