Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis
Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression.
Mortality associated with hip fracture is high in elderly patients. Surgical repair within 24 hr after admission is recommended by The Royal College of Physicians' guidelines; however, the effect of operative delay on mortality remains controversial. The objective of this study was to determine whether operative delay increases mortality in elderly patients with hip fracture. ⋯ In hip fracture patients, operative delay beyond 48 hr after admission may increase the odds of 30-day all-cause mortality by 41% and of one-year all-cause mortality by 32%. Potential residual confounding factors in observational studies may limit definitive conclusions. Although routine surgery within 48 hr after admission is hard to achieve in most facilities, anesthesiologists must be aware that an undue delay may be harmful to hip fracture patients, especially those at relatively low risk or those who are young.
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Review Meta Analysis
Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression.
Mortality associated with hip fracture is high in elderly patients. Surgical repair within 24 hr after admission is recommended by The Royal College of Physicians' guidelines; however, the effect of operative delay on mortality remains controversial. The objective of this study was to determine whether operative delay increases mortality in elderly patients with hip fracture. ⋯ In hip fracture patients, operative delay beyond 48 hr after admission may increase the odds of 30-day all-cause mortality by 41% and of one-year all-cause mortality by 32%. Potential residual confounding factors in observational studies may limit definitive conclusions. Although routine surgery within 48 hr after admission is hard to achieve in most facilities, anesthesiologists must be aware that an undue delay may be harmful to hip fracture patients, especially those at relatively low risk or those who are young.
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Review Comparative Study
Brief review: the Cobra Perilaryngeal Airway (CobraPLA and the Streamlined Liner of Pharyngeal Airway (SLIPA) supraglottic airways.
To summarize the published literature related to two, new supraglottic airways (SGAs): the Cobra Perilaryngeal Airway (CobraPLA) and the Streamlined Liner of Pharyngeal Airway (SLIPA). ⋯ Both the CobraPLA and the SLIPA are intended for use during short procedures under general anesthesia, and have comparable efficacy and complication rates in comparison to the LMA Classic. Both airways may be considered as primary SGA devices, and the CobraPLA may be also be used as a rescue airway device.
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Review
Transcranial Doppler monitoring in subarachnoid hemorrhage: a critical tool in critical care.
To review the literature regarding the use of transcranial Doppler ultrasonography (TCD) for monitoring cerebral vasospasm following subarachnoid hemorrhage (SAH). ⋯ Vasospasm following SAH is a very important source of morbidity and mortality. Too often, the first sign is a neurologic deficit, which may be too late to reverse. Transcranial Doppler ultrasonography assists in the clinical decision-making regarding further diagnostic evaluation and therapeutic interventions. When performed in isolation, the contribution of TCD to improving patient outcome has not been established. Nevertheless, TCD has become a regularly employed tool in neurocritical care and perioperative settings.
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Review Case Reports
[Serotonin syndrome following methylene blue infusion during parathyroidectomy: a case report and literature review].
To report a case of autonomic, neurological and neuromuscular instability following methylene blue infusion for parathyroidectomy; to advance the argument for a diagnosis of serotonin syndrome; and to consider this diagnosis in previous, unexplained reports of adverse reactions amongst patients undergoing parathyroidectomy using methylene blue. ⋯ An interaction between methylene blue and serotonergic agents may give rise to the serotonin syndrome. Consideration should be given to avoiding methylene blue in patients taking serotonergic agents. The diagnosis should be considered in patients with autonomic, neuromuscular or neurological changes and should be managed accordingly.