Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review
Effect of early cognitive interventions on delirium in critically ill patients: a systematic review.
A systematic review of the literature was conducted to determine the effects of early cognitive interventions on delirium outcomes in critically ill patients. ⋯ The study of early cognitive interventions in critically ill patients was identified in a small number of studies with limited sample sizes. An overall high risk of bias and variability within protocols limit the utility of the findings for widespread practice implications. This review may help to promote future large, multi-centre trials studying the addition of cognitive interventions to current delirium prevention practices. The need for robust data is essential to support the implementation of early cognitive interventions protocols.
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Canadian donor management practices have not been reported. Our aim was to inform clinicians and other stakeholders about the range of current practices. ⋯ These study findings highlight areas for knowledge translation and further clinical research. Interprovincial discrepancies will likely pose unique challenges to national randomized trials.
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Observational Study
Impact of leg movement on skin-adductor canal distance: a potential cause for catheter tip displacement?
Catheter-based adductor canal blocks are an effective pain management strategy for total knee arthroplasty. Nevertheless, catheter-based techniques may fail if the tip migrates because of leg movement. This observational study used ultrasound to measure the distance from the skin to the adductor canal (SAC). We tested the hypothesis that leg movements mimicking those occurring during postoperative physiotherapy change the SAC distance. ⋯ Passive leg movements in five standardized positions increase the SAC distance. We speculate that the altered SAC distance associated with passive leg movement may contribute to catheter tip dislodgement and adductor canal block failure.