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  1. Article ; Online: Qualitative and quantitative gastric ultrasound assessment in highly skilled regional anesthesiologists.

    Tankul, Rattanaporn / Halilamien, Pathom / Tangwiwat, Suwimon / Dejarkom, Sukanya / Pangthipampai, Pawinee

    BMC anesthesiology

    2022  Volume 22, Issue 1, Page(s) 5

    Abstract: Background: Pulmonary aspiration is a major complication in anesthesia, and various studies have shown that gastric sonography can reliably provide valuable information relative to both the qualitative and quantitative aspects of gastric content. This ... ...

    Abstract Background: Pulmonary aspiration is a major complication in anesthesia, and various studies have shown that gastric sonography can reliably provide valuable information relative to both the qualitative and quantitative aspects of gastric content. This study aimed to determine the accuracy of ultrasound assessment of gastric content compared between two novice anesthesiologist gastric sonographers.
    Methods: This prospective cohort study of two anesthesiologists learning to perform qualitative and quantitative ultrasound assessment of gastric content on healthy volunteers was conducted at Siriraj Hospital (Bangkok, Thailand). This trial was registered with ClinicalTrials.gov (reg. no. NCT04760106).
    Results: Of the 50 enrolled participants, three were excluded due to study protocol violation. Each anesthesiologist performed a qualitative assessment on 47 participants for an overall total of 94 scans. There were 15 males and 32 females (age 42 ± 11.7 years, weight 61.2 ± 13.1 kg, height 160.7 ± 7.3 cm, and BMI 23.6 ± 4.3 kg/m
    Conclusion: Our results indicate that qualitative ultrasound assessment of gastric content is highly accurate and can be easily learned. In contrast, quantification of gastric volume by novice gastric sonographers is more complex and requires more training.
    Trial registration: ClinicalTrials.gov no. NCT04760106 Date registered on Feb 11, 2021. Prospectively registered.
    MeSH term(s) Adult ; Anesthesiologists/statistics & numerical data ; Clinical Competence ; Cohort Studies ; Evaluation Studies as Topic ; Female ; Gastrointestinal Contents/diagnostic imaging ; Humans ; Male ; Prospective Studies ; Qualitative Research ; Reproducibility of Results ; Thailand ; Ultrasonography/methods
    Language English
    Publishing date 2022-01-03
    Publishing country England
    Document type Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2091252-3
    ISSN 1471-2253 ; 1471-2253
    ISSN (online) 1471-2253
    ISSN 1471-2253
    DOI 10.1186/s12871-021-01550-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Incidence, Outcomes, and Risk Factors of Intraoperative Cardiac Arrest During Orthotopic Liver Transplantation.

    Tovikkai, Parichat / Suphathamwit, Aphichat / Raksakietisak, Manee / Tovikkai, Chutwichai / Siriussawakul, Arunotai / Sujirattanawimol, Kittiphong / Piriyapatsom, Annop / Pongraweewan, Orawan / Tankul, Rattanaporn / Hemtanon, Nattachai / Boonyakarn, Sutatta / Noinonthong, Chularat / Rattanaruangrit, Chumsab / Soontarinka, Suvit

    Transplantation proceedings

    2024  Volume 56, Issue 3, Page(s) 608–612

    Abstract: Background: Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is a rare surgical complication that results in devastating outcomes. Moreover, previous worldwide studies have found inconsistencies in the risk factors associated with ... ...

    Abstract Background: Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is a rare surgical complication that results in devastating outcomes. Moreover, previous worldwide studies have found inconsistencies in the risk factors associated with ICA in LT.
    Methods: This was a retrospective cohort study of adult patients who underwent LT between January and October 2021 at Siriraj Hospital, a tertiary care hospital. The incidence of ICA and outcomes of patients who experienced ICA were examined. Risk factors associated with ICA were investigated as a secondary objective.
    Results: Among 342 patients, the incidence of ICA was 3.5% (95% CI 1.8%-6.1%). Of these, 33.3% died intraoperatively. Among patients with ICA, 41.7% died within 30 days, compared with only 7.6% in those without ICA (P = .002). Moreover, the in-hospital mortality rate of those with ICA was 58.3%, which was significantly higher than that of those without ICA (9.7%, P < .001). However, 41.7% of patients with ICA were discharged alive with long-term survival. Because ICA is a rare event, we found only 2 independent factors significantly associated with ICA. These factors include intraoperative temperature below 35°C, with an odds ratio (OR) of 6.07 (95% CI:1.32-27.88, P = .02) and elevated intraoperative serum potassium, with an OR of 4.57 (95% CI:2.15-9.67, P < .001).
    Conclusions: ICA is associated with high perioperative and in-hospital mortality. However, our findings suggest that with effective management of ICA, more than 40% of these patients could be discharged with excellent long-term outcomes. Hypothermia and hyperkalemia were independent risk factors significantly associated with ICA.
    MeSH term(s) Humans ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Heart Arrest/epidemiology ; Heart Arrest/etiology ; Risk Factors ; Male ; Retrospective Studies ; Female ; Middle Aged ; Incidence ; Intraoperative Complications/epidemiology ; Hospital Mortality ; Adult ; Treatment Outcome ; Aged
    Language English
    Publishing date 2024-02-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2024.01.029
    Database MEDical Literature Analysis and Retrieval System OnLINE

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