Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Perioperative stroke is associated with significant morbidity and mortality, with an incidence that may be underappreciated. In this review, we examine the significance, pathophysiology, risk factors, and evidence-based recommendations for the prevention and management of perioperative stroke. ⋯ Perioperative stroke carries a significant clinical burden. The incidence of perioperative stroke may be higher than previously recognized, and there are diverse pathophysiologic mechanisms. There are many opportunities for further investigation of the pathophysiology, prevention, and management of perioperative stroke.
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The purpose of this narrative review is to address perioperative bleeding and transfusion as determinants of adverse outcomes after cardiac surgery. ⋯ Perioperative bleeding itself is a complex syndrome that can be classified as an outcome measure. Red blood cell transfusion has limitations when considered as an outcome variable and can be biased by many confounders. Its relationship with clinical outcome remains uncertain. In addition to being potential outcome measures, transfusion rates and the number of allogeneic blood products transfused may also be considered as quality-of-care markers.
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The purpose of this paper is to review the current evidence relating anesthetic depth to long-term survival after surgery. ⋯ The available evidence on anesthetic depth and long-term survival is inconclusive. Randomized controlled trials with carefully controlled arterial blood pressure are required.
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The goal of this narrative review is to consider and categorize the clinically relevant outcomes that have been previously investigated in neuroanesthesia and to propose the essential outcomes and directions that deserve priority in clinical care and future outcome-oriented research. ⋯ Future endeavours in neuroanesthesia research should advocate prospective randomized trials that focus on long-term neurologic outcomes. These initiatives will require coordination of multiple centres through a clinical trials network.