Week in review November 28-December 2
Myron Yaster MD
Novel Treatment ideas for hemorrhagic shock: What the future holds
Myron Yaster MD and Justin L. Lockman MD, MSEd
Original article
Carmen Hinojosa-Laborde, Ian L Hudson, Evan Ross, Lusha Xiang, Kathy L Ryan. Pathophysiology of Hemorrhage as It Relates to the Warfighter. Physiology (Bethesda). 2022 May 1;37(3):141-153. PMID: 35001653
This repost discusses new pharmacological adjuncts that are being considered that will further improve oxygen delivery and utilization, stabilize mitochondrial function, and/or prevent regulated cell death following massive blood loss
When to transfuse?
Myron Yaster MD, Nina Deutsch MD, and Eugenie “Genie” Heitmiller, MD, FAAP
Clinical focus review article
Downey LA, Goobie SM. Perioperative Pediatric Erythrocyte Transfusions: Incorporating Hemoglobin Thresholds and Physiologic Parameters in Decision-making. Anesthesiology. 2022 Nov 1;137(5):604-619. PMID: 36264089
Perhaps targeting a specific hemoglobin value (5? 7? 8? 9?) is not the way to determine transfusion therapy and goals. Rather, we should be targeting the consequences of anemia by looking for evidence of intracellular hypoxia and ischemia, by following serial blood lactates, base deficits, and pH to guide how and when we transfuse.
How to slay a vampire: When some ideas just won’t die part 2
Myron Yaster MD and Lynn Martin MD
Original article
Ong, SY, Walker, A. Using Kotter's 8 steps of change to tackle over-fasting of children attending day surgery. Pediatr Anesth. 2022; 32: 1238- 1245. doi: 10.1111/pan.14499
The Case for Change in Clear Fluid Fasting Policy - Panel Discussion Society for Pediatric Anesthesia 36th Annual meeting. Mark Thomas, BSc MBBChir FRCA; Alexander Schmidt, MD; Sulpicio G. Soriano, III, MD, FAAP https://www2.pedsanesthesia.org/meetings/2022annual/guide/program/index.iphtml
Rather than NPO guidelines perhaps we should be encouraging clear fluids on arrival to the preop center?
Long term outcome following NEC
Myron Yaster MD, Michael E. Nemergut MD PhD, and Stephen J. Gleich MD
Original article
Ruben Vaidya, Joe X Yi, T Michael O'Shea, Elizabeth T Jensen, Robert M Joseph, Jeffrey Shenberger, Semsa Gogcu, Kathryn Wagner, Michael E Msall, Amanda L Thompson, Jean A Frazier, Rebecca Fry, Rachana Singh, ELGAN-ECHO Study Investigators. Long-Term Outcome of Necrotizing Enterocolitis and Spontaneous Intestinal Perforation. Pediatrics. 2022 Nov 1;150(5):e2022056445 PMID: 36200375
The good news? There were no differences in long-term neurodevelopmental outcomes when comparing infants with surgical or medical NEC or SIP to controls without NEC/SIP in this study population.