European journal of anaesthesiology
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Randomized Controlled Trial Multicenter Study
Effects of neoadjuvant chemo or chemoradiotherapy for oesophageal cancer on perioperative haemodynamics: A prospective cohort study within a randomised clinical trial.
Neoadjuvant chemoradiotherapy might improve oncological outcome compared with chemotherapy after surgery for oesophagus or gastrooesophageal junction cancer. However, radiotherapy may induce cardiovascular side-effects that could increase the risk of perioperative adverse effects and postoperative morbidity. ⋯ Neoadjuvant chemoradiotherapy for oesophageal or gastrooesophageal junction cancer seems to induce only a marginal negative effect on cardiac function compared with neoadjuvant chemotherapy. This difference did not remain when patients' haemodynamics were challenged by surgery.
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Multicenter Study Observational Study
Impact of disruptions on anaesthetic workflow during anaesthesia induction and patient positioning: A prospective study.
Work disruption in operating rooms hinders flow of patients and increases chances of error. Previous studies have largely considered the types of disruption occurring in operating rooms, but have not analysed systematically the objective impact of disruption. ⋯ The study quantifies time inefficiencies affecting anaesthetic work during the preoperative phase. Work disruption wastes time and is preventable.
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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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Multicenter Study Observational Study
Intraoperative anaphylaxis to neuromuscular blocking agents: the incidence over 9 years at two tertiary hospitals in South Korea: A retrospective observational study.
Intraoperative anaphylaxis to neuromuscular blocking agents (NMBAs) is a rare event that is unpredictable and potentially life threatening. Most of the previous reports on such intraoperative anaphylaxis used market share surveys or self-reported data to estimate the incidence. ⋯ Among commonly used NMBAs, rocuronium appears to have the highest incidence of anaphylaxis. Our findings suggest that future prospective investigation for NMBA-induced anaphylaxis should use internationally agreed skin test protocols.
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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.