British journal of anaesthesia
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Review Meta Analysis
Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis.
Ultrasound is a well-validated adjunct to central venous cannulation; however, previous reviews of ultrasound-guided radial artery cannulation have been inconclusive. The aim of this study was to assess the use of ultrasound in radial artery cannulation in adult and paediatric populations. ⋯ This is the first level one systematic review to demonstrate strong evidence for the use of ultrasound guidance in radial artery cannulation in adult and paediatric populations. In the adult population, ultrasound use significantly increased first-attempt success rate, which subsequently resulted in a significant reduction in the number of attempts. The benefits of ultrasound were also shown in the paediatric population, with a significant increase in first-attempt success rate and reduction in the number of attempts. The use of ultrasound as an adjunct to radial arterial cannulation should now be considered best practice.
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Randomized Controlled Trial Multicenter Study
Postpartum haemorrhage related early increase in D-dimers is inhibited by tranexamic acid: haemostasis parameters of a randomized controlled open labelled trial.
Beneficial effects of tranexamic acid (TA) have been established in surgery and trauma. In ongoing postpartum haemorrhage (PPH), a moderate reduction of blood loss was observed in a previously published randomized controlled trial. Analysis of haemostasis parameters obtained from samples collected as part of this study are presented. ⋯ ISRCTN09968140.
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Multicenter Study
Persistent pain is common 1 year after ankle and wrist fracture surgery: a register-based questionnaire study.
Substantial literature documents that persistent postsurgical pain is a possible outcome of many common surgical procedures. As fracture-related surgery implies a risk of developing neuropathic pain and complex regional pain syndrome (CRPS), further studies investigating the prevalence and pain characteristics are required. ⋯ Persistent postsurgical pain 1 yr after wrist and ankle fracture surgery is frequent, and a large proportion of patients experience symptoms suggestive of neuropathic pain and CRPS. Patients should be informed about the substantial risk of developing persistent postsurgical pain. Future studies investigating risk factors for persistent postsurgical pain that include both surgically and conservatively treated fractures are required.
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Letter Meta Analysis
Aspirin and coronary artery surgery: an updated meta-analysis.
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Comparative Study Observational Study
A Comparison of the Mallampati evaluation in neutral or extended cervical spine positions: a retrospective observational study of >80 000 patients.
The Mallampati examination is a standard component of an airway risk assessment. Existing evidence suggests that cervical spine extension improves the predictive power of the Mallampati examination for detecting difficult laryngoscopy and tracheal intubation, but a comparative effectiveness study has not been conducted. ⋯ This retrospective observational study demonstrates that cervical extension improves the specificity but decreases sensitivity of Mallampati examination. The Mallampati evaluation should be performed with the cervical spine in the neutral position to maximize test sensitivity.