British journal of anaesthesia
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Older patients undergoing cardiac surgery have a 40-60% risk of developing postoperative delirium (POD), which is associated with increased morbidity and mortality. In animals, xenon has been found to be neuroprotective. Little is known about its neuroprotective effects in humans. We evaluated whether xenon anaesthesia prevents POD in patients undergoing cardiac surgery. ⋯ EudraCT: 2014-005370-11 (May 13, 2015; https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-005370-11).
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Emergence coughing can harm the patient following completion of surgery, but it is unclear which medication is most effective at reducing this event. We conducted a systematic review and network meta-analysis of RCTs to determine the medications' relative efficacies on decreasing moderate to severe emergence coughing after general anaesthesia. Medications studied were lidocaine (i.v., intracuff, topical, or tracheal application), dexmedetomidine, remifentanil, and fentanyl. ⋯ PROSPERO registration number: CRD42018102870.
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The objective of cardiopulmonary bypass (CPB) is to maintain an adequate balance between oxygen delivery (Ḋo2) and consumption. The critical Ḋo2 is that at which consumption becomes supply dependent. This study aimed to identify the critical Ḋo2 in neonates, who have higher metabolic rates than adults. ⋯ It was found that 340 ml min-1 m-2 is likely to represent the lowest suitable Ḋo2 required in neonates to maintain aerobic metabolism during normothermic CPB.