The potential for big data analytics to enhance our knowledge of the complex regional pain syndromes

In an era of expanding costs and declining reimbursement, the healthcare industry has dramatically expanded the collection of demographic and clinical data to facilitate billing efficiency and maintain financial solvency | Journal of Clinical Anesthesia

ball-63527_960_720

Electronic health data collection has primarily emphasized the capture of diagnostic coding, medication delivery, laboratory utilization, and procedural interventions to support third party reimbursement claims, improve efficiency, and provide transparency. Although much of the electronic stored data was never directly intended to answer clinical questions, or guide clinical care, the use of data analytics has created opportunities to winnow through the vast data collections and pull out useful insights into previously unrecognized patterns of common and uncommon medical disorders

Full reference: Burgess, F. & Fragoza, K. (2017) Fishing for answers in an ocean of data: The potential for big data analytics to enhance our knowledge of the complex regional pain syndromes. Journal of Clinical Anesthesia. Volume 40. pp. 117–118

Alternative techniques for tracheal intubation

McCluskey, K. & Stephens, M.  Anaesthesia and intensive care medicine | Published online: 4 March 2017

Conventional direct laryngoscopy with the curved Macintosh blade is a fundamental skill for all anaesthetists and has been the cornerstone of airway management for many years. This technique relies on the operator aligning the oro-pharyngo-laryngeal structures and inserting an endotracheal tube into the trachea under direct vision. There is a recognized failure rate with this technique and thus alternative techniques for tracheal intubation should be available for use in difficult situations.

Awake fibreoptic intubation (AFOI) remains the ‘gold standard’ method for securing the airway in an anticipated difficult intubation. Advances in optical technology over recent years have lead to the development of several rigid indirect devices, which improve glottic visualization by enabling the operator to ‘see around the corner’. With improved views at laryngoscopy these videolaryngoscopes are emerging as important tools in airway management and useful teaching and training aids.

Read the abstract here

Current and Emerging Anesthesia Technology in 2016

Gálvez, J.A. et al. Anesthesiology News. Published online: October 27 2016

B0007020 Science research

Image source: Marina Caruso – Wellcome Images // CC BY-NC-ND 4.0

This review focuses on emerging technological developments in anesthesiology that are available in the United States and around the world. Much of this review comes from content presented at the 2016 annual meeting of the Society for Technology in Anesthesia (STA), which can be accessed online at www.stahq.org.

Innovations are included in the areas of:

  • Closed-Loop Systems
  • Quality Measurement and Health Information Exchange
  • Anesthesia Machines
  • Carbon Dioxide Absorber
  • Physiologic Monitors
  • Capnographic Analysis
  • Surgical Blood Loss Monitoring
  • Anesthesia Information Management and Clinical Decision Support Systems
  • Simulation

Read the full article here

 

Disagreement between cardiac output measurement devices: which device is the gold standard?

Y. Le Manach & G. S. Collins. British Journal of Anaesthesia (2016) 116 (4):451-453.

A common research question in perioperative haemodynamics research concerns the assessment of whether a new measurement device can replace an existing device (often referred to as method comparison studies). Typically, a new measurement method is being compared with an established reference method (unfortunately often referred to as the ‘gold standard’).

In a recent issue of the journal, Biais and colleagues reported the comparison of two cardiac output measurement devices, one based on pulse wave transit time (i.e. the new devices) and the other one based on transthoracic echocardiography (i.e. the reference method ‘gold standard’). The study concluded that devices were not interchangeable and that the new device cannot guide haemodynamic interventions in critically ill patients. Their conclusion was based on observing percentage errors exceeding the limits of 30%, suggested by Critchley and Critchley.

Read the abstract here