The Journal of international medical research
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Practice Guideline Meta Analysis
Development and feasibility study of an algorithm for intraoperative goaldirected haemodynamic management in noncardiac surgery.
This study developed an evidence-based, goal-directed haemodynamic management algorithm to standardize intraoperative haemodynamic therapy. A systematic literature search identified three haemodynamic management goals: stroke volume optimization by fluid therapy; maintenance of a target mean arterial pressure by vasopressor therapy; maintenance of a target cardiac index≥2.5 l/min per m2 by inotropic therapy. ⋯ Implementation of the algorithm into routine intraoperative management in noncardiac surgery was shown to be feasible. Compared with conventional haemodynamic management, use of the algorithm significantly reduced length of hospital stay, requirement for ventilation and incidence of prolonged hospital stay, thereby resulting in reduced hospital costs.
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Randomized Controlled Trial
Outcomes of endovascular coiling versus surgical clipping in the treatment of ruptured intracranial aneurysms.
The effects of treatment modality (endovascular coiling or surgical clipping) on incidence of cerebral vasospasm and infarction following aneurysmal subarachnoid haemorrhage (aSAH) remain controversial. This study compared outcomes between endovascular coiling versus surgical clipping to treat patients with acute (< 72 h) aSAH. ⋯ In this study, coiling yielded less symptomatic vasospasm, cerebral infarction and complete occlusion than surgical clipping, with no between-group differences in clinical outcome.
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Comparative Study
Comparison of clinical outcomes between patellar resurfacing and nonresurfacing in total knee arthroplasty: retrospective study of 130 cases.
To compare clinical outcomes between patellar resurfacing and nonresurfacing in total knee arthroplasty (TKA). ⋯ Clinical outcomes for patellar nonresurfacing, including patelloplasty and circumpatellar denervation, are similar to those for patellar resurfacing, in TKA.
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A prospective study to compare the power of the Logistic Organ Dysfunction System (LODS) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems to predict survival, in patients admitted to the neurological intensive care unit (NICU). ⋯ The LODS scoring system was more stable than the APACHE II scoring system in the NICU setting.
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This prospective, observational study aimed to identify children likely to require sedation preoperatively by measuring anxiety levels using the modified Yale Preoperative Anxiety Scale (mYPAS). Other possible predictive factors for preoperative sedation were also investigated. ⋯ High anxiety levels, young age and long waits contributed to the need for preoperative sedation in children.