British journal of anaesthesia
-
Studies of intraoperative hypotension typically specify a blood pressure threshold associated with adverse outcomes. Such thresholds are likely to be study-biased, investigator-biased, or both. We hypothesised that a newly developed modelling method without a threshold, which is biologically more plausible than a threshold-based approach, would reveal a continuous association between exposure to intraoperative hypotension and adverse outcomes. ⋯ Intraoperative hypotension appears to have a graded association with postoperative myocardial injury and mortality, with depth appearing to contribute more than duration.
-
Letter Randomized Controlled Trial
Augmented reality in paediatric oncology patients undergoing surgery: a feasibility randomised controlled trial.
-
The appropriate level of postoperative critical care for patients undergoing emergency surgery is unknown. We aimed to assess the outcomes of postoperative patients treated in the intensive care unit (ICU) and high dependency care unit (HDU) after emergency surgery. ⋯ In this national registry study, postoperative critical care in ICU was associated with lower in-hospital mortality than in HDU for patients undergoing medium-risk and high-risk emergency surgery. Further research is needed to understand the role of critical care for surgical patients.
-
Editorial Comment
'If you don't take a temperature, you can't find a fever': relevance to continuous arterial pressure monitoring.
Intraoperative hypotension is common and is associated with adverse postoperative outcomes. A substantial fraction of all perioperative hypotension occurs shortly after induction of anaesthesia and before the procedure begins. ⋯ Continuous blood pressure monitoring might help reduce hypotension. There are now strong arguments that if an arterial line is indicated, it should be placed before induction of anaesthesia to obtain maximal benefit.