British journal of anaesthesia
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Letter Randomized Controlled Trial
Nocturnal desaturation early after delivery: impact of delivery type and the beneficial effects of Fowler's position.
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Randomized Controlled Trial
Dexamethasone as an adjuvant for peripheral nerve blockade: a randomised, triple-blinded crossover study in volunteers.
The efficacy of dexamethasone in extending the duration of local anaesthetic block is uncertain. In a randomised controlled triple blind crossover study in volunteers, we tested the hypothesis that neither i.v. nor perineurally administered dexamethasone prolongs the sensory block achieved with ropivacaine. ⋯ DRKS, 00014604; EudraCT, 2018-001221-98.
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The factors determining peak susceptibility of the developing brain to anaesthetics are unclear. It is unknown why postnatal day 7 (P7) male rats are more vulnerable to anaesthesia-induced memory deficits than littermate females. Given the precocious development of certain regions in the female brain during the neonatal critical period, we hypothesised that females are susceptible to anaesthetic brain injury at an earlier time point than previously tested. ⋯ Female rats exposed to Iso at P4 are sensitive to anaesthetic injury historically observed in P7 males. This is consistent with a comparably immature developmental state in P4 females and P7 males. The window of anaesthetic vulnerability correlates with sex-specific cortical expression of chloride transporters NKCC1 and KCC2. These findings suggest that both sex and developmental age play important roles in determining the outcome after early anaesthesia exposure.
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There is a reproducibility crisis in science. There are many potential contributors to replication failure in research across the translational continuum. In this perspective piece, we focus on the narrow topic of inferential reproducibility. ⋯ Lack of contextualisation using systematic reviews, overinterpretation and misinterpretation of results, and insufficient acknowledgement of limitations are common problems in Discussion sections; these deficiencies can harm the translational process. Proposed solutions include eliminating or not reading Discussions, writing accompanying editorials, and post-publication review and comments; however, none of these solutions works very well. A second Discussion written by an independent author with appropriate expertise in research methodology is a new testable solution that could help probe inferential reproducibility, and address some deficiencies in primary Discussion sections.
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Comparative Study
Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery.
The vasoactive-inotropic score (VIS) predicts mortality and morbidity after paediatric cardiac surgery. Here we examined whether VIS also predicted outcome in adults after cardiac surgery, and compared predictive capability between VIS and three widely used scoring systems. ⋯ In adults after cardiac surgery, VISmax predicted a composite of unfavourable outcomes and predicted mortality up to 1 yr after surgery.