British journal of anaesthesia
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Editorial Comment Review
Case duration prediction and estimating time remaining in ongoing cases.
In this issue of the British Journal of Anaesthesia, Jiao and colleagues applied a neural network model for surgical case durations to predict the operating room times remaining for ongoing anaesthetics. We review estimation of case durations before each case starts, showing why their scientific focus is useful. ⋯ Most cases have few or no historical data for the scheduled procedures. Generalizability of observational results such as theirs, and automatic computer assisted clinical and managerial decision-making, are both facilitated by using structured vocabularies when analysing surgical procedures.
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Randomized Controlled Trial
Renal function during sevoflurane or total intravenous propofol anaesthesia a single-centre parallel randomised controlled study.
The choice of anaesthetic may influence regulation of renal perfusion and function. We investigated renal function in patients anaesthetised with propofol or sevoflurane before surgery and postoperatively. ⋯ EudraCT: 2017-001646-10; Clinicaltrials.gov: NCT0333680.
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Multicenter Study
Multicentre analysis of practice patterns regarding benzodiazepine use in cardiac surgery.
There is controversy regarding optimal use of benzodiazepines during cardiac surgery, and it is unknown whether and to what extent there is variation in practice. We sought to describe benzodiazepine use and sources of variation during cardiac surgeries across patients, clinicians, and institutions. ⋯ Two-thirds of the variation in benzodiazepine administration during cardiac surgery are associated with institutions and attending anaesthesiology clinicians (consultants). These data, showing wide variations in administration, suggest that rigorous research is needed to guide evidence-based and patient-centred benzodiazepine administration.
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New onset atrial fibrillation (NOAF) is the most common arrhythmia affecting critically unwell patients. NOAF can lead to worsening haemodynamic compromise, heart failure, thromboembolic events, and increased mortality. The aim of this systematic review and narrative synthesis is to evaluate the non-pharmacological and pharmacological management strategies for NOAF in critically unwell patients. ⋯ PROSPERO CRD42019121739.
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Randomized Controlled Trial
Randomised open-label trial comparing intravenous iron and an erythropoiesis-stimulating agent versus oral iron to treat preoperative anaemia in cardiac surgery (INITIATE trial).
Preoperative anaemia is a risk factor for adverse postoperative outcomes after cardiac surgery. Iron deficiency is a frequent cause of low preoperative haemoglobin. An effective treatment for preoperative anaemia associated with iron deficiency has not been determined. ⋯ ISRCTN Number: 41421863; EUDRACT number: 2011-003695-36.