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This study evaluates the changes of oxygen saturation (SpO2) after intravenous administration of methylene blue in 103 patients undergoing open repair of thoracoabdominal aortic aneurysms. We found that SpO2 decreased by a median (interquartile range [IQR]) of 49% (37%-81%)

Study Objective. We performed a systematic comparison of high-dose and low-dose opioid anesthesia in cardiac surgery. Design Systematic review and meta-analysis of randomized controlled trials (RCTs). Setting Operating room. Patients 1400 adult patients undergoing cardiac surgery using general anesthesia. Interventions All RCTs comparing the effects of various doses of intravenous opioids (morphine, fentanyl, sufentanil, and remifentanil) during adult cardiac surgery using general anesthesia published until May 2018 (full-text English articles reporting data from human subjects) were included. Measurements Primary outcome was intensive care unit (ICU) length of stay (LOS). Secondary outcomes were ventilation time, use of vasopressors, perioperative myocardial infarction, perioperative stroke, and hospital LOS. Main results Eighteen articles were included (1400 patients). There was no difference in ICU LOS between studies using high or low dose of opioids (both short-acting and long-acting) (standard mean difference [SMD]−0.02, 95%CI: −0.15–0.11, P = 0.74). Similarly, there was no difference in secondary outcomes of ventilation time (SMD−0.27, 95%CI: −0.63–0.09, P = 0.14), use of vasopressors (OR 0.61, 95%CI: 0.29–1.30, P = 0.20), myocardial infarction (risk difference 0.00, 95% CI: −0.02–0.03, P = 0.70), stroke (RD 0.00, 95% CI: −0.01–0.01, P = 0.92) and hospital LOS (SMD 0.03, 95% CI: −0.26–0.33, P = 0.84). At meta-regression, there was no effect of age, gender, or type of opioid on the difference between groups. Conclusions Our data suggest that low-dose opioids, both short acting and long acting, are safe and effective to use in adult cardiac surgery patients, independent of the clinical characteristics of the patients and the type of opioid used. In view of the current opioid epidemic, low-dose opioid anesthesia should be considered for cardiac surgery patients.

It has been well established that Epipremnum aureum (Golden Pothos) has the capability to rid the air of various toxins, including carbon monoxide, benzene, and formaldehyde. However, while various studies have looked into the threshold of toxins Pothos can remove, the metabolic pathway and products of the detoxification process, as well as its effects on the overall metabolic health and stability of the purifying species, remain unknown. In this study, an isolated Pothos leaf underwent 24-hour exposure periods during which formaldehyde solution (5.43M) was introduced at a constant rate (evaporated at atmospheric pressure) into the isolation chamber. Mass spectroscopy analysis revealed atmospheric CO2 levels to fall into a negatively-correlated phase pattern with formaldehyde vapour concentration, in contrast to control fluctuations within atmospheric O2 and N2 levels. Results implicate a C1 metabolic pathway as Pothos’ primary purification mechanism for formaldehyde, in addition to partial oxidation of the end product (i.e. formate) into CO2.