European journal of anaesthesiology
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The risks associated with surgery are elevated in patients with diabetes mellitus. For this reason, preoperative diagnostics frequently include the measurement of blood glucose and haemoglobin A1c (HbA1c), but it is unclear whether these tests contribute to improved perioperative or postoperative outcomes. ⋯ Preoperative blood glucose testing and testing for HbA1c is not required in nondiabetic patients unless there are clinical sings arousing suspicion. Patients scheduled for vascular and orthopaedic surgery carry an elevated risk justifying preoperative testing for blood glucose or HbA1c as a screening tool.
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Multicenter Study Observational Study
PREPARE: the prevalence of perioperative anaemia and need for patient blood management in elective orthopaedic surgery: A multicentre, observational study.
Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. ⋯ Most patients who underwent elective orthopaedic surgery had normal preoperative Hb levels but became anaemic after the procedure. Those who were anaemic prior to surgery had an increased intraoperative transfusion risk and postoperative complication rate. PBM measures such as iron status assessment and strategies to avoid transfusion are still underused in Europe.
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Editorial Historical Article
From cocaine to lidocaine: Great progress with a tragic ending.
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Randomized Controlled Trial
Testing a conceptual model on early opening of the microcirculation in severe sepsis and septic shock: A randomised, controlled pilot study.
Organ failure in severe sepsis and septic shock may be caused by microcirculatory failure. ⋯ Early opening of the microcirculation in patients with severe sepsis and septic shock using nitroglycerin, enoximone, dopamine and corticosteroids did not result in a faster reduction in organ failure than standard resuscitation.