Prevention of contamination after endotracheal intubation using a dedicated sleeve.

Background: Contamination of work surfaces by used laryngoscopes after endotracheal intubation is a serious infection control concern but no strategies are available to address it. We assessed if contamination of the surfaces after endotracheal intubation would be reduced when providers used a dedicated, self-erected, disposable plastic sleeve (BladePouch) to store the used laryngoscope as compared to using single gloves or double gloves and sheathing the laryngoscope with the outer gloves.

Methods: Twenty participants were recruited including attending physicians, trainees and allied health care professionals.

The Quality Improvement Fellow: Educating on Making the Difference.

The critical care medicine (CCM) fellowship is an opportunity for advanced anesthesiology trainees to refine their quality improvement (QI) skills. However, the short training period and inconsistent curricula make this challenging. The QI fellow (QIF) is described as an education program to provide consistent QI training during the CCM fellowship.

Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

Objectives: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) data, the EUROMACS-RHF, and the modified postoperative EUROMACS-RHF. The authors assessed the performance characteristics of these 2 risk score formulations in a continuous-flow LVAD cohort at their institution.

Anesthetic Management in Adults with Congenital Heart Disease.

Purpose Of Review: Adults with congenital heart disease (ACHD) are a complex and growing population that presents numerous challenges for anesthetic management. This review summarizes special considerations for anesthetic management in ACHD.

Recent Findings: The adult patient with congenital heart disease may require anesthetic care for multiple surgeries and interventions throughout their lifetime.

Durability and Efficacy of Tricuspid Valve Repair in Patients Undergoing Left Ventricular Assist Device Implantation.

Objectives: This study sought to determine the durability of tricuspid valve repair (TVr) performed concurrently with left ventricular assist device (LVAD) implantation and its association with the development of late right heart failure (RHF).

Background: Surgical management of tricuspid regurgitation (TR) at the time of LVAD implantation is performed in an attempt to reduce the occurrence of postoperative RHF. Limited data exist regarding the durability of TVr in patients with LVAD as well as its impact on development of late RHF.

Three-factor prothrombin complex concentrates for refractory bleeding after cardiovascular surgery within an algorithmic approach to haemostasis.

Background/objectives: Prothrombin complex concentrates (PCC) are increasingly administered off-label in the United States to treat bleeding in cardiovascular surgical patients and carry the potential risk for acquired thromboembolic side-effects after surgery. Therefore, we hypothesized that the use of low-dose 3-factor (3F) PCC (20-30 IU/kg), as part of a transfusion algorithm, reduces bleeding without increasing postoperative thrombotic/thromboembolic complications.

Materials/methods: After IRB approval, we retrospectively analysed 114 consecutive, complex cardiovascular surgical patients (age > 18 years), between February 2014 and June 2015, that received low-dose 3F-PCC (Profilnine ), of which seven patients met established exclusion criteria.

Quality of life and self-image in patients undergoing tracheostomy.

Objectives: The objective of this study is to understand trends in the Quality of Life and Self Image in patients undergoing an elective tracheostomy for non-malignant laryngeotracheal pathologies. We will also discuss the relationship between quality of life and patient demographics.

Study Design: A prospective, IRB approved cohort study was conducted in a tertiary referral center.

Laryngeal mask airway in laryngoscopies: a safer alternative for the difficult airway.

Purpose Of The Study: This study was undertaken to highlight the method, usefulness and postoperative morbidity of using a laryngeal mask airway (LMA) to ventilate patients with difficult airways undergoing laryngeal procedures.

Procedures: Retrospective chart review where we identified patients deemed to have a difficult airway who underwent laryngeal and upper tracheal procedures, and were electively ventilated using an LMA. The pertinent clinical history, indications for the procedure and postoperative course were discussed.

Chromatographic analysis of Hb S for the diagnosis of various sickle cell disorders in Pakistan.

Sickle cell disease remains a relatively obscure theme in research on haemoglobinopathies in Pakistan. Limited data is available regarding its prevalence in the country. The objective of our study was not only to estimate the frequency of different sickle cell diseases but also to provide quantitative estimation of haemoglobin S and other haemoglobin variants using an automated high-performance liquid chromatography (HPLC) system.