Recent ucd_ome_posters_anesthesiology items

Correlations between clinical assessments of sedation and the Patient StateIndex (PSI) in critically ill patients

Fri, 10 Jul 2026 00:00:00 +0000

Correlations between clinical assessments of sedation and the Patient StateIndex (PSI) in critically ill patients

Propofol Induction is Associated withChanges in Diastolic Function

Wed, 25 Jun 2025 00:00:00 +0000

Propofol Induction is Associated withChanges in Diastolic Function

Comparison of Depth of Sedation Performance between SedLine and BIS during General Anesthesia: Data Collection and Analysis

Thu, 5 Dec 2024 00:00:00 +0000

Electroencephalogram (EEG) monitoring has the potential to become a robust tool to characterize anesthetic depth. The goal is to develop a streamlined neuromonitoring tool that would allow clinicians to make real-time assessments and to titrate anesthetic delivery. Anesthetic overdosing can cause postoperative delirium and mortality, while underdosing can cause intraoperative awareness and pain. Of particular interest is excessively deep anesthesia, which is reflected by a burst suppression pattern on EEG monitors. Fortunately, proprietary algorithms have been developed to transform the raw EEG waveforms into a dimensionless number that quantifies the patient’s level of consciousness. Examples of these monitors are the Bispectral Index (BIS) monitor and the Sedline monitor which produces patient state index (PSI) values.

Question: How do the PSI (SedLine) and BIS perform in the setting of imminent burst suppression during general anesthesia?

RACIAL BIAS WITHIN PULSE OXIMETRY SATURATION MEASUREMENT

Mon, 18 Nov 2024 00:00:00 +0000

Pulse oximetry is a ubiquitous measurement in health care used to assess oxygen perfusion status and guide oxygen therapy. There is ongoing discussion as to whether pulse oximetry measurements are accurate in patients with darker skin colors. A recent study showed higher rates of occult hypoxemia in Black patients compared to White patients, based on selfreported race. This report triggered an FDA Safety Communication emphasizing the interpretation and limitations of pulse oximetry particularly in monitoring of patients with COVID-19 infections. Race is not binary. There is a wide range of graded skin colors. We investigated this issue by evaluating correlations between skin color and occult hypoxemia using a retrospective review and a more discriminating assessment of skin color.

Modified Preoperative Oral Dose Acetaminophen vsIntravenous Acetaminophen in Children: ARandomized Clinical Trial

Mon, 4 Nov 2024 00:00:00 +0000

Purpose: Compare opioid utilization in pediatric surgical patients undergoing tonsillectomy/adenoidectomy using

• Modified preoperative oral vs IV acetaminophen

• Standard multimodal pain regimen

Hypothesis: One loading dose of PO acetaminophen given pre-operatively will provide superior opioid sparing effects compared to one standard dose of IVacetaminophen.

Hypotension Prediction Index: Correlations between Invasive and Non-invasive Pressure Inputs

Tue, 29 Oct 2024 00:00:00 +0000

Continuous BP monitoring is essential to intraoperative care, as hypotensive events can significantly increase the risk of AKI, MI, and mortality post-op1,2 . The Hypotension Prediction Index (HPI) is a novel algorithm derived from machine learning that gives anesthesiologists the ability to predictive hypotensive events. The HPI derived from intra-arterial catheter monitoring has been shown to predict hypotensive events with sensitivity and specificity >80%3 . However, the utility and accuracy of the HPI when derived from non-invasive monitoring techniques, such the ClearSight finger cuff, have yet to be examined. This study seeks to compare the intraarterial catheter-derived HPI vs the ClearSight finger cuff-derived HPI, to see if it is viable tool for anesthesiologists to use when non-invasive monitoring is not indicated.

Comparison of Depth of Sedation Performance between SedLine and BIS during General Anesthesia: Background and Protocol Development

Mon, 28 Oct 2024 00:00:00 +0000

The ideal end-tidal concentration of anesthetic dose for a patient under general anesthesia is dynamic and depends on factors. At present, no individual brain function monitoring device has been shown to be substantially superior. Prior studies have attempted to compare the performance of these devices, but a lack of space and common placement locations compromises interpretation. The aim of this protocol is to examine the concordance between processed EEG indices (BIS and PSI) and anesthesia provider assessments across a range of anesthetic depths using a custom engineered interface box.

Utilization of processed EEG’s to evaluate depth of sedation in Critically Ill patients: A Systematic Literature Review

Mon, 21 Oct 2024 00:00:00 +0000

Maintaining accurate measurements ofsedation in the ICU are essential forpatient comfort, safety, and clinicaloutcomes. Current clinical sedation scales, such asthe Richmond Agitation-Sedation Scale(RASS) suffer from subjectivity and poorinter-rater reliability. Processed EEGs (pEEGs) may providea more objective and reliable alternativeto assess depth of sedation in ICUpatients. In this study, we conducted a systematicliterature review on 3 major pEEGs(Masimo Sedline, Bispectral Index, andNarcotrend) and their correlation withgold standard clinical sedation scales.

Association of Neuraxial Anesthesia with Postoperative Opioid Use in Pediatric Burn Patients

Wed, 16 Oct 2024 00:00:00 +0000

Split thickness skin grafts (STSG) are required for severe burns and pain is the most common cause of distress within the first year of the injury. Postoperative pain is challenging due to the painful surgical procedure performed and the dressing changes required. Poor pain control is concerning, as it has been associated with PTSD, anxiety, depression, and long-term alterations in pain processing. Currently, opioids are widely used to manage postoperative pain. While adequate pain control is essential, high dose and/ or prolonged use of opioids can also cause adverse effects to delay recovery, including sedation and tolerance. Neuraxial anesthesia administered intraoperatively is one approach to decrease postoperative pain and opioid use.

Vasopressor Bolus Effects on Dynamic Arterial Elastance (EaDyn) and Contractility (dP/dt)

Wed, 16 Oct 2024 00:00:00 +0000

The Hypotension Prediction Index is a machine learning derived algorithm that predicts intraoperative hypotension. The algorithm provides two additional hemodynamic parameters, EaDyn and dP/dt, that characterize the physiological changes and may provide guidance regarding the most efficacious treatments. dP/dt correlates with ventricular contractility from peripheral artery waveforms. EaDyn (dynamic arterial elastance) is the ratio of pulse pressure variation and stroke volume variation (PPV/SVV), correlating with peripheral vascular resistance.

Sugammadex vs Neostigmine: Possible Decrease in PACU Stay

Wed, 16 Oct 2024 00:00:00 +0000

• Neostigmine – longstanding only choice for reversal of neuromuscular blockade

• Incomplete reversal and residual neuromuscular blockade: atelectasis, pulmonary edema, desaturations, postoperative pulmonary complications, and longer hospital stay

• March 2016: sugammadex introduced at UCDMC

• Sugammadex can rapidly reverse even deep neuromuscular blockade and is associated with fewer adverse events: decreased surgery duration, PACU stay, and overall hospital stay2

• This study aims to compare patient flow -neostigmine versus sugammadex end of surgery to PACU total PACU stay

Systemic Immunological Consequences of Chronic Periodontitis

Fri, 11 Oct 2024 00:00:00 +0000

Chronic Periodontitis (ChP) is a prevalent inflammatory disease affecting 46% of the US population. ChP produces a profound local inflammatory response to dysbiotic oral microbiota that leads to destruction of alveolar bone and tooth loss. ChP is also associated with systemic illnesses including cardiovascular diseases, malignancies, and adverse pregnancy outcomes. However, the mechanisms underlying these adverse health outcomes are poorly understood. We used a highly multiplex mass cytometry immunoassay to perform an in-depth analysis of the systemic consequences of ChP in patients, before and after periodontal treatment in this prospective cohort study. A high-dimensional analysis of intracellular signaling networks revealed immune system-wide dysfunctions differentiating patients with ChP from healthy controls. Notably, we observed exaggerated pro-inflammatory responses to P. gingivalis-derived lipopolysaccharide in circulating neutrophils and monocytes from patients with ChP....

EVALUATION OF REINTUBATION RATES FOLLOWING INTRODUCTION OF NEW REVERSAL AGENT

Fri, 11 Oct 2024 00:00:00 +0000

• Postoperative residual neuromuscular blockade is associated with post-op complications

• Current blockade reversal agents are Sugammadex and Neostigmine

• Sugammadex may decrease postoperative residual neuromuscular blockade

• Sugammadex was introduced to UC Davis Academic Center on 3/11/16

Radiofrequency Ablation of the Medical Branch Nerve as a Novel Treatment for Posterior Element Pain from Vertebral Compression Fractures: A retrospective Study

Wed, 4 Sep 2024 00:00:00 +0000

Vertebral compression fractures (VCF) from trauma, osteoporosis, or pathologic reasons are a significant cause of severe pain and decreased functionality, both of which pose a considerable functional and financial burden to the patient.

An observational study of intraoperative transpulmonary pressure and intrathoracic pressure changes associated withventilator management of tidal volume and positive-end-expiratory pressure (PEEP)

Thu, 29 Aug 2024 00:00:00 +0000

SVV is the change in stroke volume during inspiration and expiration due to changes in intrathoracic pressure and consequent variations in venous return. SVV to assess fluid status and guide intraoperative fluid management. SVV utility was established using TV of 8 ml/kg while ARDSNet recommendations suggest 6 ml/kg is preferable.

Ultrasound May Be An Effective Tool for Predicting Clinical Loss of Resistance in Lumbar Epidural Steroid Injections

Wed, 28 Aug 2024 00:00:00 +0000

Assess the efficacy of ultrasound, a more accessible point of care modality, to describe the dimensions of the epidural space. Determine the reliability of ultrasound for measuring cervical and lumbar epiduralspaces for ESIs in chronic pain patients and compares these to MRI measurement.

Propofol Induction is Associated with Changes in Diastolic Function

Tue, 20 Aug 2024 00:00:00 +0000

Diastolic dysfunction associated with peri- and post-operative complications. Propofol and cardiovascular depression. Some studies report that propofol worsens diastolic function, others report improvement.