Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To evaluate the efficacy and effectiveness of red blood cell leukoreduction in reducing postoperative infection, mortality and cancer recurrence, two meta-analyses of randomized controlled trials (RCTs) were conducted. ⋯ We demonstrated that patients who were transfused leukoreduced red blood cells might benefit from a decrease in postoperative infections. A decrease in mortality may have been realized if more patients had been enrolled in the various randomized trials. Including all patients randomized, regardless of whether or not they were actually transfused diluted the observed clinical benefit of leukoreduction.
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Review Retracted Publication
Fluid choice for resuscitation of the trauma patient: a review of the physiological, pharmacological, and clinical evidence.
Volume replacement regimens are discussed very emotionally. Interpretation of the literature is difficult due to variations in study design, patient population, target for volume replacement, endpoints, and type of fluids. Meta-analyses may not be very helpful because all kinds of patients and very old studies are included. The principles and options for volume replacement were reviewed exclusively in trauma patients and studies from the literature focusing on this problem were analyzed. ⋯ The choice of fluid therapy in trauma patients engenders the most controversy and an examination of the body of literature on this subject results in confusion. It is imperative to continue the search for substances that are effective in avoiding the development of post-trauma multi-organ dysfunction syndrome without detrimental side-effects.
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An increasing number of patients with complex medical problems are now considered suitable for ambulatory surgery. The purpose of this study was to identify the current clinical practice of ambulatory surgical patient selection. ⋯ Our survey demonstrated that medical conditions with extreme grades of severity (mild or severe) are associated with majority opinion to proceed or not to proceed with ambulatory surgery. Issues with over 75% agreement reflect the common practice. Similar surveys may form a part of patient selection guidelines development in the future.