Articles: anesthesia.
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Editorial Review
New device, old algorithm? Bridging generations in perioperative coagulation management.
Viscoelastic testing permits targeted correction of coagulopathy in bleeding patients. As new generations of viscoelastic testing platforms become available, research exploring similarities and differences with older devices can provide insight for institutions seeking to use the newer technologies. Care must be taken to ensure such studies are designed to produce clinically meaningful guidance for adapting existing treatment algorithms to accommodate the latest viscoelastic testing technology.
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Editorial Letter
NAP7: high mortality risk in neonates and very low risk in children.
Editor-We congratulate Lyne and colleagues1 on their initiative to explore and improve consent around perioperative mortality in children. Providing such data for families and clinicians is a key purpose of the Royal College of Anaesthetists' National Audit Projects (NAPs), and to this end, NAP7 studied perioperative cardiac arrest.2-4.
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Large, randomised trials are the bedrock of evidence-based medicine, but the resources required to complete such trials greatly limit the number of important clinical questions that can be addressed within a reasonable period of time. Adaptive platform trials can identify effective, ineffective, or harmful treatments faster. These trials have been shown to deliver rapid evidence through the COVID-19 pandemic and are now being adopted across surgery and anaesthesia, with many opportunities for surgeons, anaesthetists, and other perioperative physicians to conduct and collaborate in platform trials.