British journal of anaesthesia
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Regional anaesthesia (RA) is often included in enhanced recovery protocols (ERPs) as an important component of a bundle of interventions to improve outcomes after surgery. We sought to delineate whether the literature supports the use of RA in this setting with regard to commonly measured outcomes. We further sought to assess whether such improvements would translate into positive impacts on healthcare value as defined by the Institute for Healthcare Improvement Triple Aim. ⋯ Where value-based outcomes were reported, RA appears to have a positive impact on global measures of health and function and on economic outcomes. Existing literature supports a positive impact of RA on ERP outcomes, which may be reflected in improved healthcare value. In order to justify the value of RA in ERPs, a future focus on appropriate measures is needed to align research with widely accepted frameworks, such as the Triple Aim.
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Multicenter Study
Early thromboelastometry variables predict maximum clot firmness in children undergoing cardiac and non-cardiac surgery.
Early clot amplitudes measured on thromboelastometry (ROTEM®) predict maximum clot firmness (MCF) in adults. In this multicentre, retrospective study, we aimed to confirm the suspected relationship between early ROTEM® variables and MCF, in children undergoing cardiac or non-cardiac surgery. ⋯ This study confirmed that early values of clot amplitudes measured as soon as five, 10 or 15 min after clotting time could be used to predict maximum clot firmness in all ROTEM® tests.