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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

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

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

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

The PROGRAM study: awake mapping versus asleep mapping versus no mapping for high-grade glioma resections: study protocol for an international multicenter prospective three-arm cohort study
This study is an international, multicenter, prospective three-arm cohort study of observational nature. Consecutive HGG patients will be operated with awake mapping, asleep mapping or no mapping with a 1:1:1 ratio. Primary endpoints are: (1) proportion of patients with National Institute of Health Stroke Scale deterioration at 6 weeks, 3 months and 6 months after surgery and (2) residual tumour volume of the contrast-enhancing and non-contrast-enhancing part as assessed by a neuroradiologist on postoperative contrast MRI scans. Secondary endpoints are: (1) overall survival and (2) progression-free survival at 12 months af...
Source: BMJ Open - July 21, 2021 Category: General Medicine Authors: Gerritsen, J. K. W., Dirven, C. M. F., De Vleeschouwer, S., Schucht, P., Jungk, C., Krieg, S. M., Nahed, B. V., Berger, M. S., Broekman, M. L. D., Vincent, A. J. P. E. Tags: Open access, Neurology Source Type: research

Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis
Conclusions The results suggest that the use of LA with vasoconstrictors (epinephrine in low doses) is safe in patients with some types of CVD. However, the low quality of evidence demonstrated that literature needs further studies in order to confirm these results. Protocol registration PROSPERO (CRD42016045421).
Source: BMJ Open - July 15, 2021 Category: General Medicine Authors: Guimaraes, C. C., Lopes, L. C., Bergamaschi, C. d. C., Ramacciato, J. C., Silva, M. T., Araujo, J. d. O., de Andrade, N. K., Motta, R. H. L. Tags: Open access, Anaesthesia Source Type: research

26 Systematic influences of the implementation of a comprehensive 24/7-telemedicine system into emergency medical service
Conclusion The implementation of a telemedicine system into routine care led to a significant decrease in conventional on-scene physician missions as well as to an overall decrease in physician guided EMS cases. Therefore, the approach can be judged resource optimising and holds a potential for economic improvements although highly qualified physicians carry out the service. References Brokmann JC, Conrad C, Rossaint R, Bergrath S, Beckers SK, Tamm M, Czaplik M, Hirsch F. Treatment of acute coronary syndrome by telemedically supported paramedics compared with physician-based treatment of acute coronary syndrome: a prospec...
Source: BMJ Open - May 21, 2017 Category: General Medicine Authors: Beckers, S., Bergrath, S., Hirsch, F., Felzen, M., Rossaint, R. Source Type: research

Rigorous anaesthesia management protocol for patients with intracranial arterial stenosis: a prospective controlled-cohort study
Conclusions The ERSIAS anaesthesia protocol successfully reduced intraoperative fluctuations of MAP and ETCO2. The protocol also achieved normocarbia and the intended hypertension. Trial registration number NCT01819597; Pre-results.
Source: BMJ Open - January 19, 2016 Category: Journals (General) Authors: Laiwalla, A. N., Ooi, Y. C., Van De Wiele, B., Ziv, K., Brown, A., Liou, R., Saver, J. L., Gonzalez, N. R. Tags: Open access, Anaesthesia, Evidence based practice, Surgery Research Source Type: research

Effects of obstructive sleep apnoea risk on postoperative respiratory complications: protocol for a hospital-based registry study
Introduction Obstructive sleep apnoea (OSA), the most common type of sleep-disordered breathing, is associated with significant immediate and long-term morbidity, including fragmented sleep and impaired daytime functioning, as well as more severe consequences, such as hypertension, impaired cognitive function and reduced quality of life. Perioperatively, OSA occurs frequently as a consequence of pre-existing vulnerability, surgery and drug effects. The impact of OSA on postoperative respiratory complications (PRCs) needs to be better characterised. As OSA is associated with significant comorbidities, such as obesity, pulmo...
Source: BMJ Open - January 13, 2016 Category: Journals (General) Authors: Shin, C. H., Zaremba, S., Devine, S., Nikolov, M., Kurth, T., Eikermann, M. Tags: Open access, Anaesthesia, Epidemiology, Pharmacology and therapeutics, Respiratory medicine, Surgery Protocol Source Type: research