British journal of anaesthesia
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Review Meta Analysis
Prone positioning for non-intubated spontaneously breathing patients with acute hypoxaemic respiratory failure: a systematic review and meta-analysis.
Prone positioning improves oxygenation & reduces mortality among non-intubated COVID positive patients, but does not appear to reduce the intubation rate.
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Preparedness for mass casualty events is essential at local, national, and global levels. Much more needs to be done by all stakeholders to avoid unnecessary morbidity and mortality despite the challenges that COVID-19 continues to present. In this editorial, we highlight the challenges and solutions for mass casualty incident preparations.
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Randomized Controlled Trial Comparative Study
Cuffed versus uncuffed tracheal tubes in a rabbit training model for establishing an emergency front-of-neck airway in infants: a prospective trial.
In a rabbit-model of infant front-of-neck airway rescue, a cuffed 3.0 mm ETT was non-inferior to uncuffed 3.5 mm ETT for success & time-to-perform, but required greater force.
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Multicenter Study
Association of postoperative complications with persistent post-surgical pain: a multicentre prospective cohort study.
Persistent post-surgical pain is an important and under-recognised problem that is difficult to treat. Postoperative complications have been identified as possible risk factors for persistent post-surgical pain. We conducted a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) cohort study to characterise the association of major postoperative complications with post-surgical pain at 30 days and 1 yr after major surgery. ⋯ Patients who developed major complications were more likely to report pain at 30 days and possibly 1 yr after surgery. Research is necessary to validate these findings and delineate underlying mechanisms.
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Editorial Comment
Meta-analyses of clinical trials: are we getting lemonade from lemons?
Meta-analyses guide planning of clinical trials and clinical care, but are subject to all the methodologic problems and potential biases present in the underlying trials. Furthermore, publication bias often contributes to overestimated benefit in meta-analyses of small trials, which are often 'corrected' by subsequent large trials. Meta-analyses are no substitute for large robust trials.