Anesthesiology
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Meta Analysis Comparative Study
Desmopressin reduces transfusion needs after surgery: a meta-analysis of randomized clinical trials.
Perioperative pathologic microvascular bleeding is associated with increased morbidity and mortality and could be reduced by hemostatic drugs. At the same time, safety concerns regarding existing hemostatic agents include excess mortality. Numerous trials investigating desmopressin have lacked power to detect a beneficial effect on transfusion of blood products. The authors performed a meta-analysis of 38 randomized, placebo-controlled trials (2,488 patients) investigating desmopressin in surgery and indicating at least perioperative blood loss or transfusion of blood products. ⋯ Desmopressin slightly reduced blood loss (almost 80 ml per patient) and transfusion requirements (almost 0.3 units per patient) in surgical patients, without reduction in the proportion of patients who received transfusions. This meta-analysis suggests the importance of further large, randomized controlled studies using desmopressin in patients with or at risk of perioperative pathologic microvascular bleeding.
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Meta Analysis Comparative Study
How much does pharmacologic prophylaxis reduce postoperative vomiting in children? Calculation of prophylaxis effectiveness and expected incidence of vomiting under treatment using Bayesian meta-analysis.
The authors calculated the effect size for treatments recommended for the pediatric population in the new Guidelines for the Management of Postoperative Nausea and Vomiting that should be implemented with the help of a new risk scale developed for children. ⋯ The authors' tables list the expected incidence of postoperative vomiting with each treatment for each risk category, and the expected relative risks that can be used with baseline risk values from any source.