Journal of clinical anesthesia
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Chronic-kidney-disease (CKD) is prevalent among adults undergoing noncardiac surgery, with surgery-related factors potentially worsening CKD or triggering acute kidney injury (AKI). We hypothesized that CKD patients experience more kidney function decline within one to two years post-surgery than those without CKD, particularly if they develop AKI. ⋯ Contrary to expectations, patients with preoperative CKD experienced a significant improvement in eGFR postoperatively. Patients without CKD exhibited minimal change. Postoperative AKI negated the eGFR improvement in CKD patients and exacerbated the decline in non-CKD patients.
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This study aimed to examine extent, fraction, and trends of general payments to anesthesiologists and non-physician anesthesia providers (NPAPs) in the United States. ⋯ This study demonstrated large financial relationships between industry and anesthesia providers, with a disproportionate concentration of payments among a minority of providers.
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Randomized Controlled Trial Multicenter Study
Personalized perioperative blood pressure management in patients having major non-cardiac surgery: A bicentric pilot randomized trial.
We hypothesize that personalized perioperative blood pressure management maintaining intraoperative mean arterial pressure (MAP) above the preoperative mean nighttime MAP reduces perfusion-related organ injury compared to maintaining intraoperative MAP above 65 mmHg in patients having major non-cardiac surgery. Before testing this hypothesis in a large-scale trial, we performed this bicentric pilot trial to determine a) if performing preoperative automated nighttime blood pressure monitoring to calculate personalized intraoperative MAP targets is feasible; b) in what proportion of patients the preoperative mean nighttime MAP clinically meaningfully differs from a MAP of 65 mmHg; and c) if maintaining intraoperative MAP above the preoperative mean nighttime MAP is feasible in patients having major non-cardiac surgery. ⋯ It seems feasible to determine the effect of personalized perioperative blood pressure management maintaining intraoperative MAP above the preoperative mean nighttime MAP on postoperative complications in a large multicenter trial.