British journal of anaesthesia
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Advances in computer technology, patient monitoring systems, and electronic health record systems have enabled rapid accumulation of patient data in electronic form (i.e. big data). Organizations such as the Anesthesia Quality Institute and Multicenter Perioperative Outcomes Group have spearheaded large-scale efforts to collect anaesthesia big data for outcomes research and quality improvement. ⋯ Visual analytics is the science of analytical reasoning facilitated by interactive visual interfaces, and it can facilitate performance of cognitive activities involving big data. Ongoing integration of big data and analytics within anaesthesia and health care will increase demand for anaesthesia professionals who are well versed in both the medical and the information sciences.
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Review Meta Analysis
Aspirin and coronary artery surgery: a systematic review and meta-analysis.
Aspirin administration before cardiac surgery represents a balance between preventing perioperative thrombotic events and promoting surgical bleeding. Clear evidence to guide the preoperative use of aspirin in patients undergoing cardiac surgery is lacking.This systematic review and meta-analysis was performed to evaluate the efficacy and safety of preoperative aspirin, in patients undergoing coronary artery surgery. ⋯ In patients undergoing coronary artery surgery, preoperative aspirin reduces perioperative MI, but at a cost of increased bleeding, blood transfusion, and surgical re-exploration.
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Observational Study
Emergence from general anaesthesia and evolution of delirium signs in the post-anaesthesia care unit.
Emergence from anaesthesia is often accompanied by signs of delirium, including fluctuating mental status and inattention. The evolution of these signs of delirium requires investigation since delirium in the post-anaesthesia care unit (PACU) may be associated with worse outcomes. ⋯ A significant proportion of patients develop delirium signs in the immediate postoperative period, primarily manifesting with a hypoactive subtype. These signs often persist to PACU discharge, suggesting the need for structured delirium monitoring in the PACU to identify patients potentially at risk for worse outcomes in the postoperative period.
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Tissue oxygen tension is the partial pressure of oxygen within the interstitial space of an organ bed. As it represents the balance between local oxygen delivery and consumption at any given time, it offers a ready monitoring capability to assess the adequacy of tissue perfusion relative to local demands. This review covers the various methodologies used to measure tissue oxygen tension, describes the underlying physiological and pathophysiological principles, and summarizes human and laboratory data published to date.