British journal of anaesthesia
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Observational Study
Association of clonal haematopoiesis with severe postoperative complications in patients undergoing radical oesophagectomy.
Clonal haematopoiesis (CH) is an age-associated clonal expansion of blood cells driven by leukaemia-associated somatic mutations. Although CH has been reported to be a risk factor for leukaemia and a number of non-haematopoietic diseases, its role in perioperative medicine remains unexplored. ⋯ ChiCTR2100044175 (Chinese Clinical Trial Registry, http://www.chictr.org.cn/showproj.aspx?proj=123193).
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Understanding the neural correlates of consciousness has important ramifications for the theoretical understanding of consciousness and for clinical anaesthesia. A major limitation of prior studies is the use of responsiveness as an index of consciousness. We identified a collection of measures derived from unresponsive subjects and more specifically their association with consciousness (any subjective experience) or connectedness (specific experience of environmental stimuli). ⋯ NCT03284307.
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Editorial
Viscoelastic coagulation monitoring for tranexamic acid: personalised antifibrinolytic dosing?
Ex vivo viscoelastic testing can be used to assess the concentration responses to tranexamic acid in blood samples obtained from pregnant women across the three trimesters and in non-pregnant controls. Minor variations in fibrinolysis across pregnancy suggest a target tranexamic acid blood concentration of 12.5 mg L-1 for complete inhibition of fibrinolysis. Although the data support the potential utility of viscoelastic testing using the ClotPro® TPA test in maintaining therapeutic tranexamic acid concentrations during postpartum haemorrhage, it might obscure potentially crucial endogenous fibrinolysis inhibitor interactions essential to the microcirculation.
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Editorial
Unmasking imposter syndrome: individual responsibility or repercussions of systemic oppression?
In contemporary and popular discourse, imposter syndrome is frequently outlined as an individual problem that can be overcome. Rather than the locus of responsibility being placed on the individual, we posit that neoliberal academic institutions contribute to imposter syndrome by (de)legitimising certain forms of knowledge.
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The neural mechanisms underlying sevoflurane-induced loss of consciousness and recovery of consciousness after anaesthesia remain unknown. We investigated whether glutamatergic pedunculopontine tegmental nucleus (PPT) neurones are involved in the regulation of states of consciousness under sevoflurane anaesthesia. ⋯ Glutamatergic PPT neurones regulate induction and emergence of sevoflurane anaesthesia.