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pearl
1
Although daily low-dose aspirin reduces vascular events in those with diabetes but no cardiovascular history, it does this at the expense of major hemorrhage risk.
ASCEND Study Collaborative Group, Bowman L, Mafham M et al. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N. Engl. J. Med. 2018 Oct 18; 379 (16): 1529-1539.
  Daniel Jolley
pearl
1
Daily low-dose aspirin does not reduce all-cause mortality in the healthy elderly.
McNeil JJ, Nelson MR, Woods RL et al. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. N. Engl. J. Med. 2018 Oct 18; 379 (16): 1519-1528.
  Daniel Jolley
pearl
1
Daily low-dose aspirin does not improve disability-free survival in the healthy elderly.
McNeil JJ, Woods RL, Nelson MR et al. Effect of Aspirin on Disability-free Survival in the Healthy Elderly. N. Engl. J. Med. 2018 Oct 18; 379 (16): 149915081499-1508.
  Daniel Jolley
pearl
1
Daily low-dose aspirin for primary prevention in the healthy elderly offers no cardiovascular benefit but does increase the risk of major hemorrhage.
McNeil JJ, Wolfe R, Woods RL et al. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. N. Engl. J. Med. 2018 Oct 18; 379 (16): 1509-1518.
  Daniel Jolley
pearl
1
Pressure control ventilation is associated with lower surgical bleeding volume when compared to volume controlled ventilation during lumbar spine surgery.
Kang WS, Oh CS, Kwon WK et al. Effect of Mechanical Ventilation Mode Type on Intra- and Postoperative Blood Loss in Patients Undergoing Posterior Lumbar Interbody Fusion Surgery: A Randomized Controlled Trial. Anesthesiology. 2016 Jul 1; 125 (1): 115-23.
  Daniel Jolley
pearl
1
Two thirds of anesthesia awareness occurs before or after surgery.
Pandit JJ, Cook TM, Jonker WR et al. A national survey of anaesthetists (NAP5 baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. Br J Anaesth. 2013 Apr 1;110(4):501-9.
  Daniel Jolley
pearl
1
ICU resuscitation with 20% ‘concentrated’ albumin decreases fluid requirements compared with 4% albumin, without apparent harm.
Mårtensson J, Bihari S, Bannard-Smith J et al. Small volume resuscitation with 20% albumin in intensive care: physiological effects : The SWIPE randomised clinical trial. Intensive Care Med. 2018 Nov 1; 44 (11): 1797-1806.
  Daniel Jolley
pearl
1
Pulse Pressure Variation and Stroke Volume Variation has limited sensitivity and specificity when assessing the response to intra-operative fluid challenge.
Messina A, Pelaia C, Bruni A et al. Fluid Challenge During Anesthesia: A Systematic Review and Meta-analysis. Anesth. Analg. 2018 Dec 1; 127 (6): 1353-1364.
  Daniel Jolley
pearl
1
It’s likely safe to continue metformin and sulphonylureas in those fasting for day surgery, in the absence of renal impairment.
Gasanova I, Meng J, Minhajuddin A et al. Preoperative Continuation Versus Interruption of Oral Hypoglycemics in Type 2 Diabetic Patients Undergoing Ambulatory Surgery: A Randomized Controlled Trial. Anesth. Analg. 2018 Oct 1; 127 (4): e54-e56.
  Daniel Jolley
pearl
1
In children single-agent antiemetic prophylaxis is as equally effective as TIVA in preventing post-operative vomiting.
Schaefer MS, Kranke P, Weibel S et al. Total intravenous anesthesia vs single pharmacological prophylaxis to prevent postoperative vomiting in children: A systematic review and meta-analysis. Paediatr Anaesth. 2017 Dec 1; 27 (12): 1202-1209.
  Daniel Jolley