Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Competency-based anesthesia training programs require robust assessment of trainee performance and commonly combine different types of workplace-based assessment (WBA) covering multiple facets of practice. This study measured the reliability of WBAs in a large existing database and explored how they could be combined to optimize reliability for assessment decisions. ⋯ Reliability is an important factor to consider when designing assessments, and measuring composite reliability can allow the selection of a WBA portfolio with adequate reliability to provide evidence for defensible decisions on trainee progression.
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Multicenter Study Observational Study
An observational study of end-tidal carbon dioxide trends in general anesthesia.
Despite growing evidence supporting the potential benefits of higher end-tidal carbon dioxide (ETCO2) levels in surgical patients, there is still insufficient data to formulate guidelines for ideal intraoperative ETCO2 targets. As it is unclear which intraoperative ETCO2 levels are currently used and whether these levels have changed over time, we investigated the practice pattern using the Multicenter Perioperative Outcomes Group database. ⋯ Between 2008 and 2016, intraoperative ETCO2 values did not change in a clinically important manner. Interestingly, we found a large inter-hospital and inter-provider variability in ETCO2 throughout the study period, possibly indicating a broad range of tolerance for ETCO2, or a lack of evidence to support a specific targeted range. Clinical outcomes were not assessed in this study and they should be the focus of future research.
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Observational Study
Association between known or strongly suspected malignant hyperthermia susceptibility and postoperative outcomes: an observational population-based study.
Whether current standards of care management for malignant hyperthermia (MH)-susceptible patients result in acceptable postoperative clinical outcomes at a population level is not known. Our objective was to determine if patients with susceptibility to MH experienced similar outcomes as patients without MH susceptibility after surgery under general anesthesia. ⋯ Among adults in Ontario who underwent common surgeries under general anesthesia from 2009 to 2016, known or strongly suspected MH was not associated with a higher risk of adverse postoperative outcomes. These findings support the current standard of care management for MH-susceptible patients.
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Abstract
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Editorial Comment
A friend in need: evaluating the impact of Lifebox in Burkina Faso.
Abstract