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Note that the reported ’reduction in respiratory failure’ was entirely due to a small difference in post-op ventilation duration in the ICU between the groups. Significant, but perhaps not clinically remarkable.
Rigg JR, Jamrozik K, Myles PS et al. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet. 2002 Apr 13; 359 (9314): 127612821276-82.
  Daniel Jolley
pearl
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Perioperative epidural analgesia in high-risk patients undergoing major abdominal surgery improves analgesia but does not have other morbidity or mortality benefits.
Rigg JR, Jamrozik K, Myles PS et al. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet. 2002 Apr 13; 359 (9314): 127612821276-82.
  Daniel Jolley
pearl
1
Intraoperative warming of patients avoids hypothermia, reduces wound infection and shortens hospital stay after colorectal surgery.
Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N. Engl. J. Med. 1996 May 9;334(19):1209-15.
  Daniel Jolley
pearl
1
Perioperative aspirin use does not reduce mortality or myocardial infraction, but does increase the risk of major bleeding.
Devereaux PJ, Mrkobrada M, Sessler DI et al. Aspirin in patients undergoing noncardiac surgery. N. Engl. J. Med. 2014 Apr 17;370(16):1494-503.
  Daniel Jolley
pearl
1
Plasma fibrinogen measurement is usually a more important target in post-partum hemorrhage than other coagulation lab results.
Collins PW, Bell SF, de L et al. Management of postpartum haemorrhage: from research into practice, a narrative review of the literature and the Cardiff experience. Int J Obstet Anesth. 2019 Feb 1; 37: 106-117.
  Daniel Jolley
pearl
1
The surgeon-anesthesiologist relationship is probably the most critical in determining overall team performance.
Cooper JB. Critical Role of the Surgeon-Anesthesiologist Relationship for Patient Safety. Anesthesiology. 2018 Sep 1; 129 (3): 402-405.
  Daniel Jolley
pearl
1
In traumatic brain injury resuscitation with albumin is associated with a higher mortality than resuscitation with saline.
SAFE Study Investigators, Australian New Zealand Intensive Care Society Clinical Trials Group, Australian Red Cross Blood Service et al. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. N. Engl. J. Med. 2007 Aug 30;357(9):874-84.
  Daniel Jolley
pearl
1
ICU resuscitation with either normal saline or 4% albumin results in similar outcomes, in the absence of traumatic brain injury.
Finfer S, Bellomo R, Boyce N et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N. Engl. J. Med. 2004 May 27;350(22):2247-56.
  Daniel Jolley
comment
0
Hmmm... not particularly helpful.
Lewis SR, Pritchard MW, Schofield-Robinson OJ et al. Continuation versus discontinuation of antiplatelet therapy for bleeding and ischaemic events in adults undergoing non-cardiac surgery. Cochrane Db Syst Rev. 2018 Jul 18; 7: CD012584.
  Daniel Jolley
pearl
1
High troponin levels pre-operatively are associated with cardiac events and mortality after non-cardiac surgery.
Shen JT, Xu M, Wu Y et al. Association of pre-operative troponin levels with major adverse cardiac events and mortality after noncardiac surgery: A systematic review and meta-analysis. Eur J Anaesthesiol. 2018 Nov 1; 35 (11): 815-824.
  Daniel Jolley