Anesthesia Essay

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Recommended: History of general anesthesia

The delivery of anesthesia to surgical patients is safer today than ever before. Advancements in technology such as end tidal carbon dioxide monitoring, oxygen saturation monitoring, video laryngoscopy and safer medication profiles are just a few examples in the realm of anesthesia that assist in protecting patients from potential harm. As the face of healthcare payments change into a patient-satisfaction and outcomes-driven model, it is important for the specialty of anesthesia to continue to find ways to keep patients safer by examining current accepted practices in anesthesia and challenging and changing practices that continue to place patients at risk for harm.
One of the most common procedures performed in U.S. hospitals is the transfusion of red blood cells (RBC). One in every ten patients in U.S. hospitals will receive one or more units of RBC during a hospitalization.1 There are well known risks that anesthesia providers are aware of when patients receive allogeneic blood transfusions such as allergic reactions and fluid volume overloads. The not-so-obvious risks of RBC transfusion involve immunodilution factors that increase incidence of post-operative infections and a higher overall mortality. A meta-analysis of pooled results from multiple observational studies, each of which varies for risks between patients, shows patients receiving allogeneic blood transfusions have an 88% higher mortality, 69% higher infection rate, and 250% higher rate of ARDS.2 All intraoperative transfusions should be placed through a risk-benefit analysis by the medical provider.
The purpose of this paper is to examine current research results concerning technology that indicates it may decrease the incidence of unnecessary intraoper...

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.... (Level 4).
10. Moreno I, Artieda O, Vicente R, Zarragoikoetxea I, Vicente JL, Barberá M. [Evaluation of non-invasive hemoglobin measurements using the Masimo Rainbow Radical-7(®) device in a patient with extracorporeal membrane oxygenation.]. Rev Esp Anestesiol Reanim. 2013
This single case study describes a patient undergoing cardiac surgery that subsequently required extracorporeal membrane support after falling into severe cardiogenic shock. The Radical-7 device was utilized to continually monitor Hb levels. These levels were compared to bedside POC results from invasive blood sampling methods. It was discovered that the spectrophotometric monitor showed statistically comparable Hb levels as compared with the invasive POC monitor. It was considered that the Masimo device is a viable alternative for invasive testing in this complex situation. (Level 6).

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