Blood sugar: how low should we go?

Van den Berghe G, Bouillon R, & Mesotten D. Glucose control in critically ill patients. New England Journal of Medicine 2009; 361: 89

RHH Journal Club. July 11th, 2013. Dr Pavan Battu

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Does normalisation of blood glucose levels with insulin therapy improve the prognosis of critically ill patients?

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The origin of the magic MAC number

Eger EI, Saidman LJ & Brandstater B. Minimum alveolar anesthetic concentration: a standard of anesthetic potency. Anesthesiology 1965; 26:756-763.

RHH Journal Club. July 4th, 2013. Dr Niv Jena

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This seminal body of work performed by Eger and his team in the 1960’s provides the basis for much of how we practice anaesthesia today. It continues to be referenced nearly 50 years later because of its importance. They introduced the concept of MAC and using it as a standard and comparison of potency of inhalational agents.

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BIS Off? No need for that…

Avidan MS, Jacobsohn E, Glick D et al. A. Prevention of intraoperative awareness in a high-risk surgical population. New England Journal of Medicine, 2011; 365: 591-600.

RHH Journal Club. July 4th, 2013. Dr Helen Findley

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Is keeping BIS 40-60 better at preventing awareness than keeping end tidal at minimum 0.7 age adjusted MAC?

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Why an appendicectomy now takes 2 hrs…

Pedersen AG, Petersen OB, Wara P, Rønning H, Qvist N & Laurberg S. Randomized clinical trial of laparoscopic versus open appendicectomy. British Journal of Surgery 2001; 88: 200-205.

RHH Journal Club. June 20th, 2013. Dr Sunita Asif

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Is laparoscopic appendicectomy superior to open appendicectomy?

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Pneumoperitoneum and PAFCs…

Joris JL, Noirot DP, Legrand MJ, Jacquet NJ, & Lamy ML. Hemodynamic changes during laparoscopic cholecystectomy. Anesthesia & Analgesia 1993;76: 1067-1071.

RHH Journal Club. June 20th, 2013. Dr Ramya Sriraman

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Haemodynamic changes reported during gynaecological laparoscopy in earlier studies include an increase in mean arterial blood pressure, a decrease in cardiac output, and an increase in systemic vascular resistance. The authors hypothesized that peritoneal insufflation for laparoscopic cholecystectomy would result in more significant haemodynamic changes.

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The origin of DO2 and the magic 600….

Shoemaker WC, Appel PL, Kram HB, Waxman K, & Lee TS. Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. CHEST Journal  1988; 94: 1176-1186.

RHH Journal Club. June 13th, 2013. Dr Andy Cruikshanks

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Does the targeting of supranormal oxygen delivery reduce mortality in high-risk surgical patients?

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Labour analgesia the VIP way…

Gambling D, Berkowitz J, Farrell TR et al. A Randomized Controlled Comparison of Epidural Analgesia and Combined Spinal-Epidural Analgesia in a Private Practice Setting: Pain Scores During First and Second Stages of Labor and at Delivery. Anesthesia & Analgesia 1013; 116: 636-643.

RHH Journal Club. June 6th, 2013. Dr Vinayak Kumar

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Does a CSE technique provide superior analgesia for the first two stages of labour compared to a standard lumbar epidural?

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