Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Multicenter Study
Outcomes of elderly critically ill medical and surgical patients: a multicentre cohort study.
Very elderly (over 80 yr of age) critically ill patients admitted to medical-surgical intensive care units (ICUs) have a high incidence of mortality, prolonged hospital length of stay, and dependent living conditions should they survive. The primary purpose of this study is to describe the outcomes and differences in outcomes between very elderly medical patients and their surgical counterparts admitted to Canadian ICUs, thereby informing decision-making for clinicians and substitute decision-makers. ⋯ In this large sample of critically ill medical and surgical patients, the admission SOFA score and hospital lengths of stay were not different between the two groups, but medical patients had longer ICU lengths of stay and higher ICU and hospital mortality than surgical patients.
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Observational Study
Non-essential blood tests in the intensive care unit: a prospective observational study.
Non-essential blood testing in the acute care setting can be a prominent source of morbidity, patient discomfort, increased workload for the healthcare provider, and wasteful spending. The magnitude of such non-essential blood testing has not been well described. We aimed to measure the extent of unnecessary blood testing in a 33-bed intensive care unit (ICU) at a tertiary-care teaching hospital in Ontario, Canada. ⋯ Attending physicians deemed a substantial proportion of the blood tests processed in a tertiary care ICU setting as unnecessary. Furthermore, the non-essential tests incurred substantial additional cost. Further work is required to gain a better understanding of the underlying factors contributing to these wasteful practices.
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Randomized Controlled Trial
Low dose intravenous dexamethasone (4 mg and 10 mg) significantly prolongs the analgesic duration of single-shot interscalene block after arthroscopic shoulder surgery: a prospective randomized placebo-controlled study.
Although intravenous dexamethasone prolongs the analgesic duration of interscalene brachial plexus block, it is uncertain whether this effect can be observed using lower doses of dexamethasone. This study evaluated the impact of intravenous dexamethasone (4 mg and 10 mg) on the analgesic duration of single-shot interscalene block after arthroscopic shoulder surgery. We hypothesized that both doses would prolong the analgesic duration compared with placebo. ⋯ Low doses of intravenous dexamethasone (4 mg and 10 mg) significantly prolong the analgesic duration of interscalene block. This trial was registered at ClinicalTrials.gov (NCT02412657).