Anaesthesia
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Multicenter Study
The association between platelet dysfunction and adverse outcomes in cardiac surgical patients.
Haemostatic activation during cardiopulmonary bypass is associated with prothrombotic complications. Although it is not possible to detect and quantify haemostatic activation directly, platelet dysfunction, as measured with point-of-care-assays, may be a useful surrogate. In this study, we assessed the association between cardiopulmonary bypass-associated platelet dysfunction and adverse outcomes in 3010 cardiac surgical patients. ⋯ The median (IQR [range]) percentage platelet dysfunction was less for those without the outcome as compared with those with the outcome; 14% (8-28% [1-99%]) vs. 19% (11-45% [2-98%]), p < 0.001. After risk adjustment, platelet dysfunction was independently associated with the composite outcome (p < 0.001), such that for each 1% increase in platelet dysfunction there was an approximately 1% increase in the composite outcome (OR 1.012; 95%CI 1.006-1.018). This exploratory study suggests that cardiopulmonary bypass-associated platelet dysfunction has prognostic value and may be a useful clinical measure of haemostatic activation in cardiac surgery.
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Multicenter Study
A survey of antenatal and peripartum provision of information on analgesia and anaesthesia.
A significant proportion of women do not recall intrapartum information before labour analgesia (38%) or anaesthesia for cesarean section (72%). Verbally-provided information was best recalled.
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Observational Study
Time to oxygenation for cannula- and scalpel-based techniques for emergency front-of-neck access: a wet lab simulation using an ovine model.
In a wet-lab cannot-intubate cannot-oxygenate front-of-neck access simulation, a needle-cannula technique resulted in faster and more reliable oxygen delivery than scalpel-bougie.
pearl