Abstract:
BACKGROUND:Postoperative respiratory failure is associated with increased morbidity and mortality, as well as high costs of hospital care. METHODS:Using electronic anesthesia records, billing data, and chart review, the authors developed and validated a score predicting reintubation in the hospital after primary extubation in the operating room, leading to unplanned mechanical ventilation within the first 3 postoperative days. Using multivariable logistic regression analysis, independent predictors were determined and a score postulated and validated. RESULTS:In the entire cohort (n = 33,769 surgical cases within 29,924 patients), reintubation occurred in 137 cases (0.41%). Of those, 16%, (n = 22) died subsequently, whereas the mortality in patients who were not reintubated was 0.26% (P < 0.0001). Independent predictors for reintubation were: American Society of Anesthesiologist Score 3 or more, emergency surgery, high-risk surgical service, history of congestive heart failure, and chronic pulmonary disease. A point value of 3, 3, 2, 2, and 1 were assigned to these predictors, respectively, based on their β coefficient in the predictive model. The score yielded a calculated area under the curve of 0.81, whereas each point increment was associated with a 1.7-fold (odds ratio: 1.72 [95% CI, 1.55-1.91]) increase in the odds for reintubation in the training dataset. Using the validation dataset (n = 16,884), the score had an area under the curve of 0.80 and similar estimated probabilities for reintubation. CONCLUSION:The authors developed and validated a score for the prediction of postoperative respiratory complications, a simple, 11-point score that can be used preoperatively by anesthesiologists to predict severe postoperative respiratory complications.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Brueckmann B,Villa-Uribe JL,Bateman BT,Grosse-Sundrup M,Hess DR,Schlett CL,Eikermann Mdoi
10.1097/ALN.0b013e318293065csubject
Has Abstractpub_date
2013-06-01 00:00:00pages
1276-85issue
6eissn
0003-3022issn
1528-1175journal_volume
118pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全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:In airway smooth muscle (ASM), volatile anesthetics deplete sarcoplasmic reticulum (SR) Ca(2+) stores by increasing Ca(2+) "leak." Accordingly, SR replenishment becomes dependent on Ca(2+) influx. Depletion of SR Ca(2+) stores triggers Ca(2+) influx via specific plasma membrane channels, store-operated Ca(2+...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200408000-00018
更新日期:2004-08-01 00:00:00
abstract::The authors hypothesized that relaxation of airway smooth muscle by halothane lessens the dependence of airway resistance on lung volume, and that halothane alters the relationship between pulmonary resistance and lung volume by changing both the airway and tissue components of pulmonary resistance. The relationship a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199202000-00012
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:Evidence concerning the concentrations of volatile anesthetics that prevent learning and recall is limited. Epinephrine is believed to enable learning during anesthesia. We investigated the effects of isoflurane and its interaction with epinephrine on learning and subsequent retention of the rabbit's classic...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199407000-00029
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Inhalation anesthetics may interfere with the synthesis or action of endothelium-derived vasoactive factors. We investigated the effects of desflurane, enflurane, halothane, isoflurane, and sevoflurane on the release of nitric oxide and endothelium-derived hyperpolarizing factor (EDHF) in the isolated endoth...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199509000-00017
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Ketamine was previously suggested to relax vascular smooth muscle by reducing the intracellular Ca2+ concentration ([Ca2+]i). However, no direct evidence is available to indicate that ketamine reduces the [Ca2+]i in vascular smooth muscle of systemic resistance arteries. METHODS:Endothelium-intact or -denud...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200108000-00030
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Ketamine is an anesthetic drug. Subanesthetic doses of ketamine have been shown to reduce interleukin-6 concentrations after surgery and to reduce mortality and the production of tumor necrosis factor alpha and interleukin 6 in septic animals. Similarly, adenosine was shown to reduce tumor necrosis factor al...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200506000-00017
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Mask ventilation is an essential element of airway management that has rarely been studied as the primary outcome. The authors sought to determine the incidence and predictors of difficult and impossible mask ventilation. METHODS:A four-point scale to grade difficulty in performing mask ventilation (MV) is ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200611000-00007
更新日期:2006-11-01 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::The safety and efficacy of epidural morphine injected into the caudal space for control of postoperative pain following open cardiac surgery in children was studied. Thirty-two children between the ages of 2-12 yr for whom early postoperative tracheal extubation was anticipated were randomly assigned to control and st...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-198903000-00009
更新日期:1989-03-01 00:00:00
abstract::Halothane-induced lipid peroxidation was studied in microsomes from phenobarbital-pretreated male rats at defined steady state oxygen partial pressures (PO2). At PO2 less than 10 mmHg on addition of halothane to NADPH-reduced microsomes, significant increases in malondialdehyde (MDA) formation, oxygen uptake, and conj...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198501000-00009
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Methylprednisolone, dexamethasone, and other glucocorticoids have been found effective against nausea and vomiting induced by chemotherapy and surgery. Although the specific 5-hydroxytriptamine3 (5-HT3) receptor antagonists such as ondansetron and ramosetron are used as antiemetics, reports show that the use...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200409000-00014
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:General anesthetics modify airway responsiveness by several mechanisms, including direct effects on airway smooth muscle and reductions in neural reflex activity. Halothane has been shown to reduce responsiveness through both of these mechanisms. The airway effects of barbiturates are controversial, and the ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199308000-00014
更新日期:1993-08-01 00:00:00
abstract::ECG changes suggestive of myocardial ischemia are common during cesarean delivery under regional anesthesia. To determine the time course, duration, and significance of these ECG changes, we monitored 111 parturients with continuous ambulatory ECG (Holter) during and after cesarean delivery. Twenty-two parturients und...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199210000-00004
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:To assess changing patterns of injury and liability associated with central venous or pulmonary artery catheters, the authors analyzed closed malpractice claims for central catheter injuries in the American Society of Anesthesiologists Closed Claims database. METHODS:All claims for which a central catheter ...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00000542-200406000-00013
更新日期:2004-06-01 00:00:00
abstract::The effects of local infiltration anesthesia, brachial plexus blockade, isoflurane, or halothane anesthesia on blood flow through the brachial artery and through a newly created forearm arteriovenous fistula (AVF) were compared in 36 patients with endstage renal failure. Brachial artery blood flow was measured at two ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198906000-00005
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:The role of endothelial nitric oxide synthase (eNOS) in isoflurane postconditioning (IsoPC)-elicited cardioprotection is poorly understood. The authors addressed this issue using eNOS mice. METHODS:In vivo or Langendorff-perfused mouse hearts underwent 30 min of ischemia followed by 2 h of reperfusion in th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181c4a607
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Whether intraoperative use of hydroxyethyl starch impairs kidney function remains unknown. The authors thus tested the primary hypothesis that Hextend promotes renal injury in surgical patients. Secondarily, the authors evaluated the dose-outcome relationship, in-hospital and 90-day mortality, and whether th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000375
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:In vitro studies have shown that isoflurane, enflurane, and halothane inhibit the hypoxic pulmonary vasoconstriction (HPV) with essentially the same potency. The aim of this study is to compare the effects of sevoflurane and isoflurane on HPV in constant-flow perfused rabbit lungs. METHODS:Constant-flow per...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199312000-00026
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Neuropathic pain is a condition resulting from injury to the peripheral and/or central nervous system. Despite extensive research over the last several decades, neuropathic pain remains difficult to manage. METHODS:The authors conducted a randomized, placebo-controlled, double-blinded, and crossover clinica...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000000693
更新日期:2015-07-01 00:00:00
abstract::The adsorption characteristics, such as the adsorption capacity, the nature of the mass transfer zone, and heats of adsorption, are important for evaluating the performances of carbon canisters for removal of waste anesthetic vapors. The adsorption capacities and the natures of the mass transfer zones were measured fo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197703000-00001
更新日期:1977-03-01 00:00:00
abstract:BACKGROUND:This study aimed to characterize the electroencephalogram in children who emerged with emergence delirium (ED) compared with children without ED using methods that involved the assessment of cortical functional connectivity. METHODS:Children aged 5 to 15 yr had multichannel electroencephalographic recording...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000376
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Catheter-related infection is a serious complication of continuous regional anesthesia. The authors tested the hypothesis that single-dose antibiotic prophylaxis is associated with a lower incidence of catheter-related infections. METHODS:Our analysis was based on cases in the 25-center German Network for R...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001218
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Endothelium-derived hyperpolarizing factor is thought to be a cytochrome P450-derived arachidonic acid metabolite that hyperpolarizes vascular smooth muscle cells by opening Ca(2+)-activated K+ channels (K+Ca channels). In the rabbit carotid artery both volatile and intravenous anesthetics inhibit the acetyl...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199606000-00025
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Lamotrigine is a sodium channel blocker that inhibits the neuronal release of glutamate. Systemic administration of lamotrigine induces analgesia in short- and long-term models of hyperalgesia in rats. Considering the key role of N-methyl-D-aspartate receptors in the sensitization of dorsal horn neurons that...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199802000-00028
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Conventional cardiopulmonary resuscitation (CPR) includes 80-100/min precordial compressions with intermittent positive pressure ventilation (IPPV) after every fifth compression. To prevent gastric insufflation, chest compressions are held during IPPV if the patient is not intubated. Elimination of IPPV woul...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199904000-00022
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:The concept of the axillary "sheath" has been a central tenet of brachial plexus regional anesthesia for many years. Recent investigations have cast doubt on its nature and existence. This study further examines the issue. METHODS:Computerized axial tomographic dye studies were performed using continuous ca...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200609000-00021
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Nonimmobilizers are agents that lack anesthetic properties, although their chemical structure is very similar to known anesthetics. The primary action site of both agents, whether at the membrane or target protein level, is still a matter of debate. However, increasing evidence points to the distinct modific...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200210000-00016
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Preterm and ex-preterm infants are at risk for life-threatening apnea after general anesthesia. The authors attempted to define the postconceptual age beyond which apnea is less likely to occur and to identify the factors that predispose to postanesthetic apnea. METHODS:Ninety-one infants younger than 60 we...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199306000-00009
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Propofol has not been studied directly in animals subject to cerebral ischemia in the conscious state. Strokes are usually induced in animals while they are anesthetized, making it difficult to eliminate anesthetic interactions as a complicating factor. Therefore, to compare the neuroprotective effects of pr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200205000-00023
更新日期:2002-05-01 00:00:00