British journal of anaesthesia
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Randomized Controlled Trial Multicenter Study
Intraoperative tranexamic acid use in major spine surgery in adults: a multicentre, randomized, placebo-controlled trial†.
Perioperative tranexamic acid (TXA) use can reduce bleeding and transfusion requirements in several types of surgery, but level I evidence proving its effectiveness in major spine surgery is lacking. This study was designed to investigate the hypothesis that TXA reduces perioperative blood loss and transfusion requirements in patients undergoing major spine procedures. ⋯ NCT01136590.
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Multicenter Study
Change in end-tidal carbon dioxide outperforms other surrogates for change in cardiac output during fluid challenge.
During fluid challenge, volume expansion (VE)-induced increase in cardiac output (Δ VE CO) is seldom measured. ⋯ Δ VE E'CO2 outperformed Δ VE PP, Δ VE SBP, Δ VE MBP, Δ VE FemFlow, and Δ VE HR and, during protective ventilation, arrhythmia, or both, it also outperformed Δ VE PPV. A value of Δ VE E'CO2 >1 mm Hg (>0.13 kPa) indicated a likely response to VE.