British journal of anaesthesia
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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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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.
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Perioperative anaphylaxis is a serious and often life-threatening immediate hypersensitivity reaction. There are few published data on paediatric perioperative anaphylaxis (pPOA). We evaluated the incidence of and risk factors involved in the occurrence of pPOA within a large US national database. ⋯ The incidence of pPOA was one in 12,125 cases. Risk factors included age, procedure type, and comorbidities.
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Observational Study
Chronic pain in multiple sites is associated with cardiovascular dysfunction: an observational UK Biobank cohort study.
Chronic pain is associated with development of cardiovascular disease. We investigated the association between how widespread chronic pain is and the development of cardiovascular dysfunction. ⋯ A greater number of chronic pain sites is associated with increased arterial stiffness and poorer cardiac function, suggesting that widespread chronic pain is an important contributor to cardiovascular dysfunction.
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Unravelling the impact of the sex of the anaesthesia provider on the outcomes of patients requires careful statistical analysis and the validity of many assumptions. A recent study in the British Journal of Anaesthesia investigates the effect of anaesthesia provider sex on patient outcomes, using data from two academic healthcare networks in the USA. ⋯ There have been several recent studies considering the effect of healthcare provider sex on outcomes. We will discuss the interpretation of these results and the validity of the underlying assumptions.