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British Journal of Anaesthesia

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https://www.readbyqxmd.com/read/29661417/postoperative-delirium-in-total-knee-and-hip-arthroplasty-patients-a-study-of-perioperative-modifiable-risk-factors
#1
S M Weinstein, L Poultsides, L R Baaklini, E E Mörwald, C Cozowicz, J N Saleh, M B Arrington, J Poeran, N Zubizarreta, S G Memtsoudis
BACKGROUND: Postoperative delirium continues to pose major clinical difficulties. While unmodifiable factors (e.g. age and comorbidity burden) are commonly studied risk factors for delirium, the role of modifiable factors, such as anaesthesia type and commonly used perioperative medications, remains understudied. This study aims to evaluate the role of modifiable factors for delirium after hip and knee arthroplasties. METHODS: We performed a retrospective study of 41 766 patients who underwent hip or knee arthroplasties between 2005 and 2014 at a single institution...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661416/anaemia-and-red-blood-cell-transfusion-in-intracranial-neurosurgery-a-comprehensive-review
#2
REVIEW
A Kisilevsky, A W Gelb, M Bustillo, A M Flexman
Both anaemia and blood transfusion are associated with poor outcomes in the neurosurgical population. Based on the available literature, the optimal haemoglobin concentration for neurologically injured patients appears to be in the range of 9.0-10.0 g dl-1 , although the individual risks and benefits should be weighed. Several perioperative blood conservation strategies have been used successfully in neurosurgery, including correction of anaemia and coagulopathy, use of antifibrinolytics, and intraoperative cell salvage...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661415/reversal-of-dabigatran-by-intraosseous-or-intravenous-idarucizumab-in-a-porcine-polytrauma-model
#3
N Akman, T Braunschweig, M Honickel, K Schütt, H Schöchl, C Stoppe, R Rossaint, O Grottke
BACKGROUND: Idarucizumab is licensed to reverse dabigatran in life-threatening haemorrhage. Establishment of venous access can be challenging, and the intraosseous (IO) route is a potentially life-saving alternative. In this study, we compared the efficacy and safety of IO or intravenous (i.v.) idarucizumab for dabigatran reversal in a porcine polytrauma model. METHODS: Male pigs (n=21) received oral dabigatran etexilate (30 mg kg-1 bid) for 3 days. On the 4th day, animals received dabigatran infusion and were randomised 1:1:1 to receive IO saline (control), i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661414/dexmedetomidine-metabolic-clearance-is-not-affected-by-fat-mass-in-obese-patients
#4
A Rolle, S Paredes, L I Cortínez, B J Anderson, N Quezada, S Solari, F Allende, J Torres, D Cabrera, V Contreras, J Carmona, C Ramírez, A M Oliveros, M Ibacache
BACKGROUND: Obesity has been associated with reduced dexmedetomidine clearance, suggesting impaired hepatic function or reduced hepatic blood flow. The aim of this study was to clarify the effect of obesity in dexmedetomidine metabolic clearance. METHODS: Forty patients, ASA I-III, 18-60 yr old, weighing 47-126 kg, scheduled for abdominal laparoscopic surgery, were enrolled. Anaesthetic agents (propofol, remifentanil, and dexmedetomidine) were dosed based on lean body weight measured by dual X-ray absorptiometry...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661413/pharmacokinetic-and-pharmacodynamic-study-of-intranasal-and-intravenous-dexmedetomidine
#5
A Li, V M Yuen, S Goulay-Dufaÿ, Y Sheng, J F Standing, P C L Kwok, M K M Leung, A S Leung, I C K Wong, M G Irwin
BACKGROUND: Intranasal dexmedetomidine produces safe, effective sedation in children and adults. It may be administered by drops from a syringe or by nasal mucosal atomisation (MAD NasalTM ). METHODS: This prospective, three-period, crossover, double-blind study compared the pharmacokinetic (PK) and pharmacodynamic (PD) profile of i.v. administration with these two different modes of administration. In each session each subject received 1 μg kg-1 dexmedetomidine, either i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661412/pharmacokinetic-pharmacodynamic-model-for-propofol-for-broad-application-in-anaesthesia-and-sedation
#6
D J Eleveld, P Colin, A R Absalom, M M R F Struys
BACKGROUND: Pharmacokinetic (PK) and pharmacodynamic (PD) models are used in target-controlled-infusion (TCI) systems to determine the optimal drug administration to achieve a desired target concentration in a central or effect-site compartment. Our aim was to develop a PK-PD model for propofol that can predict the bispectral index (BIS) for a broad population, suitable for TCI applications. METHODS: Propofol PK data were obtained from 30 previously published studies, five of which also contained BIS observations...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661411/the-fragility-of-statistically-significant-findings-in-randomised-controlled-anaesthesiology-trials-systematic-review-of-the-medical-literature
#7
REVIEW
G Mazzinari, L Ball, A Serpa Neto, C L Errando, A M Dondorp, L D Bos, M Gama de Abreu, P Pelosi, M J Schultz
The fragility index (FI), the number of events the statistical significance a result depends on, and the number of patients lost to follow-up are important parameters for interpreting randomised clinical trial results. We evaluated these two parameters in randomised controlled trials in anaesthesiology. For this, we performed a systematic search of the medical literature, seeking articles reporting on anaesthesiology trials with a statistically significant difference in the primary outcome and published in the top five general medicine journals, or the top 15 anaesthesiology journals...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661410/use-of-prothrombin-complex-concentrate-for-management-of-coagulopathy-after-cardiac-surgery-a-propensity-score-matched-comparison-to-plasma
#8
J Fitzgerald, M Lenihan, J Callum, S A McCluskey, C Srinivas, A van Rensburg, K Karkouti
BACKGROUND: An important cause of coagulopathy in cardiac surgery is impaired thrombin generation. While plasma is often used to correct this element of the coagulopathy, studies in vitro suggest that prothrombin complex concentrates (PCCs) might be more effective. Comparative data, however, are scant. METHODS: We compared the outcomes of those who received only plasma with those who received PCCs (with or without plasma) for management of coagulopathy in patients who underwent cardiac surgery with cardiopulmonary bypass at a single institution from 2012 to 2016...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661409/anticoagulant-and-side-effects-of-protamine-in-cardiac-surgery-a-narrative-review
#9
REVIEW
C Boer, M I Meesters, D Veerhoek, A B A Vonk
Neutralisation of systemic anticoagulation with heparin in cardiac surgery with cardiopulmonary bypass requires protamine administration. If adequately dosed, protamine neutralises heparin and reduces the risk of postoperative bleeding. However, as its anticoagulant properties are particularly exerted in the absence of heparin, overdosing of protamine may contribute to bleeding and increased transfusion requirements. This narrative review describes the mechanisms underlying the anticoagulant properties and side-effects of protamine, and the impact of protamine dosing on the activated clotting time and point-of-care viscoelastic test results, and explains the distinct protamine dosing strategies in relation to haemostatic activation and postoperative bleeding...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661408/cerebrospinal-fluid-drain-related-complications-in-patients-undergoing-open-and-endovascular-repairs-of-thoracic-and-thoraco-abdominal-aortic-pathologies-a-systematic-review-and-meta-analysis
#10
REVIEW
L Q Rong, M K Kamel, M Rahouma, R S White, A D Lichtman, K O Pryor, L N Girardi, M Gaudino
BACKGROUND: Cerebrospinal-fluid (CSF) drainage is recommended by current guidelines for spinal protection during open and endovascular repairs of thoracic and thoraco-abdominal aortic aneurysms. In the published literature, great variability exists in the rate of CSF-related complications and morbidity. Herein, we perform a systematic review and meta-analysis on the incidence of CSF drainage-related complications, and compare the complication rates between open and endovascular repairs...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661407/big-data-for-big-patients-gaining-insight-into-risks-for-tracheal-intubation-in-obese-patients
#11
EDITORIAL
J Hinkelbein
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661406/pre-hospital-anaesthesia-no-longer-the-poor-relative-of-high-quality-in-hospital-emergency-airway-management
#12
EDITORIAL
D J Lockey, K Crewdson
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661405/front-of-neck-continued-discovery-of-this-anatomy-essential-for-airway-management
#13
EDITORIAL
M S Kristensen, W H Teoh
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661404/bioblasts-anaesthesia-and-power-failure-rein-in-the-excitement
#14
EDITORIAL
M Perouansky, H C Hemmings
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661403/can-nitric-oxide-tame-the-ketamine-tiger
#15
EDITORIAL
J Sleigh
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661402/increasing-the-utility-of-target-controlled-infusions-one-model-to-rule-them-all
#16
EDITORIAL
T G Short, D Campbell, T D Egan
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661401/erratum-to-management-of-antiplatelet-therapy-in-patients-with-coronary-stents-undergoing-noncardiac-surgery-association-with-adverse-events-br-j-anaesth-2018-120-67-76
#17
A Rodriguez, N Guilera, A Mases, P Sierra, J C Oliva, C Colilles
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661400/corrigendum-to-perineural-dexamethasone-the-dilemma-of-systematic-reviews-and-meta-analyses-br-j-anaesth-2018-120-201-203
#18
P Marhofer, M Columb, P M Hopkins
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661399/uvula-necrosis-after-fibreoptic-intubation
#19
LETTER
A Budde, C Parsons, M Eikermann
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661398/response-to-surgical-cricothyroidotomy-the-tracheal-tube-dilemma
#20
LETTER
A Higgs, B A McGrath, C Goddard, J Rangasami, G Suntharalingam, R Gale, T M Cook
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
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