Abstract:
BACKGROUND:Increasing costs of material resources challenge hospitals to stay profitable. Particularly in anesthesia departments and intensive care units, bronchoscopes are used for various indications. Inefficient management of single- and multiple-use systems can influence the hospitals' material costs substantially. Using mathematical modeling, we developed a strategic decision support tool to determine the optimum mix of disposable and reusable bronchoscopy devices in the setting of an intensive care unit. METHODS:A mathematical model with the objective to minimize costs in relation to demand constraints for bronchoscopy devices was formulated. The stochastic model decides whether single-use, multi-use, or a strategically chosen mix of both device types should be used. A decision support tool was developed in which parameters for uncertain demand such as mean, standard deviation, and a reliability parameter can be inserted. Furthermore, reprocessing costs per procedure, procurement, and maintenance costs for devices can be parameterized. RESULTS:Our experiments show for which demand pattern and reliability measure, it is efficient to only use reusable or disposable devices and under which circumstances the combination of both device types is beneficial. CONCLUSIONS:To determine the optimum mix of single-use and reusable bronchoscopy devices effectively and efficiently, managers can enter their hospital-specific parameters such as demand and prices into the decision support tool.The software can be downloaded at: https://github.com/drdanielgartner/bronchomix/.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Edenharter GM,Gartner D,Pförringer Ddoi
10.1213/ANE.0000000000001729subject
Has Abstractpub_date
2017-06-01 00:00:00pages
1963-1967issue
6eissn
0003-2999issn
1526-7598journal_volume
124pub_type
杂志文章abstract::The purpose of this canine study was to examine the cerebral vascular and metabolic effects of adding nitrous oxide to isoflurane from 1.4% expired (1 MAC) up to a concentration giving an isoelectric electroencephalogram (EEG). Cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) were determined us...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199101000-00013
更新日期:1991-01-01 00:00:00
abstract::The influence of preoxygenation in the supine (n = 10) versus the 45 degrees head-up (n = 10) position on the duration of apnea leading to a decrease in arterial oxygen saturation to 95%, as monitored by pulse oximetry, was investigated in 20 women undergoing elective cesarean section at term of pregnancy. The results...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199211000-00018
更新日期:1992-11-01 00:00:00
abstract::Spontaneous positive end-expiratory pressure (sPEEP) is a simple, low-cost method of providing low to moderate levels of PEEP as an alternative to continuous positive airway pressure (CPAP), whether used alone or with continuous positive pressure ventilation (CPPV) in intermittent mandatory ventilation (IMV). The ther...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract::Our overall goal was to investigate the mechanism by which fentanyl attenuates acetylcholine-induced contraction in porcine coronary artery. We tested the hypothesis that fentanyl attenuates muscarinic coronary contraction via sigma receptor activation. Left coronary artery vascular rings were isolated from porcine he...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199605000-00016
更新日期:1996-05-01 00:00:00
abstract::The antagonism of a pancuronium-curare (P + C) neuromuscular block was assessed and compared to the antagonism of a pancuronium (P) block. One group of seven patients received P + C (0.024 mg/kg + 0.144 mg/kg); another similar group of seven patients received P (0.07 mg/kg). Both groups were anesthetized with nitrous ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract:UNLABELLED:We investigated the effect of epidural local anesthetic blockade on urinary substance P levels in five patients suffering from painful flare-ups of interstitial cystitis. Urine was collected in 24-h intervals commencing at the onset of an epidural bolus of 0.25% bupivacaine followed by maintenance epidural i...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000099362.01312.3a
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia is typically tested for using time-consumin...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000001465
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Severe pain has been linked to depression, which raises the question of whether epidural analgesia (EDA) during childbirth is associated with a reduced risk of postpartum depression (PPD). This association has been explored previously, but the studies were restricted by small sample sizes and the inability t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004292
更新日期:2020-03-01 00:00:00
abstract::Because no completely effective antiemetic exists for the prevention of postoperative nausea and vomiting (PONV), we hypothesize that a multimodal approach to management of PONV may reduce both vomiting and the need for rescue antiemetics in high-risk patients. After IRB approval, women undergoing outpatient laparosco...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200012000-00020
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reduci...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析
doi:10.1213/ANE.0000000000004165
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Postoperative delirium is an important problem for surgical inpatients and was the target of a multidisciplinary quality improvement project at our institution. We developed and tested a semiautomated delirium risk stratification instrument, Age, WORLD backwards, Orientation, iLlness severity, Surgery-specif...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005085
更新日期:2020-12-01 00:00:00
abstract::We compared intrathecal ropivacaine to bupivacaine in patients scheduled for transurethral resection of bladder or prostate. Doses of ropivacaine and bupivacaine were chosen according to a 3:2 ratio found to be equipotent in orthopedic surgery. One hundred patients were randomly assigned to blindly receive either 10 m...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200012000-00030
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:The blood/gas partition coefficient of a certain volatile anesthetic is of clinical importance because it determines its velocity of uptake into and elimination from the body of a patient and thus its pharmacokinetic behavior. To date, the blood/gas partition coefficients of isoflurane, sevoflurane, and desf...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000516
更新日期:2015-01-01 00:00:00
abstract::The fatal/anesthetic ratio (FAR) in 44 swine weighing 32.6 +/- 0.7 kg (SEM) was determined. Fatal anesthetic concentration (the numerator for FAR) was defined as the end-tidal concentration at which the pig lived at least 10 min, during experiments that involved step increments in anesthetic concentrations. Previously...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Postsurgical quality of recovery is worse in female than that in male patients. Duloxetine has been used successfully for the treatment of chronic pain conditions, but its use for preventing acute postoperative pain has been limited to a single previous study. More importantly, the effect of preoperative dul...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000971
更新日期:2016-01-01 00:00:00
abstract::To test the hypothesis that, after anesthesia for noncardiac surgical procedures, the increased cardiac work during recovery induces wall motion and ejection fraction (EF) abnormalities in patients with mild angina pectoris, gated radionuclide angiography was performed in patients undergoing simple cholecystectomy und...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::Two hundred twenty-two spinal anesthesias were administered with 10 mg. of tetracaine and 1 ml. of 10 percent dextrose to investigate the effects of vasopressors, patients age, and pH of cerebrospinal fluid on the onset and duration of spinal anesthesia. Neither the differences in overall age, cerebrospinal fluid pH, ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1975-07-01 00:00:00
abstract:BACKGROUND:Postpartum depression is a common psychiatric disorder in parturients after delivery. The etiology remains unclear, and multiple factors may be involved. In this study, we investigated whether epidural labor analgesia was associated with a decreased risk of postpartum depression development. METHODS:Two hun...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000107
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Paravertebral analgesia is useful for breast surgery. Patient controlled analgesia by IV or epidural routes is well established for delivering postoperative analgesia. Our objective was to apply patient control to paravertebral analgesia and evaluate the efficacy and tolerability of two distinct dosing regim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31817b7f01
更新日期:2008-08-01 00:00:00
abstract::This study evaluates the changes of oxygen saturation (SpO2) after intravenous administration of methylene blue in 103 patients undergoing open repair of thoracoabdominal aortic aneurysms. We found that SpO2 decreased by a median (interquartile range [IQR]) of 49% (37%-81%) <1 minute after methylene blue administratio...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004325
更新日期:2019-11-01 00:00:00
abstract::We describe an unusual complication during flotation of a pulmonary artery catheter through a preexisting percutaneous introducer sheath. A malfunctioning pulmonary artery catheter, which was placed through an introducer sheath in the right internal jugular vein, was removed. Attempts at repositioning a second pulmona...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000133244.59867.6F
更新日期:2004-09-01 00:00:00
abstract:UNLABELLED:Accidental intravascular injection of an epinephrine-containing test dose increases T-wave amplitude of lead II electrocardiogram (EKG) in anesthetized children. We designed this study to test whether the choice of EKG lead would affect the usefulness of simulated intravascular test dose. We studied 32 ASA p...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000070230.10328.08
更新日期:2003-08-01 00:00:00
abstract:UNLABELLED:We evaluated the effect of 1, 20, and 40 mL of epidural saline flush on recovery from lidocaine epidural anesthesia. Eight volunteers were studied for three study periods, each separated by 72 h. The volume of saline was randomized, and a new catheter was inserted for each study period. A standardized dose o...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199910000-00034
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Lung isolation with bronchial blockers is a well-described and accepted procedure, often described for use during the management of massive hemoptysis. Recommendations for balloon inflation are sparse, with some advocating for saline whereas other suggest air, including the manufacturers. We sought to evalua...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000004397
更新日期:2019-12-01 00:00:00
abstract:UNLABELLED:The effect of opioid administration on the bispectral index (BIS) during general anesthesia is controversial. Several investigators have reported BIS to be insensitive to opioid addition, whereas others have found a hypnotic response. We designed this study to examine the effect of remifentanil on BIS during...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200206000-00028
更新日期:2002-06-01 00:00:00
abstract::Patients receiving metoprolol before cardiac revascularization surgery were randomly divided into those in whom metoprolol was discontinued before the operation (N = 10) and those in whom metoprolol was continued up to the time of operation (N = 10). Cardiovascular responses to neuroleptanesthesia and sternotomy were ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-04-01 00:00:00
abstract::Animal studies suggest that increased circulating estrogen and progesterone, and activation of the endorphin system cause prenancy-induced antinociceptive effects. Human studies have provided inconsistent results and have often lacked a nonpregnant control group. In this study, we compared sensitivity to experimental ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000239224.48719.28
更新日期:2006-11-01 00:00:00
abstract::Cimetidine blunts the increase in cerebral blood flow (CBF) normally observed during hypoxia. It is important, therefore, to know whether other H2-blockers also affect the cerebral circulation adaptation to hypoxia. Cerebral blood flow was measured in 24 awake dogs after an intravenous injection of either saline (cont...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199104000-00020
更新日期:1991-04-01 00:00:00
abstract::The nucleus raphe magnus (NRM) is an important descending pain inhibitory system. We postulated that the analgesic action of supraspinally administered opiates results from increased descending inhibitory control of the NRM. We tested whether fentanyl activates NRM neurons in the rat slice preparation using extra-cell...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199505000-00007
更新日期:1995-05-01 00:00:00
abstract::The effect of release of intraoperative thigh tourniquets on velocity of blood flow in the middle cerebral artery was examined in five patients given general anesthesia with controlled ventilation for lower extremity orthopedic procedures using transcranial Doppler sonography. Middle cerebral artery blood flow velocit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199011000-00009
更新日期:1990-11-01 00:00:00