European journal of anaesthesiology
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Multicenter Study Observational Study
Risk prediction model for respiratory complications after lung resection: An observational multicentre study.
Patients undergoing lung surgery are at risk of postoperative pulmonary complications (PPCs). Identifying those patients is important to optimise individual perioperative management. The Clinical Prediction Rule for Pulmonary Complications (CPRPCs) after thoracic surgery, developed by the Memorial Sloan-Kettering Cancer Center, might be an ideal predictor. The hypothesis was that CPRPC performs well for the prediction of PPCs. ⋯ In this external validation, the CPRPC performed poorly despite its simplicity. The CPRPC was not a useful scale in our cohort. In contrast, we used a more accurate score to predict the occurrence of PPCs in our cohort. It is based on age, smoking status and predicted postoperative forced expiratory volume in 1 s. We propose that our formula should be externally validated.
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Letter Multicenter Study Observational Study
Postanaesthesia pulmonary complications after use of muscle relaxants in Europe: Study protocol of the POPULAR study.
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Multicenter Study Observational Study
Swedish surgical outcomes study (SweSOS): An observational study on 30-day and 1-year mortality after surgery.
The European Surgical Outcomes Study (EuSOS) revealed large variations in outcomes among countries. In-hospital mortality and ICU admission rates in Sweden were low, going against the assumption that access to ICU improves outcome. Long-term mortality was not reported in EuSOS and is generally poorly described in the current literature. ⋯ Mortality rate increased almost five-fold at 1 year compared with 30-day mortality after surgery, demonstrating a significantly sustained long-term risk of death in this surgical population. In Sweden, factors associated with long-term postoperative mortality were age, number of comorbidities and surgical urgency.
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Randomized Controlled Trial
Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomised controlled trial.
Epidural analgesia (EDA) is known to be an independent risk factor for perioperative hypothermia and its many known adverse effects. Combined general and epidural anaesthesia decreases intraoperative core temperature more rapidly than general anaesthesia alone. Hence, adequate warming procedures are needed for these patients. ⋯ Warming for 15 min before and after initiation of EDA in patients receiving combined anaesthesia is effective in preventing postoperative hypothermia.
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Chemokine ligand 20 (CCL20) is a chemokine released by mainly liver and blood leucocytes. Particularly under pro-inflammatory circumstances it triggers chemotaxis of lymphocytes and dendritic cells via activating receptor chemokine receptor 6 (CCR6) that is specific to it. In experimental sepsis models, the chemokine-receptor pair has been identified as a potential pathophysiological axis affecting mortality. ⋯ There were early increased plasma concentrations of CCL20 and CCR6 in patients with sepsis. CCL20 and CCR6 correlate with severity of illness in ICU patients. Levels of CCR6 predicted the length of patients' admission.