Trending Articles
-
Randomized Controlled Trial Observational Study
Concurrence of Intraoperative Hypotension, Low Minimum Alveolar Concentration, and Low Bispectral Index Is Associated with Postoperative Death.
An intraoperative concurrence of mean arterial pressure less than 75 mmHg, minimum alveolar concentration less than 0.8, and bispectral index less than 45 has been termed a "triple low" state. An association between triple low and postoperative mortality has been reported but was not replicated in a subsequent study. The authors pooled existing data from clinical trials to further evaluate the purported association in an observational study. ⋯ There is a weak independent association between the triple low state and postoperative mortality, and the propensity-matched analysis does not suggest that this is an epiphenomenon.
-
European heart journal · Oct 2019
Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.
Taking oral antihypertensive agents at bedtime rather than the morning, improves BP control and reduces the incidence of cardiac death, myocardial infarct, revascularization, heart failure and stroke.
pearl -
We tested the ability of mean acceleration (Acc) and peak velocity (V peak) of the aortic velocity signal measured by oesophageal Doppler to reflect left ventricular (LV) systolic performance. ⋯ V peak and, to a lesser extent, Acc measured by oesophageal Doppler behaved as markers of LV systolic performance as they were almost insensitive to fluid administration and changed to a much larger extent with dobutamine. These indices could be used to estimate LV systolic performance and to assess the effects of inotropic therapy.
-
Calabadion is a new heterocyclic molecule that offers rapid and complete reversal of both aminosteroids, such as rocuronium, and benzylisoquinoline NMBDS, such as cisatracurium.
summary -
Pre-operative oral carbohydrate decreases postoperative insulin resistance, speeds gastrointestinal functional recovery and reduces hospital stay, most significantly after major surgery.
pearl