European journal of anaesthesiology
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The TFA-1 adhesive forehead sensor is a newly developed pulse oximeter for the measurement of the plethysmographic variability index (PVI) at the forehead, and for the rapid detection of changes in oxygen saturation during low perfusion. ⋯ www.clinicaltrials.gov, NCT03132480.
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Peri-operative hyperbaric oxygen therapy is associated with a range of outcome improvements, including various surgical-recovery and peri-operative indices.
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Meta Analysis
Postoperative atrial fibrillation following emergency noncardiothoracic surgery: A systematic review.
Postoperative atrial fibrillation (POAF) occurs frequently following cardiothoracic surgery and is associated with a higher mortality and a longer hospital stay. The condition is less studied following noncardiothoracic surgery as well as emergency surgery. ⋯ In this study, atrial fibrillation occurred frequently, especially following emergency orthopaedic, vascular and neurosurgery. Emergency surgery and age were independent risk factors for developing atrial fibrillation. POAF seems to be related to a higher risk of postoperative complications and mortality, though further studies with long-term follow-up are needed.
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The altered neurodevelopment of children operated on during the neonatal period might be due to peri-operative changes in the homeostasis of brain perfusion. Monitoring of vital signs is a standard of care, but it does not usually include monitoring of the brain. ⋯ Neuromonitoring with the techniques currently used will neither help our understanding of the altered neonatal pathophysiology, nor enable early detection of deviation from the norm. The modalities lack specificity and are not related to clinical (long-term) outcome or prognosis. Accordingly, we were unable to draw up a monitoring guideline.
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Observational Study
Systemic and regional cerebral perfusion in small infants undergoing minor lower abdominal surgery under awake caudal anaesthesia: An observational study.
Infants undergoing general anaesthesia have an increased risk of severe respiratory and cardiovascular critical events. Awake caudal anaesthesia is an alternative for small infants undergoing minor lower abdominal surgery. While clinical experience has shown stable intra-operative haemodynamic conditions, there are no studies evaluating systemic and regional cerebral perfusion during such a procedure. ⋯ The current study shows that awake caudal anaesthesia does not impair systemic and regional cerebral perfusion in small infants.