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PerIoperative iNflammatory reSponse assessment In hiGH-risk patienTs undergoing non-cardiac surgery (INSIGHT): study protocol of a prospective non-interventional observational study
This study was approved by the ethics committees at the Medical University of Vienna (2458/2020) and at the Medical University of Graz (33-274 ex 20/21). Trial registration number NCT04753307.
Source: BMJ Open - July 19, 2023 Category: General Medicine Authors: Pichler, A., Kurz, A., Eichlseder, M., Graf, A., Eichinger, M., Taschner, A., Kabon, B., Fleischmann, E., Reiterer, C., for the INSIGHT study group, Pichler, Reiterer, Eichlseder, Graf, Eichinger, Kabon, Hantakova, Schallmeiner, Kuhrn, Kurz, Taschner, Fre Tags: Open access, Anaesthesia Source Type: research

Pragmatic anesthetic approach for extracranial to intracranial bypass surgery in a patient with moyamoya disease and sickle cell disease: a case report
ConclusionOptimal preprocedural optimization can decrease complications in patients with critically comprised cerebral circulation booked for extensive surgery such as ECIC bypass. We believe the presentation of anesthetic management of a patient with moyamoya disease and sickle cell disease may prove helpful.
Source: Journal of Medical Case Reports - March 31, 2023 Category: General Medicine Source Type: research

Remote ischaemic preconditioning versus no remote ischaemic preconditioning for vascular and endovascular surgical procedures
CONCLUSIONS: Overall, compared with no RIPC, RIPC probably leads to little or no difference in perioperative mortality, myocardial infarction, renal impairment, stroke, hospital stay, and operating time, and may lead to little or no difference in limb loss in people undergoing elective major vascular and endovascular surgery. Adequately powered and designed randomised studies are needed, focusing in particular on the clinical endpoints and patient-centred outcomes.PMID:36645250 | DOI:10.1002/14651858.CD008472.pub3
Source: Cochrane Database of Systematic Reviews - January 16, 2023 Category: General Medicine Authors: Fuxiang Liang Shidong Liu Guangzu Liu Hongxu Liu Bing Song Liang Yao Qi Wang Source Type: research

Aortic arch surgery for type B aortic dissection: How far should we go? The value of a hybrid approach
Surgical treatment for aortic disease remains challenging and demanding. Treatment often needs to be tailored to the patient or the group of patients being referred. A hybrid approach may have a role to play as an additional option to the surgical armamentarium. Cooperation between different specialists is essential. AbstractTraditionally, the management of type B aortic dissection has been the domain of the vascular surgeons. Timing and type of intervention still generate debate. We sought to review our early experience with the treatment of this condition based on a hybrid approach following an aortic multi-disciplinary ...
Source: Clinical Case Reports - January 4, 2023 Category: General Medicine Authors: Massimo Capoccia, Mohamed Ashur Sherif, Ahmed Nassef, David Shaw, Paul Walker, Betsy Evans, Pankaj Kaul, Walid Elmahdy Tags: CASE REPORT Source Type: research

Increased blood pressure variability during general anaesthesia is associated with worse outcomes after mechanical thrombectomy: a prospective observational cohort study
Conclusions Increased intraprocedural BPV was more likely to have poor functional outcome in patients with LVO following MT with general anaesthesia. This finding indicates that special precautions should be taken to minimise BP fluctuation during procedure.
Source: BMJ Open - October 5, 2022 Category: General Medicine Authors: Xu, C., Jin, T., Chen, Z., Zhang, Z., Zhang, K., Mao, H., Ye, S., Geng, Y., Shi, Z. Tags: Open access, Neurology Source Type: research

Type of anaesthesia for acute ischaemic stroke endovascular treatment
CONCLUSIONS: In early outcomes, general anaesthesia improves target artery revascularisation compared to non-general anaesthesia with moderate-certainty evidence. General anaesthesia may improve adverse events (haemodynamic instability) compared to non-general anaesthesia with low-certainty evidence. We found no evidence of a difference in neurological impairment, stroke-related mortality, all intracranial haemorrhage and haemodynamic instability adverse events between groups with low-certainty evidence. We are uncertain whether general anaesthesia improves functional outcomes and time to revascularisation because the cert...
Source: Cochrane Database of Systematic Reviews - July 20, 2022 Category: General Medicine Authors: Renato Tosello Rachel Riera Giuliano Tosello Caroline Nb Clezar Jorge E Amorim Vladimir Vasconcelos Benedito B Joao Ronald Lg Flumignan Source Type: research

Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting)
CONCLUSIONS: This review concluded that the data available were too limited to either support or refute the use of routine or selective shunting in carotid endarterectomy when performed under general anaesthesia. Large-scale randomised trials of routine shunting versus selective shunting are required. No method of monitoring in selective shunting has been shown to produce better outcomes.PMID:35731671 | PMC:PMC9216235 | DOI:10.1002/14651858.CD000190.pub4
Source: Cochrane Database of Systematic Reviews - June 22, 2022 Category: General Medicine Authors: Busaba Chuatrakoon Sothida Nantakool Amaraporn Rerkasem Saritphat Orrapin Dominic Pj Howard Kittipan Rerkasem Source Type: research

Stroke volume variation for predicting responsiveness to fluid therapy in patients undergoing cardiac and thoracic surgery: a systematic review and meta-analysis
Conclusion SVV had good predictive performance in cardiac surgery or ICU after cardiac surgery and had moderate predictive performance in thoracic surgery. Nevertheless, technical and clinical variables may affect the predictive value potentially.
Source: BMJ Open - May 18, 2022 Category: General Medicine Authors: Huan, S., Dai, J., Song, S., Zhu, G., Ji, Y., Yin, G. Tags: Open access, Anaesthesia Source Type: research

Long-term outcomes of percutaneous left atrial appendage closure for the prevention of stroke in patients with atrial fibrillation: Asia-Pacific experience
CONCLUSION: This long-term follow-up study shows that percutaneous closure of LAA is a safe and technically feasible procedure with satisfactory outcomes in Asia. The procedure success rate, efficacy and adverse event were similar to those reported in the Caucasian populations.PMID:34799213 | DOI:10.1016/j.jfma.2021.10.010
Source: J Formos Med Assoc - November 20, 2021 Category: General Medicine Authors: Fu-Chun Chiu Pang-Shuo Huang Jien-Jiun Chen Juey-Jen Hwang Chia-Ti Tsai Source Type: research

Local versus general anaesthesia for carotid endarterectomy
CONCLUSIONS: The incidence of stroke and death were not convincingly different between local and general anaesthesia for people undergoing carotid endarterectomy. The current evidence supports the choice of either approach. Further high-quality studies are still needed as the evidence is of limited reliability.PMID:34642940 | DOI:10.1002/14651858.CD000126.pub5
Source: Cochrane Database of Systematic Reviews - October 13, 2021 Category: General Medicine Authors: Amaraporn Rerkasem Saritphat Orrapin Dominic Pj Howard Sothida Nantakool Kittipan Rerkasem Source Type: research

Continuation versus discontinuation of aspirin-based antiplatelet therapy for perioperative bleeding and ischaemic events in adults undergoing neurosurgery: protocol for a systematic review and meta-analysis
Introduction Antiplatelet therapy is commonly used in primary or secondary prevention of atherosclerotic and thrombotic diseases, such as coronary artery disease, transient ischaemic attack or stroke. Recent studies noted that antiplatelet therapy should be continued perioperatively in patients at high risk of thrombosis and low bleeding risk in orthopaedic, spinal or urological surgery. However, evidence in neurosurgery is lacking. Thus, we aim to conduct a systematic review and meta-analysis to assess whether the continuous use of antiplatelet drugs in neurosurgery increases the risk of perioperative bleeding. Methods a...
Source: BMJ Open - September 30, 2021 Category: General Medicine Authors: Wang, X., Wang, X., Yu, Y., Han, R. Tags: Open access, Anaesthesia Source Type: research

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