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NIHR Signal Cell salvage during caesarean section doesn’t reduce blood transfusions
In a large UK trial, cell salvage for women at risk of blood loss during caesarean did not reduce the need for donor blood transfusion, though few needed transfusion (2.5% compared with 3.5% among controls). More babies are being born by caesarean section and if blood loss is excessive, transfusions may be required, probably by about one in 20 women. Collecting the mother’s own lost blood during the procedure, filtering and returning it to her (cell salvage) is a potential alternative tha...
NIHR Signal Dexamethasone before bowel surgery reduces postoperative nausea and vomiting
A single dose of dexamethasone given at the time of anaesthesia for bowel surgery reduced vomiting in the next 24 hours, with no increase in complications. Thirteen people need to be treated to prevent one extra episode of vomiting. Dexamethasone (a steroid) is one of several drugs recommended for patients at moderate and high risk of postoperative nausea and vomiting. It isn’t widely used in bowel surgery. In this large UK-based trial, treating eight people also prevented one person re...
NIHR Signal Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events
Adverse breathing events are about three times more common when using endotracheal tubes than laryngeal mask airways for infants under 12 months receiving non-urgent surgery. Airway problems are common during anaesthesia in children, accounting for three quarters of critical incidents and a third of cardiac arrests. They are more frequent in younger children, especially infants under 12 months, who have smaller airways and rapidly use up their oxygen reserves. Laryngeal mask airways have been ...
NIHR Signal Laminar airflow in surgery might not reduce surgical site infections
The type of theatre ventilation system used during hip and knee replacement, abdominal or vascular surgery has no effect on the rate of surgical site infections. Prevention of surgical site infection is a complex area with many potential targets for action. So decisions relating to commissioning or decommissioning these systems will need to consider the totality of the evidence alongside the costs. This systematic review included 12 observational studies comparing wound infection rates followin...
NIHR Signal Providing regular feedback on patient outcomes improves anaesthetists’ performance
This NIHR-funded study found that enhanced continuous monitoring and feedback was associated with an improvement in the performance of anaesthetists. A detailed monthly report contained data about outcomes, such as nausea, pain and discomfort, for individual patients. Anaesthetists received data by subspecialty and this included details of unusual cases, comparative data across patients and anaesthetists and long-term data on trends, where available. The study also gathered information about th...
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