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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Multicenter Study Observational Study
Assessment of Neutrophil Gelatinase-associated Lipocalin in the Brain-dead Organ Donor to Predict Immediate Graft Function in Kidney Recipients: A Prospective, Multicenter Study.
Delayed graft function is a major determinant of long-term renal allograft survival. Despite considerable efforts to improve donor selection and matching, incidence of delayed graft function remains close to 25%. As neutrophil gelatinase-associated lipocalin (NGAL) has been shown to predict acute renal failure, the authors tested the hypothesis that NGAL measurement in brain-dead donors predicts delayed graft function in kidney recipients. ⋯ NGAL measurement in brain-dead donors at the time of recovery failed to predict delayed or normal graft function in kidney recipients.
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Cerebral autoregulation describes a mechanism that maintains cerebral blood flow stable despite fluctuating perfusion pressure. Multiple nonperfusion pressure processes also regulate cerebral perfusion. These mechanisms are integrated. ⋯ The authors conclude that hypercapnia causes the plateau to progressively ascend, a rightward shift of the lower limit, and a leftward shift of the upper limit. Conversely, hypocapnia results in the plateau shifting to lower cerebral blood flows, unremarkable change of the lower limit, and unclear change of the upper limit. It is emphasized that a sound understanding of both the limitations and the dynamic and integrated nature of cerebral autoregulation fosters a safer clinical practice.