British journal of anaesthesia
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Editorial Review
Safety improvement requires data: the case for automation and artificial intelligence during incident reporting.
The reporting of incidents has a long association with safety in healthcare and anaesthesia, yet many incident reporting systems substantially under-report critical events. Better understanding the underlying reasons for low levels of critical incident reporting can allow such factors to be addressed systematically to arrive at a better reporting culture. However, new forms of automation in anaesthesia also provide powerful new approaches to be adopted in the future.
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Cerebrovascular autoregulation is defined as the capacity of cerebral blood vessels to maintain stable cerebral blood flow despite changing blood pressure. It is assessed using the pressure reactivity index (the correlation coefficient between mean arterial blood pressure and intracranial pressure). The objective of this scoping review is to describe the existing evidence concerning the association of EEG and cerebrovascular autoregulation in order to identify key concepts and detect gaps in the current knowledge. ⋯ There is a paucity of studies evaluating the link between EEG and cerebrovascular autoregulation. The studies identified included a variety of EEG and cerebrovascular autoregulation acquisition methods, age groups, and diseases allowing for few overarching conclusions. However, the preliminary evidence for the presence of an association between EEG metrics and cerebrovascular autoregulation prompts further in-depth investigations.
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Multicenter Study
Hospital variation in quality indicators for patient blood management in total knee and hip arthroplasty: a retrospective cohort study.
Anaemia, blood loss, and blood transfusion are critical aspects of patient care in major orthopaedic surgery. We assessed hospital adherence to guideline-recommended Patient Blood Management (PBM) care, analysed variations between hospitals, and validated two composite indicators of hospital PBM performance in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA). ⋯ Hospital adherence to guideline-recommended patient blood management care in total hip and knee arthroplasty was suboptimal and varied across centres. Using data that are widely available in hospitals, quality indicators and composite scores could become valuable tools for patient blood management monitoring and comparisons between healthcare organisations.
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Multicenter Study
Association of anaesthesia provider sex with perioperative complications: a two-centre retrospective cohort study.
Care by female anaesthetists is associated with a lower risk of intraoperative complications, particularly among specialist anaesthetists.
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Guideline adherence in the medical field leaves room for improvement. Digitalised decision support helps improve compliance. However, the complex nature of the guidelines makes implementation in clinical practice difficult. ⋯ NCT04058769.