Anesthesia care in a medium-developed country: a nationwide survey of Mongolia

Jochberger, Stefan; Bataar, Otgon; Mendsaikhan, Naranpurev; Grander, Wilhelm; Tsenddorj, Ganbat; Lundeg, Ganbold; Dünser, Martin W.

doi:10.1016/j.jclinane.2009.12.005

Cited by 9 publications

(13 citation statements)

References 14 publications

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“…8 Similar shortages of resources to care for acutely and critically ill patients have been reported from other middleor low-income countries. [16][17][18][21][22][23] Such findings and those of the present survey suggest that other international guidelines cannot be fully implemented in Mongolia owing to a lack of the resources required. Although our findings would appear to be intuitively deducible, our study is the first to show that a lack of resources may prevent international treatment guidelines for intensive care medicine from being implemented in non-high-income countries.…”

Section: Discussionmentioning

confidence: 88%

“…These resources, which are routinely available in high-income countries, are often lacking in health-care facilities in middle-or low-income countries, according to recent reports. [16][17][18][19][20] The availability of the resources needed to properly treat sepsis in middle-or low-income countries needs to be inUne traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español.…”

Section: Introductionmentioning

confidence: 99%

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Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia

Bataar

Lundeg

Tsenddorj

et al. 2010

Bull. World Health Organ.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia

Bataar

Lundeg

Tsenddorj

et al. 2010

Bull. World Health Organ.

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“…Today, sevoflurane has replaced halothane for induction and maintenance of pediatric anesthesia because of its rapid induction and recovery characteristics, acceptable cardiovascular profile, and lower incidence of side effects. Although halothane has been abandoned in western anesthesia, it is still preferred in low‐ or medium‐income countries having large pediatric populations …”

Section: Discussionmentioning

confidence: 86%

Neuromuscular‐blocking agents for tracheal intubation in pediatric patients (0‐12 years): A systematic review and meta‐analysis

Vanlinthout

Geniets

Driessen

et al. 2020

Pediatric Anesthesia

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Background:The benefit of using neuromuscular-blocking agents to facilitate tracheal intubation in pediatric patients remains unclear due to variations in design, treatments, and results among trials. By combining the available evidence, we aimed to establish whether scientific findings are consistent and can be generalized across various populations, settings, and treatments. Methods:A systematic search for randomized controlled trials, related to the use of neuromuscular-blocking agents for tracheal intubation in American Society of Anesthesiologists class I-II participants (0-12 years), was performed. We considered all randomized controlled trials that studied whether intubation conditions and hemodynamics obtained by using neuromuscular-blocking agents were equivalent to those that were achieved without neuromuscular-blocking agents. We combined the outcomes in Review Manager 5.3 (RevMan, The Cochrane Collaboration) by pairwise random-effects meta-analysis using a risk ratio (RR) for intubation conditions and mean difference for hemodynamic values (mean [95% Confidence Intervals]).Heterogeneity among trials was explored using sensitivity analyses. Results:We identified 22 eligible randomized controlled trials with 1651 participants.Overall, the use of a neuromuscular-blocking agent was associated with a clinically important increase in the likelihood of both excellent (RR = 1.41 [1.19-1.68], I 2 = 76%) and acceptable (RR = 1.13 [1.07-1.19], I 2 = 68%) intubating conditions. There is strong evidence that both unacceptable intubation conditions (RR = 0.35 [0.22-0.46], I 2 = 23%) and failed first intubation attempts (RR = 0.25 [0.14-0.42], I 2 = 0%) were less likely to occur when a neuromuscular-blocking agent was used compared with when it was not. Higher systolic or mean arterial pressures (mean difference = 13.3 [9.1-17.5] mm Hg, I 2 = 69%) and heart rates (mean difference = 15.9 [11.0-20.8] beats/ min, I 2 = 75%) as well as a lower incidence of arrhythmias were observed when tracheal intubation was facilitated by neuromuscular-blocking agents. Conclusion:The use of a neuromuscular-blocking agent during light-to-moderate depth of anesthesia can improve the quality as well as the success rate of tracheal intubation and is associated with better hemodynamic stability during induction of anesthesia. S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Vanlinthout LE, Geniets B, Driessen JJ, et al. Neuromuscular-blocking agents for tracheal intubation in pediatric patients: A systematic review and meta-analysis.

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“…The factors limiting provision of this anaesthesia care are myriad and common throughout LMICs. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The re- cent Ebola epidemic, with the tragic loss of many vital providers has exacerbated these problems. In some LMICs 25 there are disproportionately fewer anaesthesia-providers than surgeons, making anaesthesia manpower the 'rate-limiting factor' in unmet surgi-cal need.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is recognized that surgery and anaesthesia services in low-and middle-income countries (LMICs) are un-der-equipped and under-staffed. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Most of this data comes from assessments of personnel, supplies and workload at institutions throughout the low resource world. It clearly demonstrates that surgical and anaesthesia services are unable to meet the current need, but gives no sense as to the true extent and nature of unmet need.…”

Section: Introductionmentioning

confidence: 99%

Assessing unmet anaesthesia need in Sierra Leone: a secondary analysis of a cluster-randomized, cross-sectional, countrywide survey

Harris

Kamara

Hanciles³

et al. 2015

Afr H. Sci.

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Objectives: To determine the unmet anaesthesia need in a low resource region. Introduction: Surgery and anaesthesia services in low-and middle-income countries (LMICs) are under-equipped, under-staffed, and unable to meet current surgical need. There is little objective measure as to the true extent and nature of unmet need. Without such an understanding it is impossible to formulate solutions. Therefore, we re-examined Surgeons OverSeas (SOSAS) unmet surgical need data to extrapolate unmet anaesthesia need. Methods: For the untreated surgical conditions identified by SOSAS, we assigned anaesthetic technique required to carry out the procedure. The chosen anaesthetic was based on common practice in the region. Procedures were categorized into minimal anaesthesia, spinal anaesthesia, regional anaesthesia, ketamine/monitored anaesthesia care (MAC), and general endotracheal anaesthesia (GETA Sci. 2015;15(3):1028-33. doi: http://dx.doi. org/10.4314/ahs.v15i3.43

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Anesthesia care in a medium-developed country: a nationwide survey of Mongolia

Cited by 9 publications

References 14 publications

Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia

Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia

Neuromuscular‐blocking agents for tracheal intubation in pediatric patients (0‐12 years): A systematic review and meta‐analysis

Assessing unmet anaesthesia need in Sierra Leone: a secondary analysis of a cluster-randomized, cross-sectional, countrywide survey

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