Anesthesiology Commons^™

Glucagon-Like Peptide-1 Receptor Agonists: Exciting Avenues Beyond Weight Loss, Lalitha Sundararaman, Divakara Gouda, Anil Kumar, Sumithra Sundararaman, Basavana Goudra

Department of Anesthesiology Faculty Papers

The last two decades have proffered many remarkable choices in managing type 1 and type 2 diabetes mellitus. Leading the list are glucagon-like peptide-1 receptor agonists (GLP1RAs), the first of which, exenatide, was approved by the FDA in 2005. Two other major classes of drugs have also entered the market: dipeptidyl peptidase-4 (DPP-4) inhibitors, commonly known as gliptins and approved in 2006, and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, with the first approval occurring in 2013. These drugs have revolutionized the treatment of diabetes. Additionally, on the horizon, the once-weekly basal insulin analog insulin icodec and the once-weekly combination of insulin icodec …

Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr

Digital Journal of Clinical Medicine

Hypertension ranks among the top ten causes of mortality, with around 4% attributed to hypertensive complications. High salt intake, Type 2 diabetes, smoking, elevated serum lipids, a sedentary lifestyle, a diet heavy in saturated fat, genetic predisposition, as well as stress are among the factors that contribute to hypertension. Hypertension affects about 1 billion people worldwide, with considerable differences between populations and ethnic groups [2]. The Framingham Heart Study indicates that a person's lifetime risk of developing hypertension is 90% if they are normotensive at age 55. According to the NHANES IV (4th National Health and Nutrition Examination Survey), the …

Objective Structured Clinical Examination For Intraoperative Hypotension And Hypertension Management, Andrew Mcginity, James David Ingram

Doctoral Projects

Managing intraoperative hypotension and hypertension is a non-technical skill anesthesia providers need to maintain patient safety. Upon transitioning from didactic training to clinical training, SRNAs may find it difficult to manage a patient’s blood pressure intraoperatively. The ultimate consequence of the delayed or improper treatment of intraoperative blood pressure perturbations is end-organ damage at the patient’s expense. Unintentionally causing a patient harm will lead to an SRNA losing confidence in their abilities. This OSCE is intended to increase SRNA confidence and competence regarding intraoperative hypotension and hypertension management before entering the clinical arena.

The hypotension and hypertension management tools and …

Nsaids For Analgesia In The Era Of Covid-19, Daniel L Herzberg, Harry P Sukumaran, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

Globally, non-steroidal anti-inflammatory drugs (NSAIDs) are highly used to treat pain. With the rise of the COVID-19 pandemic, the safety of NSAIDs use has been called into question. These concerns are worthy of review. At present, there is no compelling data showing that NSAIDs worsen the severity of COVID-19 symptoms or increase one's likelihood of contracting the illness. For patients in pain and without symptoms that could potentially be attributed to COVID-19 (cough, fevers/chills, lethargy, myalgias, anosmia and so on), NSAIDs should continue to remain a viable option to provide analgesia to patients in need.

Frequency Of Intraoperative Hypotension After The Induction Of Anesthesia In Hypertensive Patients With Preoperative Angiotensin-Converting Enzyme Inhibitors, Fahad Salim, Fazal Hameed Khan, Muhammad Nasir, Rashid Ali, Ayesha Iqbal, Amir Raza

Department of Anaesthesia

Introduction: The renin-angiotensin-aldosterone system (RAAS) is an important target in the treatment of hypertension. Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to angiotensin II. ACE inhibitors not only treat hypertension but also decrease morbidity and mortality in heart failure patients and in patients with acute myocardial infarction. The discontinuation of ACE inhibitors before the surgery is still controversial. To assess the current magnitude of the problem in our population, we aimed to conduct this study, which evaluated the frequency of intraoperative hypotension after the induction of anesthesia in controlled hypertensive patients with preoperative ACE inhibitors.
Material and …

Hypertension As A Reason For Cancellation Of Elective Surgical Cases On Day Of Surgery: A Five Year Audit Report From The Aga Khan University Hospital Karachi, Abdul Monem, Amjad Nadeem, Fauzia Khan

Department of Anaesthesia

Objective: To assess the controllable factors in preventing undue cancellation of elective surgical cases and to suggest measures to address the issue.
Methods: The retrospective audit was conducted at the Aga Khan University Hospital, Karachi, and comprised all cancellations of elective surgery from 2011 to 2015. The cases reviewed had been cancelled primarily due to hypertension. A three-member committee regularly reviewed files regarding case cancellations and data was gathered.
Results: Of the 42,242 surgical cases scheduled during the period, 2903 (6.8%) were cancelled. In 11(0.37%) of these cases, hypertension was the primary reason. Of them, 10(91%) were men and 1(9%) …

Cuff-Less Methods For Blood Pressure Telemonitoring., Dylan M. Bard, Jeffrey I. Joseph, Noud Van Helmond

Department of Anesthesiology Faculty Papers

Blood pressure telemonitoring (BPT) is a telemedicine strategy that uses a patient's self-measured blood pressure (BP) and transmits this information to healthcare providers, typically over the internet. BPT has been shown to improve BP control compared to usual care without remote monitoring. Traditionally, a cuff-based monitor with data communication capabilities has been used for BPT; however, cuff-based measurements are inconvenient and cause discomfort, which has prevented the widespread use of cuff-based monitors for BPT. The development of new technologies which allow for remote BP monitoring without the use of a cuff may aid in more extensive adoption of BPT. This …

The Accuracy Of Blood Pressure Measurement By A Smartwatch And A Portable Health Device, Vignesh Murali, Noud Van Helmond, Cecilia G. Freeman, Christina Hahnen, Nilanjan Haldar, Jacquelyn N. Hamati, Dylan M. Bard, Geno J. Merli, Jeffrey I. Joseph

Phase 1

Introduction: Hypertension is a leading cause of mortality. Proper blood pressure (BP) control can be achieved by lifestyle modification, pharmacotherapy, and frequent measurements. With the growing popularity of cuffless blood pressure monitors, it is important to independently validate their accuracy.

Objective: We evaluated two cuffless blood pressure monitors, The Everlast TR10 fitness watch and the BodiMetrics Performance Monitor, for their accuracy and precision in BP measurements.

Methods: Using a protocol derived from the ANSI/AAMI/ISO 2013 standard for evaluating automated sphygmomanometers, we measured the blood pressures of 85 patients recruited from the Thomas Jefferson University Hospital Preadmission Testing Center with two …

Blood Pressure Measurement Validation Off The Cuff? Comment On "A New Cuffless Device For Measuring Blood Pressure: A Real-Life Validation Study"., Noud Van Helmond, Timothy B. Plante, Jeffrey I. Joseph

Department of Anesthesiology Faculty Papers

No abstract provided.