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pearl
1
Although feasible, non-surgical antibiotic treatment of uncomplicated acute appendicitis is associated with both a lower treatment success rate and higher complication rate than primary surgical appendicectomy.
Podda M, Gerardi C, Cillara N et al. Antibiotic Treatment and Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children: A Systematic Review and Meta-analysis. Ann. Surg. 2019 Dec 1; 270 (6): 1028-1040.
  Daniel Jolley
pearl
1
Corticosteroids may reduce length of ICU stay in patients with septic shock.
Wen Y, Zhu Y, Jiang Q et al. The Effectiveness and Safety of Corticosteroids Therapy in Adult Critical Ill Patients With Septic Shock: A Meta-Analysis of Randomized Controlled Trials. Shock. 2019 Aug 1; 52 (2): 198-207.
  Daniel Jolley
pearl
1
Corticosteroids may reduce 28 day mortality in patients with severe sepsis or septic shock.
Ni YN, Liu YM, Wang YW et al. Can corticosteroids reduce the mortality of patients with severe sepsis? A systematic review and meta-analysis. Am J Emerg Med. 2019 Sep 1; 37 (9): 1657-1664.
  Daniel Jolley
pearl
1
Point-of-care ultrasound performed by emergency physicians to diagnose intussusception has a diagnostic accuracy equivalent to radiology-performed ultrasound.
Tsou PY, Wang YH, Ma YK et al. Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis. Am J Emerg Med. 2019 Sep 1; 37 (9): 1760-1769.
  Daniel Jolley
pearl
1
Intravenous resuscitation with balanced crystalloid fluids does not reduce mortality or kidney injury compared with normal saline in critically ill patients.
Liu C, Lu G, Wang D et al. Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis. Am J Emerg Med. 2019 Nov 1; 37 (11): 2072-2078.
  Daniel Jolley
pearl
1
Suprascapular block may be an acceptable and safer alternative to interscalene block for analgesia after shoulder surgery.
Hussain N, Goldar G, Ragina N et al. Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2017 Dec 1; 127 (6): 998-1013.
  Daniel Jolley
pearl
1
Use of processed-EEG monitoring to guide anaesthesia depth is associated with a 38% odds reduction of developing postoperative delirium.
MacKenzie KK, Britt-Spells AM, Sands LP et al. Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis. Anesthesiology. 2018 Sep 1; 129 (3): 417-427.
  Daniel Jolley
pearl
0
Up to 20% of patients ≥ 65 years experience post-operative delirium after major surgery.
MacKenzie KK, Britt-Spells AM, Sands LP et al. Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis. Anesthesiology. 2018 Sep 1; 129 (3): 417-427.
  Daniel Jolley
pearl
1
Major adverse cardiac events and death after electroconvulsive therapy are infrequent and occur in about 1 of 50 patients and after about 1 of 200 to 500 electroconvulsive therapy treatments.
Duma A, Maleczek M, Panjikaran B et al. Major Adverse Cardiac Events and Mortality Associated with Electroconvulsive Therapy: A Systematic Review and Meta-analysis. Anesthesiology. 2019 Jan 1; 130 (1): 83-91.
  Daniel Jolley
pearl
1
The pectoralis-II myofascial block for breast cancer surgery is a safe and effective alternative to the paravertebral block, demonstrating non-inferiority for 24 hour pain and analgesia need.
Hussain N, Brull R, McCartney Colin J L CJL et al. Pectoralis-II Myofascial Block and Analgesia in Breast Cancer Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2019 Sep 1; 131 (3): 630-648.
  Daniel Jolley