British journal of anaesthesia
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Citation scores (CS) are traditionally used to measure the impact of scientific publications. Altmetric Attention Scores (AAS), in contrast, consider the digital dissemination of articles across social media platforms to track their audience reach. In this cross-sectional study, we aimed to determine the correlation between AAS and CS in 12 high-impact-factor journals in the category of 'Clinical Medicine'. ⋯ Altmetric Attention Scores correlated with citation scores, suggesting that audience engagement via social media can influence the future impact of publications and their citation scores.
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The ability of current depth-of-anaesthesia monitors to differentiate subtle changes in the conscious state has not been well characterised. We examine the variability in bispectral index (BIS) scores associated with disconnected conscious and unconscious states as confirmed by a novel serial awakening paradigm. ⋯ These results agree with previous studies that BIS scores fail to reliably differentiate between states of consciousness, exacerbated by segregating connected, disconnected, and unconscious states. To develop a method that reliably identifies the conscious state of an individual (not an average), work is needed to establish the causal mechanisms of disconnection and unconsciousness.
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Meta Analysis Comparative Study
Comparative efficacy of balanced crystalloids versus 0.9% saline on delayed graft function and perioperative outcomes in kidney transplantation: a meta-analysis of randomised controlled trials.
Delayed graft function after kidney transplantation is linked to poor graft survival and increased chronic allograft injury. Recent guidelines suggest using balanced crystalloids over 0.9% saline owing to better metabolic profiles, but their impact on DGF remains unclear. ⋯ Balanced crystalloid intravenous fluid therapy reduced delayed graft function incidence and maintained more favourable serum chemistry profiles compared with 0.9% saline in patients undergoing kidney transplantation. However, crystalloid type did not significantly influence vasopressor requirements and length of hospital stay.
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Clinical guidelines and consensus statements are an essential aid to clinical practice. However, they bring with them risks. ⋯ This editorial explores the challenges of producing robust consensus statements and guidelines that have impact, and identifies current frameworks for addressing these. It is important to conduct clinical consensus exercises using recognised and accepted methodologies.