Articles: adult.
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Several recently published randomized controlled trials have evaluated various noninvasive oxygenation strategies for the treatment of acute hypoxemic respiratory failure. ⋯ A helmet interface for noninvasive ventilation probably reduces mortality and the risk of mechanical ventilation, as well as the duration of hospital and ICU stay. An HFNC probably reduces the risk of invasive mechanical ventilation and may be as comfortable as SOT. Further research is necessary to understand the role of these interfaces in acute hypoxemic respiratory failure.
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Minerva anestesiologica · Oct 2023
Meta AnalysisPharmacologic interventions for the therapy of postanesthetic shivering in adults: a systematic review and network meta-analysis.
Shivering is a common side effect after general anesthesia. Risk factors are hypothermia, young age and postoperative pain. Severe complications of shivering are rare but can occur due to increased oxygen consumption. Previous systematic reviews are outdated and have summarized the evidence on the topic using only pairwise comparisons. The objective of this manuscript was a quantitative synthesis of evidence on pharmacological interventions to treat postanesthetic shivering. ⋯ Nefopam, tramadol, pethidine and clonidine are the most effective treatments to stop postanesthetic shivering. The efficacy of doxapram is uncertain since different doses showed contradictory effects and the evidence for methylphenidate is based on a single comparison in only one network. Furthermore, both lack data on side effects. Further studies are needed to clarify the efficacy of dexmedetomidine to treat postanesthetic shivering.
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Comment Meta Analysis
In adults, MRAs reduce AF occurrence vs. non-MRAs.
Fatima K, Asad D, Shaikh N, et al. A systematic review and meta-analysis on effectiveness of mineralocorticoid receptor antagonists in reducing the risk of atrial fibrillation. Am J Cardiol. 2023;199:85-91. 37269781.
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Meta Analysis
Factors Influencing Primary Care Practitioners' Cancer Screening Recommendations for Older Adults: a Systematic Review.
Primary care practitioners (PCPs) play a key role in cancer screening decisions for older adults (≥ 65 years), but recommendations vary by cancer type and jurisdiction. ⋯ NHMRC APP1113532.
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Atypical antipsychotic (AAP) augmentation is an alternative strategy for patients with major depressive disorder (MDD) who had an inadequate response to antidepressant therapy (ADT). We aimed to compare and rank the efficacy and safety of 4 AAPs in the adjuvant treatment of MDD. ⋯ Adjuvant AAPs had significant efficacy compared with PBO, but treatment decisions must be made to balance the risks and benefits.