Aprotinin: Pharmacological Benefits and Safety Concerns
Meta-analysis Year of publication Number of patients Number of studies OR (CI 95 %) OR (CI 95 %) OR (CI 95 %) – – – – Aprotinin versus tranexamic acid Aprotinin versus aminocaproic…
Consensus Conference on Perioperative Mortality: An Update
Search strategy for meta-analyses of RCTs Systematic [sb.] AND (surgery [tiab] OR surgical* [tiab] OR operation* [tiab]) AND [(myocardial AND infarction) OR (death* OR survival OR mortality OR prognosis)] AND…
Role of Insulin in Reducing Mortality in the Perioperative Period
Route of administration Insulin Onset of action Peak of action Effective duration of action Subcutaneous Regular human insulin 30–60 min 2–3 h 4–6 h Subcutaneous Rapid-acting analogues (aspart, lispro, glulisine) 15 min 30–90 min 3–4 h…
Selective Decontamination of the Digestive Tract
Target PPM, antimicrobials, manoeuvres Total daily dosea <5 years 5–12 years >12 years Parenteral antimicrobials – – – Cefotaxime, mg 150/kg 200/kg 4,000 Enteral antimicrobials – – – Oropharynx – – – AGNB:…
Reducing Perioperative Mortality with Intra-Aortic Balloon Counterpulsation (IABP)
Clinical summary Indications Cautions Complications Notes High-risk coronary artery bypass grafting Aortic regurgitation Aggravation of aortic regurgitation Imaging is required to confirm correct aortic placement of this device Severe myocardial…
The Process of Consensus Building
Fig. 2.1 Consensus conference process 2.1 Step 1. Evidence Collection and Analysis The aim of this conference was to identify all the interventions influencing mortality in the perioperative period, including only…
Leukocyte Depletion of Transfused Blood to Reduce Perioperative Mortality
Study Setting No. of patients Blood products End points Results (%) p van de Watering [5] Cardiac surgery 914 BCD-RBC vs. LR (pre-storage) vs. LR (poststorage) 60-day mortality 7.8 vs….
Perioperative β-Blocker Therapy and Survival
Study N Drug Onset and duration Surgery Results Mangano/1966 200 Atenolol 50–100 mg Before induction—7-d postop Noncardiac surgery Reduced mortality at 6 m (0 vs. 8 %, p < 0.001), at 1 y (3 vs. 14 %, p = 0.005),…
Could Clonidine Contribute to a Reduction in Perioperative Mortality?
RCT Sites Dates N patients Inclusion criteria Rx protocol Endpoints Results a Wallace et al. [13] (2004) double-blind clonidine vs placebo single center None 190 patients Randomization 2:1 Rx = 125 Placebo = 65…
Can Neuraxial Anesthesia Reduce Perioperative Mortality?
Clinical summary Technique Indications Cautions Notes Neuraxial anesthesia Lower extremity major joint procedures – Suggestive reduction in mortality Neuraxial anesthesia/analgesia Cardiac surgery Neuraxial hematoma No conclusive effect on mortality Neuraxial…
