British journal of anaesthesia
-
Multicenter Study
Low end-tidal CO2 as a real-time severity marker of intra-anaesthetic acute hypersensitivity reactions.
Prompt diagnosis of intra-anaesthetic acute hypersensitivity reactions (AHR) is challenging because of the possible absence and/or difficulty in detecting the usual clinical signs and because of the higher prevalence of alternative diagnoses. Delayed epinephrine administration during AHR, because of incorrect/delayed diagnosis, can be associated with poor prognosis. Low end-tidal CO2 (etCO2) is known to be linked to low cardiac output. Yet, its clinical utility during suspected intra-anaesthetic AHR is not well documented. ⋯ NCT01637220.
-
Heterogeneity among the primary studies included in a systematic review (SR) is one of the most challenging considerations for systematic reviewers. Current practices in anaesthesiology SRs have not been evaluated, but traditional methods may not provide sufficient information to evaluate the true nature of these differences. We address these issues by examining the practices for evaluating heterogeneity in anesthesiology reviews. ⋯ Subgroup analysis was used in 59% Cochrane reviews, while sensitivity analysis was used in 62%. Many reviews did not provide sufficient detail regarding heterogeneity. We are calling for improvement to reporting practices.
-
Randomized Controlled Trial Multicenter Study
Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial.
Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphone-based application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on postoperative recovery compared with standard care. ⋯ NCT02492191.
-
Randomized Controlled Trial
Influence of Bayesian optimization on the performance of propofol target-controlled infusion.
Target controlled infusion (TCI) systems use population-based pharmacokinetic (PK) models that do not take into account inter-individual residual variation. This study compares the bias and inaccuracy of a population-based vs a personalized TCI propofol titration using Bayesian adaptation. Haemodynamic and hypnotic stability, and the prediction probability of alternative PK models, was studied. ⋯ Dutch Trial Registry NTR4518.