Abstract:
BACKGROUND:Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation. METHODS:We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia. RESULTS:15,388 subjects were included; 6351 in the intervention cohort and 9037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p = 0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p = 0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p = 0.010). CONCLUSIONS:The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery. TRIAL REGISTRATION:ClinicalTrials.gov, ID NCT02450929 .
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Martini RP,Yanez ND,Treggiari MM,Tekkali P,Soelberg C,Aziz MFdoi
10.1186/s12871-020-01117-4subject
Has Abstractpub_date
2020-08-24 00:00:00pages
211issue
1issn
1471-2253pii
10.1186/s12871-020-01117-4journal_volume
20pub_type
杂志文章abstract:BACKGROUND:Quadratus lumborum block (QLB) is an effective analgesia that lowers opioid consumption after lower abdominal and hip surgeries. The subcostal approach to transmuscular QLB is a novel technique that can provide postoperative analgesia by blocking more dermatomes. The aim of this study is to evaluate the effi...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0825-4
更新日期:2019-08-14 00:00:00
abstract:BACKGROUND:Ultrasound gels may contain propylene glycol and glycerol, which are neurotoxic in high concentrations. If the needle passes through gel during regional anesthesia, gel may be injected near the nerve. It is unknown if this practice poses a risk for neurotoxicity. Using an animal model, we assessed the histol...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-18
更新日期:2013-09-03 00:00:00
abstract:BACKGROUND:Sugammadex, a γ-cyclodextrin derivative, belongs to a new class of selective relaxant binding agents. Sugammadex was approved 10-years ago by the European medicines agency and today is used in clinical anesthesia and emergency medicine globally. In this review, indications for neuromuscular block, the challe...
journal_title:BMC anesthesiology
pub_type: 杂志文章,评审
doi:10.1186/s12871-018-0605-6
更新日期:2018-11-06 00:00:00
abstract:BACKGROUND:Preoperative oral carbohydrates has been suggested to attenuate insulin resistance and decrease postoperative complications. In this study, a vitamin-rich carbohydrate beverage was administered before surgery in an animal model to investigate its effects on the surgical stress response and S-100β levels. ME...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0748-0
更新日期:2019-05-15 00:00:00
abstract:BACKGROUND:Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0440-1
更新日期:2017-10-24 00:00:00
abstract:BACKGROUND:Perioperative immune function plays an important role in the prognosis of patients. Several studies have indicated that low-dose opioid receptor blockers can improve immune function. METHODS:Sixty-nine patients undergoing video-assisted thoracoscopic resection of the lung cancer were randomly assigned to ei...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0912-6
更新日期:2019-12-19 00:00:00
abstract:BACKGROUND:Gabapentin is an antiepileptic drug used in a variety of chronic pain conditions. Increasing numbers of randomized trials indicate that gabapentin is effective as a postoperative analgesic. This procedure-specific systematic review aims to analyse the 24-hour postoperative effect of gabapentin on acute pain ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-7-6
更新日期:2007-07-07 00:00:00
abstract:BACKGROUND:Endotracheal extubation is the most crucial step during emergence from general anesthesia and is usually carried out when patients are awake with return of airway reflexes. Alternatively, extubations can also be accomplished while patients are deeply anesthetized, a technique known as "deep extubation", in o...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01191-8
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND:Blood biomarkers are increasingly used to diagnose, guide therapy in, and risk-stratify community-acquired pneumonia (CAP) patients in emergency departments (EDs). How pre-analytic factors affect these markers' initial levels in this population is unknown. METHODS:In this secondary analysis of consecutive E...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2253-14-102
更新日期:2014-11-15 00:00:00
abstract:UNLABELLED: BACKGROUND:Hyperventilation may be used to hasten recovery from general anesthesia with potent inhaled anesthetics. However, its effect may be less pronounced with the newer, less soluble agents, and it may result in rehypnotization if subsequent hypoventilation occurs because more residual anesthetic will...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-12-22
更新日期:2012-09-18 00:00:00
abstract:BACKGROUND:Induction of the COX-2 isoenzyme appears to play a major role in the genesis of central sensitization after nociceptive stimulation. This study aimed to investigate the efficacy of a single, oral dose of the specific COX-2 inhibitor-valdecoxib in attenuating the central sensitization - induced secondary hype...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-6-3
更新日期:2006-03-10 00:00:00
abstract:BACKGROUND:The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. Most of the studies in adults have demonstrated the positive effects of clonidine on intra- and postoperative analgesia when used as an adjunctive agent or in some cases as a single to regional techniques. In the ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-12-2
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Since blood pressure tends to be unstable during induction of anesthesia in patients undergoing cardiovascular surgery, an artery catheter is often inserted before induction to continuously monitor arterial pressure during induction of anesthesia. ClearSight System™ enables noninvasive continuous measurement...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01091-x
更新日期:2020-07-20 00:00:00
abstract:BACKGROUND:Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS:A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who ...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0355-x
更新日期:2017-05-12 00:00:00
abstract:BACKGROUND:Sodium nitroprusside (SNP) is a potent vasodilator that has been used to induce deliberate hypotension in children during surgery involving significant blood loss, including craniofacial and spinal fusion procedures. SNP metabolism liberates cyanide, which may cause interference with cellular energy metaboli...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-9
更新日期:2013-04-30 00:00:00
abstract:BACKGROUND:Early prediction of outcome would be useful for an optimal intensive care management of liver transplant recipients. Indocyanine green clearance can be measured non-invasively by pulse spectrophometry and is closely related to liver function. METHODS:This study was undertaken to assess the predictive value ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-103
更新日期:2014-11-15 00:00:00
abstract:BACKGROUND:To determine the median effective concentration of sufentanil as an analgesic during wake-up tests after sevoflurane anesthesia during surgery for adolescent idiopathic scoliosis (AIS). METHODS:This is a randomised controlled trial. Sixty patients aged 13-18 years scheduled for AIS surgery were randomized i...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-015-0003-2
更新日期:2015-03-08 00:00:00
abstract:BACKGROUND:Postoperative hypothermia is a common cause of complications in patients who underwent laparoscopic cholecystectomy. Hypothermia is known to elicit electrophysiological, biochemical, and cellular alterations thus leading to changes in the active and passive membrane properties. These changes might influence ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-11-2
更新日期:2011-02-16 00:00:00
abstract:BACKGROUND:The significance of intraoperative anesthesia handoffs on patient outcomes are unclear. One aspect differentiating the disparate results is the treatment of confounding factors, such as patient comorbidities and surgery time of day. We performed this study to quantify the significance of confounding variable...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0858-8
更新日期:2019-10-15 00:00:00
abstract:BACKGROUND:Tramadol is an atypical centrally acting analgesic agent available as both oral and parenteral preparations. For patients who are unable to take tramadol orally, the subcutaneous route of administration offers an easy alternative to intravenous or intramuscular routes. This study aimed to characterise the ab...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-33
更新日期:2014-05-12 00:00:00
abstract:BACKGROUND:The aim of the present study was to verify whether propofol impaired learning and memory through the interplay of N-methyl-D-aspartate (NMDA) receptor with brain-derived neurotrophic factor (BDNF)-tyrosine kinase B (TrkB) signaling pathway. METHODS:120 Sprague-Dawley (SD) rats were randomly assigned into ei...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0491-y
更新日期:2018-04-05 00:00:00
abstract:OBJECTIVE:To compare the analgesic effects of patient-controlled intravenous analgesia (PCA) with hydromorphone and sufentanil after thoracic surgery on postoperative pulmonary complications (PPCs). METHODS:A total of 142 patients who were scheduled for thoracic surgery were randomly allocated to receive PCA with hydr...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0657-7
更新日期:2018-12-19 00:00:00
abstract:BACKGROUND:Breast cancer surgery is one of the most common surgeries among the female population. Nearly half of the patients suffer chronic pain following breast cancer surgery, and 24% of them categorizing their pain as moderate to high. In this study, effects of ultrasound-guided erector spinae plane (ESP) block per...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0700-3
更新日期:2019-03-04 00:00:00
abstract:BACKGROUND:The calcium sensitizer levosimendan is increasingly used to improve hemodynamics in patients with acutely decompensated heart failure. By binding to cardiac troponin C the conformation of the calcium-troponin C complex is stabilized, which leads to acceleration of actin-myosin crossbrigde formation and incre...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0644-z
更新日期:2018-12-03 00:00:00
abstract:BACKGROUND:The effort to improve tracheal intubation process is clinically valuable. We hypothesized that a preoperative brief exercise therapy would increase mouth opening and neck extension, enhancing intubation conditions during general anesthesia. METHODS:Patients undergoing general anesthesia were randomized into...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12871-020-0939-8
更新日期:2020-01-29 00:00:00
abstract:BACKGROUND:This paper describes the design of a multifunction alerting display for intraoperative anesthetic care. The design was inspired by the multifunction primary flight display used in modern aviation. RESULTS:The display retrieves live data from multiple sources; the physiologic monitors, the anesthesia informa...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0478-8
更新日期:2018-02-05 00:00:00
abstract:BACKGROUND:Ketamine and hyperoxia are widely used in obstetric and pediatric settings. Either ketamine or hyperoxia has been reported to cause neuroapoptosis in the developing brain, and ketamine-induced neuronal apoptosis may involve a compensatory upregulation of the N-methyl-D-aspartate (NMDA) receptor NR1 subunit. ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0511-y
更新日期:2018-05-10 00:00:00
abstract:BACKGROUND:McGrath MAC video laryngoscope offers excellent laryngosopic views and increases the success rate of orotracheal intubation in some cases. The aim of this study was to determine the usefulness of McGrath MAC for routine nasotracheal intubation by comparing McGrath MAC with Airway scope and Macintosh laryngos...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0451-y
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients. METHODS:A ...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2253-14-16
更新日期:2014-03-10 00:00:00
abstract:BACKGROUND:Tenascin-C is a pro-inflammatory glycoprotein with various biological functions. High expression of tenascin-C is found in inflammation, tissue remodeling, and autoimmune diseases. However, its expression and clinical significance in sepsis remain unclear. This study was designed to investigate the relations...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0634-1
更新日期:2018-11-15 00:00:00