Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Cesarean delivery (CD) is the most commonly performed inpatient surgery in Canada, with 103,425 performed in 2016-2017. Mobile technology can contribute to patient-centred perioperative care. Our aim was to involve patients and anesthesiologists in designing a mobile application to enhance the perioperative care of CD patients. ⋯ The participant-driven changes in direction of the prototype showed the importance of involving key stakeholders early. This study provides guidance on further iterative development and implementation of an interdisciplinary mobile platform for patient-centred perioperative care and outcomes research.
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When children with autism spectrum disorder (ASD) are in hospital, difficulties with socialization, communication, and behaviour can be exacerbated. The purpose of this study was to establish feasibility of an enhanced perioperative care pathway. ⋯ We showed that a multidisciplinary perioperative care plan for children with severe ASD was feasible and 100% accepted at our institution. The individual nature of anxiolysis plans was considered a strength of the protocol.
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Tranexamic acid (TXA) reduces perioperative blood loss and transfusion requirement following cardiac surgery. Nevertheless, TXA remains underutilized because of concerns regarding development of adverse events. We conducted a systematic review to determine which patients are commonly excluded from TXA cardiac surgery clinical trials to determine if there are patient groups lacking safety data on TXA. ⋯ We found that systemic TXA is safe to use in cardiac surgery. Certain patient groups are frequently excluded from TXA cardiac surgery trials, and may consequently have limited efficacy and safety data on TXA. Further research in these patient groups may be needed; nevertheless, for many patient populations there are sufficient data to inform evidence-based guidelines for TXA use in cardiac surgery.