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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
pearl
1
Elective surgery should be delayed at least 9 months after stroke or cerebrovascular event, although there is a persisting increased risk of perioperative stroke in these patients.
Jørgensen ME, Torp-Pedersen C, Gislason GH et al. Time elapsed after ischemic stroke and risk of adverse cardiovascular events and mortality following elective noncardiac surgery. JAMA. 2014 Jul 16;312(3):269-77.
  Daniel Jolley
pearl
1
The intravascular expansion effect of 20% albumin is roughly double its infused volume, although 15% greater again in the healthy versus those with sepsis.
Margarson MP Soni NC. Changes in serum albumin concentration and volume expanding effects following a bolus of albumin 20% in septic patients. Br J Anaesth. 2004 Jun 1; 92 (6): 821-6.
  Daniel Jolley
pearl
1
Although daily low-dose aspirin reduces vascular events in those with diabetes but no cardiovascular history, it does this at the expense of major hemorrhage risk.
ASCEND Study Collaborative Group, Bowman L, Mafham M et al. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N. Engl. J. Med. 2018 Oct 18; 379 (16): 1529-1539.
  Daniel Jolley
pearl
1
Daily low-dose aspirin does not reduce all-cause mortality in the healthy elderly.
McNeil JJ, Nelson MR, Woods RL et al. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. N. Engl. J. Med. 2018 Oct 18; 379 (16): 1519-1528.
  Daniel Jolley
pearl
1
Daily low-dose aspirin does not improve disability-free survival in the healthy elderly.
McNeil JJ, Woods RL, Nelson MR et al. Effect of Aspirin on Disability-free Survival in the Healthy Elderly. N. Engl. J. Med. 2018 Oct 18; 379 (16): 149915081499-1508.
  Daniel Jolley
pearl
1
Daily low-dose aspirin for primary prevention in the healthy elderly offers no cardiovascular benefit but does increase the risk of major hemorrhage.
McNeil JJ, Wolfe R, Woods RL et al. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. N. Engl. J. Med. 2018 Oct 18; 379 (16): 1509-1518.
  Daniel Jolley
pearl
1
Pressure control ventilation is associated with lower surgical bleeding volume when compared to volume controlled ventilation during lumbar spine surgery.
Kang WS, Oh CS, Kwon WK et al. Effect of Mechanical Ventilation Mode Type on Intra- and Postoperative Blood Loss in Patients Undergoing Posterior Lumbar Interbody Fusion Surgery: A Randomized Controlled Trial. Anesthesiology. 2016 Jul 1; 125 (1): 115-23.
  Daniel Jolley
pearl
1
Two thirds of anesthesia awareness occurs before or after surgery.
Pandit JJ, Cook TM, Jonker WR et al. A national survey of anaesthetists (NAP5 baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. Br J Anaesth. 2013 Apr 1;110(4):501-9.
  Daniel Jolley
pearl
1
ICU resuscitation with 20% ‘concentrated’ albumin decreases fluid requirements compared with 4% albumin, without apparent harm.
Mårtensson J, Bihari S, Bannard-Smith J et al. Small volume resuscitation with 20% albumin in intensive care: physiological effects : The SWIPE randomised clinical trial. Intensive Care Med. 2018 Nov 1; 44 (11): 1797-1806.
  Daniel Jolley