Articles: cations.
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Minerva anestesiologica · Jun 2019
Meta Analysis Comparative StudyInhalation versus intravenous anesthesia for adults undergoing heart valve surgery: a systematic review and meta-analysis.
Many studies have found that volatile anesthetics are associated with improved clinical outcomes for adults undergoing coronary artery bypass grafting. However, the effect of volatile anesthetics for adults after heart valve surgery has been unclear. So we conducted a meta-analysis of randomized controlled trials (RCTs) to explore whether the choice of an anesthetic regimen might influence patients' outcomes after valve surgery. ⋯ Among patients undergoing heart valve surgery, the use of inhalation anesthesia compared with TIVA failed to demonstrate superiority for survival and major postoperative complications, and the evidence was insufficient to draw firm conclusions due to the limited sample size. A determination of equivalence or superiority between these two anesthetic regimens requires further researches.
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Semin Respir Crit Care Med · Jun 2019
ReviewAdvances and Controversies in Thoracentesis and Medical Thoracoscopy.
Pleural effusions are common and associated with high morbidity and mortality. Whereas thoracentesis can assist in achieving a diagnosis or therapy, advances in education and in the technique may prevent morbidity associated with the procedure. Medical thoracoscopy is often useful for undiagnosed effusions, as well as for therapeutic purposes. ⋯ These include biopsies using a diathermic knife as well as cryoprobes. Similarly, adhesiolysis or other techniques to improve therapy in multiloculated effusions using medical thoracoscopy are contested. This review attempts to synthesize recent advances and controversies in thoracentesis and medical thoracoscopy as clinicians head into the next decade of treatment.