British journal of anaesthesia
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Randomized Controlled Trial
Evaluation of the intratidal compliance profile at different PEEP levels in children with healthy lungs: a prospective, crossover study.
Optimal intraoperative lung protective ventilation (LPV) strategies in young children are largely under-explored. Individualised PEEP levels are likely to contribute to optimal lung protection. We determined optimal PEEP levels in young children during general anaesthesia by evaluating changes in intratidal compliance with varying PEEP. ⋯ NCT03533296.
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Review
Analysis of practices to promote reproducibility and transparency in anaesthesiology research.
Reliable, high-quality research is essential to the field of anaesthesiology. Reproducibility and transparency have been investigated in the biomedical domain and in the social sciences, with both lacking to provide necessary information to reproduce the study findings. In this study, we investigated 14 indicators of reproducibility in anaesthesiology research. ⋯ Anaesthesiology research needs to improve indicators of reproducibility and transparency. By making research publicly available and improving accessibility to detailed study components, primary research can be reproduced in subsequent studies and help contribute to the development of new practice guidelines.
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Randomized Controlled Trial
Neutrophil extracellular trapping and angiogenesis biomarkers after intravenous or inhalation anaesthesia with or without intravenous lidocaine for breast cancer surgery: a prospective, randomised trial.
Experimental and, retrospective, clinical data indicate that anaesthetic technique might influence the risk of metastasis after cancer surgery. Neutrophil extracellular trapping (NETosis) is an immunological mechanism strongly linked with increased metastatic risk. Similarly, vascular endothelial growth factor A is linked to angiogenesis implicated in recurrence. Therefore, we investigated the effect of four anaesthetic techniques on NETosis and angiogenic factors expression in women undergoing breast cancer resection. ⋯ NCT02839668.
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Multicenter Study
Frailty and long-term postoperative disability trajectories: a prospective multicentre cohort study.
Frailty is associated with early postoperative outcomes. How frailty influences long-term postoperative recovery is poorly described. Our objective was to evaluate the association of frailty with postoperative disability trajectories in the year after surgery. ⋯ Decision-making and care planning should integrate the possible trade-offs between early adverse outcomes with longer-term benefit when frailty is present in older surgical patients.
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Observational Study
MicroRNA signatures of perioperative myocardial injury after elective noncardiac surgery: prospective observational mechanistic cohort study.
Elevated plasma or serum troponin, indicating perioperative myocardial injury (PMI), is common after noncardiac surgery. However, underlying mechanisms remain unclear. Acute coronary syndrome (ACS) is associated with the early appearance of circulating microRNAs, which regulate post-translational gene expression. We hypothesised that if PMI and ACS share pathophysiological mechanisms, common microRNA signatures should be evident. ⋯ Circulating microRNAs associated with cardiac ischaemia were universally elevated in patients after surgery, independent of development of myocardial injury.