British journal of anaesthesia
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Multicenter Study Comparative Study Clinical Trial Observational Study
Association between tracheostomy timing and outcomes for older critically ill COVID-19 patients: prospective observational study in European intensive care units.
Tracheostomy is performed in patients expected to require prolonged mechanical ventilation, but to date optimal timing of tracheostomy has not been established. The evidence concerning tracheostomy in COVID-19 patients is particularly scarce. We aimed to describe the relationship between early tracheostomy (≤10 days since intubation) and outcomes for patients with COVID-19. ⋯ ClinicalTrials.gov NCT04321265.
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There is variation in care quality and outcomes for children undergoing emergency abdominal surgery, such as appedectomy. Addressing this requires paediatric-specific quality metrics. The aim of this study was to identify perioperative structure and process measures that are associated with improved outcomes for these children. ⋯ PROSPERO CRD42017055285.
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Editorial Comment
Epidural labour analgesia and autism spectrum disorder: is the current evidence sufficient to dismiss an association?
Findings from a population-based study using a sibling-matched analysis published in this issue of the British Journal of Anaesthesia indicate that epidural labour analgesia is not associated with an increased risk of autism spectrum disorder. These findings are consistent with those from three other population-based studies that used similar methodological approaches. Cumulatively, these robust, high-quality epidemiological data support the assertion that there is no meaningful association between epidural labour analgesia and autism spectrum disorder in offspring.
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Letter Randomized Controlled Trial
A randomised trial of adaptive support ventilation in patients with neuroparalytic snake envenomation.
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Despite substantial advocacy for the scientific community to focus on sex-specific differences in biology, the role of sex hormones remains inadequately studied in the field of anaesthesia-induced developmental neurotoxicity. A recent study by Yang and colleagues published in this journal addresses the importance of studying sex hormones during critical stages of brain development. The authors demonstrate that exogenous testosterone administered to immature mice pups around the time of sevoflurane exposure increased brain levels of testosterone, attenuated tau phosphorylation, inhibited glycogen synthase kinase-3β activation and its interaction/binding with tau, reversed sevoflurane-induced decreases in neuronal activation, and attenuated cognitive impairments. Their well-designed experiments suggest an important role that testosterone plays in balancing several important pathways crucial for neuronal protection and normal function of neuronal circuits in the male mammalian brain.