Anesthesiology and Intensive Care

         Type A lactic acidosis is by far the commonest group and is usually due to tissue hypoxia caused by systemic or local hypoperfusion, increased glycolysis, reduced oxygen carrying capacity of the blood or reduced tissue oxygen delivery . Apart from excessive muscle activity, other causes of type A lactic acidosis are rare. The inadequate oxygen supply slows mitochondrial metabolism and leads to increased production of lactate from pyruvate. As a byproduct, NAD +  is regenerated so that glycolysis can continue. If hypoxaemia is the only factor, it must be severe to overwhelm the compensatory increase in tissue blood flow triggered by low PO 2 .

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    Preoperative: Anemia: consider iron, folate, erythropoietin; Anticoagulation: Early withdrawal of antiplatelet agents and warfarin. Switch to unfractionated heparin if necessary;

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Proper positioning avoids injuries and facilitates surgical exposure:

Cephalosporin Antibiotics Classification keywords:cephalosporins, beta-lactam antibiotics, antibiotic classification, MRSA treatment, gram-positive bacteria, gram-negative bacteria, skin infections, respiratory infections, ceftriaxone, cefazolin Cephalosporin antibiotics are the largest and most diverse group of beta-lactam antibiotics. They are classified into five generations, with some cephalosporins not assigned to a specific generation.

Dose of opioid and anesthetic requirements may vary according to pain stimulation: Stay tuned! Sign up with Facebook!

ACC/AHA  Recommendations for Antithrombotic Therapy in Patients With Mechanical Heart Valves:

      The spinal cord terminates on average at the disc between the 1st and 2nd lumbar vertebral bodies (in the adult) . However, there is considerable variation in this level. Frequently, the cord ends opposite the body of L1 or L2, or, rarely, T12 or even L3.

Related to preexisting disease Chronic hypertension, increased intracranial pressure, autonomic hyperreflexia, aortic dissection, early acute myocardial infarction.

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Spinal Opioid Dosages for Labor and Delivery: A Guide for Anesthesiologists Keywords: spinal opioid dosages, labor and delivery analgesia, epidural vs spinal anesthesia, intrathecal opioids, pain management in labor Pain management during labor and delivery is a cornerstone of obstetric anesthesiology. Among the most effective techniques is the use of spinal opioid dosages , often administered via intrathecal injection as part of a combined spinal-epidural (CSE) or standalone spinal anesthesia. These methods provide rapid, targeted pain relief with minimal systemic side effects. In 2025, advancements in dosing protocols and opioid selection have refined their use, making them a go-to choice for labor analgesia. This article explores the latest recommendations for spinal opioid dosages in labor and delivery , their benefits, risks, and practical tips for anesthesiologists aiming to optimize maternal outcomes.

             The harmful effects of aggressive fluid resuscitation on the outcome of sepsis are supported by experimental studies and data accumulated from clinical trials.   Multiple clinical studies have demonstrated an independent association between an increasingly positive fluid balance and increased mortality in patient with sepsis.  The most compelling data that fluid loading in sepsis is harmful, comes from the landmark ‘ Fluid Expansion as Supportive Therapy  (FEAST)’ study performed in 3141 sub-Saharan children with severe sepsis.  In this randomized study, aggressive fluid loading was associated with a significantly increased risk of death. After the Rivers' Early Goal Directed Therapy trial,  which formed the basis for the concept of early aggressive fluid resuscitation, a number of EGDT studies have been published. 

Classification of Inotropes and Vasoconstrictors: A Guide for Critical Care Keywords: classification of inotropes, vasoconstrictors in critical care, inotropic agents, hemodynamic support drugs, vasopressor classification In critical care and anesthesiology, inotropes and vasoconstrictors are lifeline medications for managing hemodynamic instability, such as in shock, heart failure, or perioperative settings. These drugs enhance cardiac output or maintain blood pressure, but their diverse mechanisms and effects require a clear understanding of their classification. In 2025, with updated research and clinical guidelines, the classification of inotropes and vasoconstrictors offers a structured framework for optimizing patient outcomes. This article breaks down these drug classes, their applications, and key considerations for medical professionals.

According to " Intravenous fluid therapy in adults in hospital" by NICE

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  Indicators that a patient may need urgent fluid resuscitation include:

     A standardised track-and-trigger system for acute illness in people presenting to, or within hospitals. The remit also included the need for recommendations on the urgency of the clinical response required, the clinical competency of the clinical responders and the most appropriate environment for ongoing clinical care, according to the NEWS.