British journal of anaesthesia
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Randomized Controlled Trial Multicenter Study
An educational intervention to reduce the incidence of postoperative residual curarisation: a cluster randomised crossover trial in patients undergoing general anaesthesia.
The incidence of postoperative residual curarisation remains unacceptably high. We assessed whether an educational intervention on perioperative neuromuscular block management can reduce it. ⋯ NCT03128151.
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Multicenter Study
German Patient Blood Management Network: effectiveness and safety analysis in 1.2 million patients.
Patient Blood Management (PBM) is a patient-centred, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient's own blood whilst promoting patient safety and empowerment. The effectiveness and safety of PBM over a longer period have not yet been investigated. ⋯ NCT02147795.
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Over the past century, education has been a core component for improving patient safety. The initial focus was developing a curriculum and an assessment process. ⋯ Conceptions of feedback have moved from a transactional information transfer from the supervisor to the trainee to a learner-centred and collaborative process occurring in a complex socio-cultural environment. In this narrative review we describe the evolution of the feedback conversation, provide a model synthesising the core concepts of feedback, and offer some guidance for the development of effective feedback in anaesthesia education.
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Major cardiac surgery related blood loss is associated with increased postoperative morbidity and mortality. Platelet dysfunction is believed to contribute to post-cardiopulmonary bypass (CPB)-induced microvascular bleeding. We hypothesised that moderately hypothermic CPB induces platelet dysfunction and that supplemental fibrinogen can restore in vitro thrombus formation. ⋯ Single valve surgery using moderately hypothermic CPB induces partial platelet dysfunction. Thrombus formation was restored in an experimental study design by ex vivo supplementation of fibrinogen.
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Editorial Comment
Phase-amplitude coupling during maintenance of general anaesthesia: towards a better understanding of anaesthetic-induced brain dynamics in children.
Electroencephalogram signatures associated with anaesthetic-induced loss of consciousness have been widely described in adult populations. A recent study helps verify our understanding of brain dynamics induced by anaesthetics in a paediatric population by describing a specific pattern in terms of an interaction of the phase of delta oscillations and the amplitude of alpha oscillations. This feature has potential translational implications for optimising future monitoring technologies.