Anesthesiology

Frank, Steven M.; Rothschild, James A.; Masear, Courtney G.; Rivers, Richard J.; Merritt, William T.; Savage, Will J.; Ness, Paul M.

Anesthesiology. 118(6):1286-1297, June 2013.

doi: 10.1097/ALN.0b013e3182923da0

The recommended maximum surgical blood order schedule (MSBOS) for common surgical procedures that was published over 30 yr ago may be obsolete because many new procedures have been introduced while others have been improved upon. Data on 53,526 surgical patients having 1,632 types of surgical procedures were acquired from an anesthesia information management system (AIMS). The type and crossmatch–to–transfusion ratios of all surgical services except cardiac and vascular/transplant greatly exceeded the proposed optimal ratio of 2. An updated, institution-specific MSBOS for each surgical specialty was created from a novel blood order algorithm and the AIMS data. Implementing the algorithm and an institution-specific MSBOS could improve operating room efficiency, enhance patient safety, and reduce costs.

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Lee, UnCheol; Ku, SeungWoo; Noh, GyuJeong; Baek, SeungHye; Choi, ByungMoon; Mashour, George A.

Anesthesiology. 118(6):1264-1275, June 2013.

doi: 10.1097/ALN.0b013e31829103f5

This study demonstrates in human surgical patients that both GABAergic and non-GABAergic anesthetics disrupt frontal–parietal communication, despite distinct neurophysiologic profiles

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Schäfer, Simon T.; Frede, Stilla; Winning, Sandra; Bick, Alexandra; Roshangar, Paktis; Fandrey, Joachim; Peters, Jürgen; Adamzik, Michael

Anesthesiology. 118(6):1426-1436, June 2013.

doi: 10.1097/ALN.0b013e31828baa67

In sepsis, oxygen utilization can be impaired. Hypoxia-inducible factor-1α, the key player in adaptation to inflammation/hypoxia, was suppressed both in leukocytes from septic patients and in endotoxin-tolerant monocytic cells. This might contribute to disturbed adaptation to tissue hypoxia in sepsis.

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Levy, Jerrold H.; Faraoni, David; Spring, Jenna L.; Douketis, James D.; Samama, Charles M.

Anesthesiology. 118(6):1466-1474, June 2013.

doi: 10.1097/ALN.0b013e318289bcba

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Fellahi, Jean-Luc; Fischer, Marc-Olivier; Daccache, Georges; Gerard, Jean-Louis; Hanouz, Jean-Luc

Anesthesiology. 118(6):1460-1465, June 2013.

doi: 10.1097/ALN.0b013e31828f4fc3

Positive inotropic agents should be used judiciously when managing surgical patients with acute myocardial ischemia–reperfusion injury, as use of these inotropes is not without potential adverse effects.

Legrand, Matthieu; Payen, Didier

Anesthesiology. 118(6):1446-1454, June 2013.

doi: 10.1097/ALN.0b013e3182923e8a