British journal of anaesthesia
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Hip fractures are a serious health concern and a major contributor to healthcare resource utilisation. We aimed to investigate nationwide trends in the USA in patient characteristics and outcomes in patients after hip fracture repair surgery. ⋯ Over the 6-yr period from 2016 to 2021, a majority of hip fracture repairs continued to be performed under general anaesthesia but with that percentage declining over time. Notable trends included a lower percentage of female patients, an increase in femoral neck fractures, a higher comorbidity burden among patients, and a decrease in complications.
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Review Meta Analysis
Efficacy and safety of intraoperative controlled hypotension: a systematic review and meta-analysis of randomised trials.
While controlled intraoperative hypotension significantly reduces blood loss, existing trials are not adequately powered to investigate safety, particularly myocardial and renal injury.
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Higher inspired oxygen fraction during one-lung ventilation is not independently associated with postoperative pulmonary complications.
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Editorial Review
Talk before they sleep: strategies for patient-centred communication in anaesthesiology.
Patient-physician communication is an integral part of daily anaesthetic practice. Although it is an undeniably powerful means of building a solid therapeutic alliance, several of its fundamental aspects are often overlooked, which can hinder successful communication in the preoperative period. We outline these underexploited elements by analysing the various phases of preoperative patient-physician interactions to provide the practising anaesthesiologist with a useful framework for achieving thoughtful and patient-centred communication.
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Multicenter Study
Preoperative neurologic comorbidity and unanticipated early postoperative reintubation: a multicentre cohort study.
The risk of respiratory complications is highest in the first 72 h post-surgery. Postoperative respiratory events can exacerbate pre-existing respiratory compromise and lead to reintubation of the trachea, particularly in patients with neurologic disorders. This study examined the association between neurologic comorbidities and unanticipated early postoperative reintubation in children. ⋯ Children with neurologic comorbidities have an increased risk of unanticipated early postoperative reintubation and prolonged mechanical ventilation. Given the high mortality risk associated with these outcomes, children with neurologic comorbidities require heightened monitoring and risk assessment.