Charles Andrew Vacchiano

Journal Article Surg Today · July 2024 PURPOSE: To identify tidal volume (VT) and positive end-expiratory pressure (PEEP) associated with the lowest incidence and severity of postoperative pulmonary complications (PPCs) for each phenotype based on preoperative characteristics. METHODS: The subj ... Full text Link to item Cite

Fast-Tracking Patients in an Academic Hospital to Increase Efficiency and Decrease Discharge Delays: A Process Improvement Plan.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · December 2021 PurposeThe purpose of this quality improvement project was to determine if implementing a Phase II postanesthesia care unit (PACU II) to fast-track patients following surgery in an academic hospital would decrease OR hold times and increase patien ... Full text Cite

Review of the Mechanisms of Ventilator Induced Lung Injury and the Principles of Intraoperative Lung Protective Ventilation.

Journal Article AANA journal · June 2021 Intraoperative ventilator induced lung injury is associated with development of postoperative pulmonary complications. Despite advances in modes and methods of mechanical ventilation, postoperative pulmonary complications remain as one of the leading cause ... Cite

Optimizing Intraoperative Fluid Replacement for Patients Receiving Mannitol During Neurosurgical Procedures: A Quality Improvement Initiative.

Journal Article AANA journal · February 2021 Patients undergoing craniotomy are at increased risk of intravascular volume changes due to the use of mannitol. This quality improvement project was conducted to implement a standardized goal-directed fluid therapy (GDFT) protocol using a dynamic physiolo ... Cite

Recertification and Reentry to Practice for Nurse Anesthetists Using High-Fidelity Simulation: Phase III

Journal Article Journal of Nursing Regulation · October 1, 2020 The National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA) uses high-fidelity simulation for high-stakes competency assessment as a part of the Reentry Program. Purpose: This quality improvement project aimed to develop and vali ... Full text Cite

Use of the NBCRNA Self-Evaluation Examination to Predict Applicant Success in Passing the National Certification Examination on the First Attempt

Journal Article Journal of Nursing Regulation · July 1, 2020 Introduction: The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) produces the National Certification Examination (NCE) and grants credentials to registered nurse anesthetists. To provide the profession with adequately p ... Full text Cite

Use of a preoperative screening tool to optimize patients with anemia before cardiac valve procedures

Journal Article MEDSURG Nursing · July 1, 2020 This quality improvement project focused on identifying and treating preoperative anemia in patients undergoing cardiac valve surgery. A standardized screening checklist and proce-dure for patient referral to a preoperative anemia clinic were developed and ... Cite

Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions?

Journal Article AANA J · April 2020 The presence of gastric content before induction of general anesthesia is the primary modifiable risk factor in the prevention of pulmonary aspiration. The purpose of this project was to determine if ultrasonography could be routinely used to measure gastr ... Link to item Cite

Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations.

Journal Article Br J Anaesth · December 2019 Postoperative pulmonary complications (PPCs) occur frequently and are associated with substantial morbidity and mortality. Evidence suggests that reduction of PPCs can be accomplished by using lung-protective ventilation strategies intraoperatively, but a ... Full text Link to item Cite

Low-Flow Domiciliary Oxygen as a Mechanism of Ongoing Oxidative Stress.

Journal Article Respiratory care · November 2019 BackgroundOxidative stress occurs when imbalances exist between the production of oxygen free radicals and endogenous antioxidants that neutralize their harmful effects, causing irreversible tissue damage. Oxygen free radicals readily interact wit ... Full text Cite

Evaluating a Quality Improvement Initiative to Increase Anesthesia Providers' Use of and Understanding of Quantitative Neuromuscular Monitors.

Journal Article AANA journal · October 2019 Improved understanding of the monitoring and dosing practices of anesthesia providers regarding neuromuscular blockade is necessary. The use of subjective methods such as peripheral nerve stimulation and clinical assessment tests can increase the risk of r ... Cite

Nursing Perceptions and Workload Impact of a Standardized Emergence Delirium Assessment Scale in a Postanesthesia Care Unit.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · August 2019 PurposeEmergence delirium (EDL) is a psychomotor behavioral phenomenon that occurs immediately after emergence from general anesthesia. EDL is nearly 1.5 times more common among military than nonmilitary patients. Indirect delirium scales have pre ... Full text Cite

Preparing for Total Power Failure in the Operating Room.

Journal Article AANA journal · August 2019 Total electrical power failure in the operating room is an uncommon event, but when it occurs, it poses a major threat to patient safety. Perhaps the most curable threat to patient safety is the lack of provider knowledge regarding what equipment capabilit ... Cite

Recertification and Reentry to Practice for Nurse Anesthetists, Phase II: Evaluating Reentry to Anesthesia Practice Using High-Fidelity Simulation Technology

Journal Article Journal of Nursing Regulation · July 1, 2019 Background: Certified Registered Nurse Anesthetists (CRNAs) who fail to comply with the Continued Professional Certification Program, or those out of practice for an extended time, must recertify with the National Board of Certification and Recertification ... Full text Cite

Enhancing the Quality of the Anesthesia to Postanesthesia Care Unit Patient Transfer Through Use of an Electronic Medical Record-Based Handoff Tool.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · June 2019 PurposeAnesthesia to postanesthesia care unit (PACU) handoffs are often incomplete, imprecise, and highly variable with respect to information transfer, and therefore can jeopardize patient safety. A standardized anesthesia to PACU electronic medi ... Full text Cite

Use of Near-Infrared Spectroscopy to Measure Tissue Oxygen Saturation During Total Knee Arthroplasty With Use of a Tourniquet.

Journal Article AANA J · June 2019 The primary purpose of this proof-of-concept quality improvement effort was to evaluate the practicality of using near-infrared spectroscopy (NIRS) to measure tissue oxygen saturation (Sto2) during total knee arthroplasty (TKA) with use of a tourniquet. NI ... Link to item Cite

Improving infection control practices of nurse anesthetists in the anesthesia workspace.

Journal Article American journal of infection control · May 2019 BackgroundAnesthesia providers commonly cross-contaminate their workspace and subsequently put patients at risk for a health care-acquired infection. The primary objective of this project was to determine if education and implementation of standar ... Full text Cite

Recertification and Reentry to Practice for Nurse Anesthetists: Determining Core Competencies and Evaluating Performance via High-Fidelity Simulation Technology

Journal Article Journal of Nursing Regulation · January 1, 2018 Introduction The National Board of Certification and Recertification for Nurse Anesthetists addressed a barrier to return to practice of uncertified practitioners by replacing required direct patient care experiences with high-fidelity simulation. Objectiv ... Full text Cite

Characterization of bilateral frontal lobe cerebral oxygen saturation in patients with mild traumatic brain injury.

Journal Article Nursing outlook · September 2017 BackgroundThere is clear evidence of the potential for long-term neuro behavioral and cognitive sequelae following a mild traumatic brain injury (mTBI). Although the source of these persistent behavioral and cognitive issues is unclear, several st ... Full text Cite

Point-of-Contact Assessment of Nurse Anesthetists' Knowledge and Perceptions of Management of Anesthesia-Related Critical Incidents.

Journal Article AANA journal · February 2017 Most anesthesia providers will experience at least one perioperative critical incident during their career, potentially causing critical incident stress symptoms that may affect their ability to provide patient care. The purpose of this descriptive pilot i ... Cite

Retinal oximetry measures systemic hypoxia in central nervous system vessels in chronic obstructive pulmonary disease.

Journal Article PloS one · January 2017 BackgroundDetermination of the blood oxyhemoglobin saturation in the retinal vessels of the eye can be achieved through spectrophotometric retinal oximetry which provides access to the state of oxyhemoglobin saturation in the central nervous syste ... Full text Cite

A Theoretical Mathematical Model to Estimate Blood Volume in Clinical Practice.

Journal Article Biological research for nursing · October 2015 Perioperative intravenous (IV) fluid management is controversial. Fluid therapy is guided by inaccurate algorithms and changes in the patient's vital signs that are nonspecific for changes to the patient's blood volume (BV). Anesthetic agents, patient como ... Full text Cite

Response to Letter to the Editor.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · August 2015 Full text Cite

Fast-tracking ambulatory surgery patients following anesthesia.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · April 2015 PurposeThe purpose of this process improvement project was to introduce and evaluate the efficacy of fast-tracking ambulatory surgical patients in a community hospital.DesignAn observational pre-post design was used, in which patient data ... Full text Cite

NBCRNA response to Zambricki et al Guest Editorial.

Journal Article AANA journal · April 2015 Cite

Pre-ictal bispectral index values; are they accurate?

Journal Article British journal of anaesthesia · March 2015 Full text Cite

Exploration of specialty certification for nurse anesthetists: nonsurgical pain management as a test case.

Journal Article Pain management nursing : official journal of the American Society of Pain Management Nurses · December 2014 Certification is the outcome of the demonstration of knowledge and skills, which is an important link to licensing and credentialing. Considering the essential role that Certified Registered Nurse Anesthetists play in the practice of nonsurgical pain manag ... Full text Cite

The accuracy of a near-infrared spectroscopy cerebral oximetry device and its potential value for estimating jugular venous oxygen saturation.

Journal Article Anesth Analg · December 2014 BACKGROUND: An intriguing potential clinical use of cerebral oximeter measurements (SctO2) is the ability to noninvasively estimate jugular bulb venous oxygen saturation (SjvO2). Our purpose in this study was to determine the accuracy of the FORE-SIGHT(®) ... Full text Link to item Cite

Effects of elevated oxygen and carbon dioxide partial pressures on respiratory function and cognitive performance.

Journal Article J Appl Physiol (1985) · August 15, 2014 Hyperoxia during diving has been suggested to exacerbate hypercapnic narcosis and promote unconsciousness. We tested this hypothesis in male volunteers (12 at rest, 10 at 75 W cycle ergometer exercise) breathing each of four gases in a hyperbaric chamber. ... Full text Link to item Cite

Effect of elective surgery on subjective health in veterans with chronic posttraumatic stress disorder.

Journal Article AANA J · August 2014 Posttraumatic stress disorder (PTSD) is common, is often chronic, and has been associated with greater risk of postoperative mortality in veterans. The purpose of this study was to determine if elective outpatient surgery had a persistent effect on the phy ... Link to item Cite

Reexamining traditional intraoperative fluid administration: evolving views in the age of goal-directed therapy.

Journal Article AANA journal · June 2014 Intraoperative volume administration has long been a topic of debate in the field of anesthesia. Only recently, however, has the conversation shifted to a discussion of appropriate intraoperative volume. A thorough review of the literature explores the his ... Cite

Chapter 1 posttraumatic stress disorder: a view from the operating theater.

Journal Article Annual review of nursing research · January 2014 Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops following exposure to a traumatic event. The prevalence and symptom severity of PTSD is greater in military combat Veterans than the civilian population. Although PTSD is a psychiatr ... Full text Cite

Focused anesthesia interview resource to improve efficiency and quality.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses / American Society of PeriAnesthesia Nurses · December 2012 In an effort to reduce costs, many hospitals may use registered nurses (RNs) with little to no formal education or training in anesthetic or surgical risk to perform anesthesia preoperative interviews (APIs). This lack of education and training can result ... Full text Cite

Development and validation of a cerebral oximeter capable of absolute accuracy.

Journal Article J Cardiothorac Vasc Anesth · December 2012 OBJECTIVE: Cerebral oximetry may be a valuable monitor, but few validation data are available, and most report the change from baseline rather than absolute accuracy, which may be affected by individuals whose oximetric values are outside the expected rang ... Full text Link to item Cite

The perioperative implications of posttraumatic stress disorder.

Journal Article AANA J · December 2012 Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after exposure to a traumatic event and is characterized by symptoms of reexperiencing, emotional numbing, persistent arousal, and avoidance. Approximately 6.8% of the people in the ... Link to item Cite

Sorting through the confusion: Adverse cognitive change after surgery in adults

Journal Article AANA Journal · August 1, 2011 Cognitive change after surgery has become a common topic of research. However, postoperative delirium, emergence delirium, and postoperative cognitive dysfunction are not always phenomenologically distinct. The difficulty in distinguishing between differen ... Cite

Combined lipid emulsion and ACLS resuscitation following bupivacaine- and hypoxia-induced cardiovascular collapse in unanesthetized swine.

Journal Article AANA journal · April 2011 This study examined whether combining lipid emulsion and advanced cardiac life support (ACLS) improves survival in an unanesthetized swine model of bupivacaine- and hypoxia-induced cardiovascular collapse. Arterial and venous catheters and a tracheostomy w ... Cite

Normobaric hypoxia training: the effects of breathing-gas flow rate on symptoms.

Journal Article Aviation, space, and environmental medicine · June 2009 IntroductionThe U.S. Navy has replaced segments of refresher low-pressure chamber instruction with normobaric hypoxia training using a reduced oxygen breathing device (ROBD). A previous training evaluation revealed that this alternative instructio ... Full text Cite

Fexofenadine effects on cognitive performance in aviators at ground level and simulated altitude.

Journal Article Aviation, space, and environmental medicine · August 2008 IntroductionAntihistamines are used for the treatment of allergic rhinitis (AR) symptoms. However, the cognitive effects of some antihistamines can dramatically impair individuals in occupations that require sustained vigilance.MethodsThe ... Full text Cite

Effect of needle size on success of transarterial axillary block.

Journal Article AANA journal · February 2004 The transarterial approach to brachial plexus block is a well-established method of producing anesthesia of the upper extremity. However, it is associated with a failure rate of 20% to 30%. Failure may be secondary to the common use of a relatively long ne ... Cite

Comparison of the effects of propofol versus thiopental induction on postoperative outcomes following surgical procedures longer than 2 hours.

Journal Article AANA journal · June 2003 The use of propofol as an induction agent for surgeries lasting less than 2 hours has been shown to result in a faster emergence from anesthesia. Our study was performed to analyze the impact of propofol on surgical procedures lasting longer than 2 hours. ... Cite

Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea.

Journal Article AANA journal · April 2003 Postoperative nausea, a common complication in patients receiving general anesthesia, was studied in this randomized investigation to compare the efficacy of 70% inhaled isopropyl alcohol and intravenous ondansetron. For the study, 100 healthy women, ASA p ... Cite

Incidence of decompression sickness in hypoxia training with and without 30-min O2 prebreathe.

Journal Article Aviation, space, and environmental medicine · January 2003 BackgroundAll naval aviators, navigators, and aircrewmen are required to participate in hypoxia familiarization training. This training is performed in a hypobaric chamber and is considered high risk due to the potential for barotrauma and/or deco ... Cite

The effect of spinal introducer needle use on postoperative back pain.

Journal Article AANA journal · December 2002 Postdural puncture back pain has a reported incidence ranging from 2% to 29% following the administration of a spinal anesthetic. The purpose of this investigation was to compare the back pain and patient satisfaction scores after the administration of a s ... Cite

A comparison of rocuronium and lidocaine for the prevention of postoperative myalgia after succinylcholine administration.

Journal Article AANA journal · October 2002 The incidence of postoperative myalgia (POM) after succinylcholine administration has been reported to range from 5% to 83%. The administration of small doses of nondepolarizing muscle relaxants or lidocaine before the administration of succinylcholine has ... Cite

Assessment of postanesthesia short-term quality of life: a pilot study.

Journal Article AANA journal · August 2002 Quality of life is a major focus for researchers conducting studies on patient satisfaction and anesthetic outcomes. Efficacy and safety drive anesthesia providers' determination of the type of anesthesia administered, yet little consideration is given to ... Cite

Use of a simple forearm tourniquet as an adjunct to an intravenous regional block.

Journal Article AANA journal · August 2002 Intravenous regional anesthesia (IVRA) is a well-recognized technique for producing anesthesia during surgical procedures of the extremities. It has been suggested that the application of a tourniquet to the forearm may improve the quality of the block. Th ... Cite

Intradermal ketorolac for reduction of epidural back pain.

Journal Article International journal of obstetric anesthesia · April 2002 Between 30 and 45% of all parturients receiving epidural laboring analgesia complain of postpartum back pain. Although long-term or chronic back pain has been reported, our study focuses on acute or short-term back pain that resolves within 72 h. The purpo ... Full text Cite

The morphine-sparing effect of metoclopramide on postoperative laparoscopic tubal ligation patients.

Journal Article AANA journal · February 2002 Metoclopramide traditionally has been used as a prokinetic and antiemetic, but recently it also has been investigated as an agent to enhance analgesic efficacy. No definitive studies have been undertaken to determine whether metoclopramide can decrease pos ... Cite

The use of nalmefene for intrathecal opioid-associated nausea in postpartum patients.

Journal Article AANA journal · February 2002 The aim of this study was to compare the severity of nausea and incidence of emesis in laboring parturients who received intravenous nalmefene or placebo following an intrathecal opioid (ITO). We randomly assigned 60 ASA class I or II multiparous women to ... Cite

The addition of interscalene block to general anesthesia for patients undergoing open shoulder procedures.

Journal Article AANA journal · April 2001 Several studies have demonstrated that interscalene brachial plexus anesthesia alone decreases postoperative pain, nausea, vomiting, urinary retention, and unplanned hospital admissions compared with general anesthesia alone. Anecdotal evidence suggests th ... Cite

The effect of arthroscopic irrigation fluid warming on body temperature.

Journal Article Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · August 2000 The use of room temperature solutions for body cavity irrigation during surgical procedures can lead to the development of perioperative hypothermia. Hypothermia during this period causes patient discomfort, increases oxygen consumption, interferes with th ... Full text Cite

Quantification of insensible water loss associated with insufflation of nonhumidified CO2 in patients undergoing laparoscopic surgery.

Journal Article Journal of laparoendoscopic & advanced surgical techniques. Part A · August 1999 A growing number of surgical procedures of increased duration are being performed using laparoscopic techniques. No study to date has quantitated the potential insensible water loss associated with laparoscopic surgical procedures as a result of intra-abdo ... Full text Cite

Effect of intrathecal fentanyl dose on the duration of labor analgesia.

Journal Article AANA journal · June 1999 The short duration of effective analgesia produced by intrathecal fentanyl (ITF) at doses ranging from 5 to 25 micrograms limits the drug's use for the management of labor pain. The understanding of the potential of ITF related to duration of analgesia in ... Cite

8-ISO-PGF2alpha production by alveolar macrophages exposed to hyperoxia.

Journal Article Shock (Augusta, Ga.) · April 1998 Oxygen exposure for a sufficient duration at high partial pressure results in pulmonary edema in humans and animals. Although the specific mediators of oxygen toxicity are unknown, evidence suggests that oxygen-based radicals such as superoxide anion (O2.) ... Full text Cite

Role of nonenzymatically generated prostanoid, 8-iso-PGF2 alpha, in pulmonary oxygen toxicity.

Journal Article Journal of applied physiology (Bethesda, Md. : 1985) · December 1994 Oxygen delivery at higher than ambient concentrations is in frequent clinical use, yet prolonged exposure can produce pulmonary edema in humans and animals. The specific mediators of oxygen toxicity are unknown, although evidence suggests that oxygen-based ... Full text Cite

Cellular and molecular alterations in the beta adrenergic system with cardiomyopathy induced by tachycardia.

Journal Article Cardiovascular research · August 1994 ObjectiveThe aim was to examine the relationship between changes in myocyte function to changes in protein and mRNA content of components of the beta adrenergic system with tachycardia induced cardiomyopathy.MethodsContractile function an ... Full text Cite