Anesthesiology
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Review Meta Analysis
Immediate Rescue Designs in Pediatric Analgesic Trials: A Systematic Review and Meta-analysis.
Opioid sparing is a feasible pragmatic endpoint for pediatric pain analgesic trials.
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In 1997, the International Classification of Diseases (ICD), 9th Revision Clinical Modification (ICD-9) coding system introduced the code for malignant hyperthermia (MH) (995.86). The aim of this study was to estimate the accuracy of coding for MH in hospital discharge records. ⋯ Approximately one quarter of ICD-9 or ICD-10 coded MH diagnoses in hospital discharge records refer to incident MH episodes and an additional 47% to MH susceptibility (including personal history or family history). Information such as surgical procedure, anesthesia billing data, and dantrolene administration may aid in identifying incident MH cases among those with an ICD-9 or ICD-10 coded MH diagnosis in their hospital discharge records.
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Randomized Controlled Trial
Transfusion Requirements in Surgical Oncology Patients: A Prospective, Randomized Controlled Trial.
The researchers found that in a cohort of 198 patients admitted to ICU after major abdominal cancer surgery, those subjected to a liberal blood transfusion threshold of < 9 g/dL experienced fewer major complications (NNT 6.2) than those subjected to a restrictive transfusion threshold (< 7 g/dL).
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Neonatal exposure to general anesthetics may pose significant neurocognitive risk. Human epidemiological studies demonstrate higher rates of learning disability among children with multiple, but not single, exposures to anesthesia. The authors employ a rat model to provide a histological correlate for these population-based observations. The authors examined long-term differences in hippocampal synaptic density, mitochondrial density, and dendritic spine morphology. ⋯ This suggests a "threshold effect" for general anesthetic-induced neurotoxicity, whereby even brief exposures induce long-lasting alterations in neuronal circuitry and sensitize surviving synapses to subsequent loss.