Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Many believe that blood pressure management during cardiac surgery is associated with postoperative outcomes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the impact of high compared with low intraoperative blood pressure targets on postoperative morbidity and mortality in adults undergoing cardiac surgery on cardiopulmonary bypass (CPB). Our primary objective was to inform the design of a future large RCT. ⋯ PROSPERO (CRD42020177376); registered: 5 July 2020.
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Case Reports
Spinal cord injury-related thermoregulatory impairment masks a fatal malignant hyperthermia crisis: a case report.
Malignant hyperthermia (MH) is a hypermetabolic disorder that can occur in genetically susceptible individuals exposed to halogenated anesthetics and succinylcholine. Spinal cord injury (SCI) above the sixth thoracic vertebra is associated with dysfunction of the sympathetic/parasympathetic nervous pathways, including thermoregulatory dysfunction, presenting as hypothermia in cold environments because of vasodilation and heat loss. This effect could mitigate or obscure an MH episode. Here, we describe development of a fatal MH crisis in a patient with SCI. ⋯ Spinal cord injury-induced thermoregulatory dysfunction may obscure the early diagnosis of MH and lead to fatal outcome.
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In the COVID-19 pandemic, an unprecedented number of individuals required endotracheal intubation. To safely face these challenges, expert intubation teams were formed in some institutions. Here, we report on the experience of emergency rapid intubation teams (ERITs) in two Canadian hospitals. ⋯ www.ClinicalTrials.gov (NCT04689724); registered 30 December 2020.