Juniper Publishers Journal of Anesthesia and Intensive Care Medicine

Juniper Publishers - Journal of Anesthesia Abstract Background: Pre-existing disease is the most important factor in the prediction of health-related quality of life (HRQoL) after intensive care. We hypothesised that the “inpatient care trajectories” in the years before admission to the ICU is a stronger predictor of HRQoL and mortality after intensive care than pre-existing disease, and that it has significant effects on overall costs. Method: A retrospective investigation in two combined medical and surgical ICUs in Sweden. Inpatient care was assessed from the County administrative registry. HRQoL (SF-36) was measured at 6, 12, 24, and 36 months after discharge. Results: Of 1092 patients, 459 (73%) had pre-existing diseases, and among them 360 (57%) had at least one inpatient episode less than 3 years before the ICU period, during which the group used significantly more hospital resources than the combined cost for all ICU care during the same time. The

Authored by Julian Martin Brown Introduction Submaximal exercise testing is now used routinely to assess fitness for surgery. The anaerobic threshold determined by expired gas analysis during ramped exercise predicts surgical morbidity and mortality [1]. Cycle ergometry with a ramped protocol is typically used but there is little standardisation of protocols. A comparison between 20,30,50 and 100 watts per minute increments [2] showed no difference in anaerobic threshold and VO2 max but lower ramp increments were not tested. In another study comparing 10,30 and 50 watts per minute anaerobic threshold was unchanged but “VO2 peak” was reduced with a 10 watts per minute protocol [3]. Using a running treadmill test V Vucetić et al. [4] showed differences in peak running speed using different ramp rates but no difference in VO2max or AT. Ramp rates of 6 watts per minute and 12 watts per minute have been compared using arm crank ergometry, yielding higher end exercise la

Authored by Fabrício Tavares Mendonça                                                                    Abstract Introduction and Background: Intravenous lidocaine has been increansingly used as pain treatment in anesthesiology. The aim of this study was to review the scientific literature on the use of lidocaine for perioperative analgesia, a recent technique and still under study to demonstrate its clinical implications. Methodology: IData were derived from MD Consult e Clinical Key (1998-2014). A total of 32 articles were selected. Results and Discussion: Lidocaine acts by changing the excitatory nerve impulse driving; decreasing visceral pain, central sensitization of pain and the immune response. Intravenous lidocaine with good clinical results were used in the dose of preoperative bolus 1,5 a 2 mg.kg-1followed by continuous infusion 1,5 a 3 mg.kg-1.h-1. Most of clinical trials were in patients undergoing abdominal surgery. It is well-established an

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