British journal of anaesthesia
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This study aimed to assess whether a driving pressure-limiting strategy based on positive end-expiratory pressure (PEEP) titration according to best respiratory system compliance and tidal volume adjustment increases the number of ventilator-free days within 28 days in patients with moderate to severe acute respiratory distress syndrome (ARDS). ⋯ NCT04972318.
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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) potentially increase the risk of pulmonary aspiration resulting from impaired gastric emptying (IGE). We evaluated the association between GLP-1RAs and IGE using the US Food and Drug Administration Adverse Event Reporting System (FAERS). ⋯ GLP-1RAs were notably associated with reports of impaired gastric emptying in the FAERS. Age, weight, and sex were significantly associated with impaired gastric emptying risk for certain GLP-1RAs. IGE events tended to occur early in treatment, with risk diminishing over time. These findings provide valuable references for future research on perioperative safety with GLP-1RAs.
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In a previous phase II trial, intraperitoneal local anaesthetics shortened the time interval between surgery and adjuvant chemotherapy, an endpoint associated with improved survival in advanced ovarian cancer. Our objective was to test this in a phase III trial. ⋯ ClinicalTrials.gov (NCT04065009), European Union Clinical Trials Register (2019-003299-38/SE).
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Recent advances in artificial intelligence (AI) have enabled development of natural language algorithms capable of generating coherent texts. We evaluated the quality, validity, and safety of this generative AI in preoperative anaesthetic planning. ⋯ Preoperative anaesthetic plans generated by ChatGPT did not consistently meet minimum clinical standards and were unlikely the result of clinical reasoning. Therefore, ChatGPT is currently not recommended for preoperative planning. Future large language models trained on anaesthesia-specific datasets might improve performance but should undergo vigorous evaluation before use in clinical practice.
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Optimal composition and infusion rates of intravenous maintenance fluids for children undergoing surgery are not well defined. Avoidance of hypoglycaemia, ketosis, and hyponatraemia is important, and current guidelines recommend isotonic fluids containing 1.0-2.5% glucose. However, evidence for its safe use in infants is insufficient. The aim of this study was to investigate whether normoglycaemia is maintained in infants using a balanced electrolyte maintenance infusion with 1% glucose. ⋯ ACTRN12619000833167.