Articles: surgery.
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To examine the association between intellectual disability and both severity of disease and clinical outcomes among patients presenting with common emergency general surgery (EGS) conditions. ⋯ EGS patients with intellectual disabilities are at increased risk of more severe presentation and worse outcomes. The underlying causes of delayed presentation and worse outcomes must be better characterized to address the disparities in surgical care for this often under-recognized but highly vulnerable population.
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Pediatr Crit Care Me · Nov 2023
Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for Congenital Heart Disease: A Commentary on Recent Randomized Controlled Trials.
The recent NITRIC and STRESS trials demonstrate opportunities to perform pragmatic large randomized trials in congenital heart disease. We discuss lessons learnt from these trials which can inform future trial design and conduct in the field of pediatric heart surgery.
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Minerva anestesiologica · Nov 2023
Meta AnalysisEffects of dexmedetomidine on early cognitive function in elderly patients after abdominal surgery: a meta-analysis.
This meta-analysis aims to investigate the effect of dexmedetomidine (Dex) on postoperative cognitive dysfunction (POCD) in elderly patients undergoing abdominal surgery under general anesthesia. ⋯ Dex administered intraoperatively can enhance early cognitive function in elderly patients undergoing abdominal surgery.
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Multicenter Study
Delayed Surgical Intervention After Chemoradiotherapy in Esophageal Cancer: (DICE) Study.
To determine the impact of delayed surgical intervention following chemoradiotherapy (CRT) on survival from esophageal cancer. ⋯ Prolonged interval following CRT before esophagectomy is associated with increased 90-day mortality and poorer long-term survival. Further investigation is needed to understand the mechanism that underpins these adverse outcomes observed with a prolonged interval to surgery.
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Randomized Controlled Trial
Individualised positive end-expiratory pressure titrated intra-operatively by electrical impedance tomography optimises pulmonary mechanics and reduces postoperative atelectasis: A randomised controlled trial.
A protective intra-operative lung ventilation strategy has been widely recommended for laparoscopic surgery. However, there is no consensus regarding the optimal level of positive end-expiratory pressure (PEEP) and its effects during pneumoperitoneum. Electrical impedance tomography (EIT) has recently been introduced as a bedside tool to monitor lung ventilation in real-time. ⋯ Individualised PEEP by EIT may improve intra-operative pulmonary mechanics and oxygenation without impairing haemodynamic stability, and decrease postoperative atelectasis.