British journal of anaesthesia
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European Society of Cardiology/European Society of Anaesthesiology (ESC/ESA) guidelines inform cardiac workup before noncardiac surgery based on an algorithm. Our primary hypotheses were that there would be associations between (i) the groups stratified according to the algorithms and major adverse cardiac events (MACE), and (ii) over- and underuse of cardiac testing and MACE. ⋯ NCT02573532.
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Observational Study
Association between perioperative allogeneic red blood cell transfusion and infection after clean-contaminated surgery: a retrospective cohort study.
Allogeneic red blood cell (RBC) transfusion can induce immunosuppression, which can then increase the susceptibility to postoperative infection. However, studies in different types of surgery show conflicting results regarding this effect. ⋯ Perioperative allogeneic RBC transfusion is associated with an increased risk of infection after clean-contaminated surgery in a dose-response manner. Close monitoring of infections and enhanced prophylactic strategies should be considered after transfusion.
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Communication amongst team members is critical to providing safe, effective medical care. We investigated the role of communication failures in patient injury using the Anesthesia Closed Claims Project database. ⋯ Communication failure contributed to patient injury in 43% of anaesthesia malpractice claims. Patient/case characteristics in claims with communication failures were similar to those without failures, except that failures were more common in outpatient settings.
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Comparative Study
Dimensional compatibility of currently available equipment for cricothyroidotomy and adult airway anatomy: an in vitro analysis.
There are scant data on the dimensional compatibility of cricothyroidotomy equipment and related airway anatomy. We compared the dimensional design of devices for cricothyroidotomy with anatomical airway data for adult patients. ⋯ The outer diameter of many devices currently marketed for cricothyroidotomy are oversized for adult airway anatomy, particularly for females. For emergency front-of-neck access through the cricothyroid membrane, anatomical data suggest that cricothyroidotomy devices with outer tube diameters of <7 mm for male and <6 mm for female adult patients should be preferred.