Abstract:
BACKGROUND:Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. METHODS:Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within 10 days of start of mechanical ventilation was compared with placement of tracheostomy after 10 days if still required. Medline, EMBASE, the Cochrane Controlled Clinical Trials Register, and Google Scholar were searched for eligible trials. The co-primary outcomes were mortality within 60 days, and duration of mechanical ventilation, sedation, and intensive care unit stay. Secondary outcomes were the number of tracheostomy procedures performed, and incidence of ventilator-associated pneumonia (VAP). Outcomes are described as relative risk or weighted mean difference with 95% confidence intervals. RESULTS:Of note, 4482 publications were identified and 14 trials enrolling 2406 patients were included. Tracheostomy within 10 days was not associated with any difference in mortality [risk ratio (RR): 0.93 (0.83-1.05)]. There were no differences in duration of mechanical ventilation [-0.19 days (-1.13-0.75)], intensive care stay [-0.83 days (-2.05-0.40)], or incidence of VAP. However, duration of sedation was reduced in the early tracheostomy groups [-2.78 days (-3.68 to -1.88)]. More tracheostomies were performed in patients randomly assigned to receive early tracheostomy [RR: 2.53 (1.18-5.40)]. CONCLUSION:We found no evidence that early (within 10 days) tracheostomy reduced mortality, duration of mechanical ventilation, intensive care stay, or VAP. Early tracheostomy leads to more procedures and a shorter duration of sedation.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Szakmany T,Russell P,Wilkes AR,Hall JEdoi
10.1093/bja/aeu440subject
Has Abstractpub_date
2015-03-01 00:00:00pages
396-405issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31805-6journal_volume
114pub_type
杂志文章,meta分析,评审abstract::Puerperal women are reported to have a rate of cerebral infarction 13 times greater than non-pregnant females. We report a case of cerebral ischaemia in a 30-yr-old healthy parturient after epidural analgesia for labour, complicated by dural puncture treated with two epidural blood patches. Investigations showed the d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients after major surgery. An association between POCD and the development of dementia has been suspected. In this study, we assessed if POCD was a risk factor for the occurrence of dementia. METHODS:Danish patients enrolled b...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aes466
更新日期:2013-06-01 00:00:00
abstract::Sickle cell disease is a congenital haemoglobinopathy with a high incidence of perioperative complications. Traditional anaesthetic management, based largely on extrapolation from biochemical models, has emphasized avoidance of red cell sickling to prevent exacerbations of the disease. This historical review outlines ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aei129
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:The Bispectral Index (BIS) monitor has been suggested as a potential tool to measure depth of sedation in paediatric intensive care unit (PICU) patients. The primary aim of our observational study was to assess the difference in BIS values between the left and right sides of the brain. Secondary aims were to...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen035
更新日期:2008-05-01 00:00:00
abstract::The gliding characteristics were evaluated of 10-ml plastic syringes used to identify the extradural space by "loss of resistance" techniques. This was undertaken quantitatively, by measuring the force necessary to depress syringe plungers, and qualitatively, by examining travel characteristics in terms of the force a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/61.6.776
更新日期:1988-12-01 00:00:00
abstract::In the dog, pancuronium 0.2 mg/kg increased left ventricular systolic pressure and systemic arterial pressure, but did not change central venous pressure. Repeated doses produced diminishing responses and eventually no change in arterial pressure. After tachyphylaxis was established, a pressor response to pancuronium ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.12.1143
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:Patient dissatisfaction has been previously associated with motor block in shoulder surgery patients receiving brachial plexus block. For elective minor wrist and hand surgery, we tested whether a regional block accelerating the early return of upper extremity motor function would improve patient satisfactio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes266
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The low and moderate doses of dexmedetomidine reduce arterial pressure and heart rate (HR), suggesting attenuation of sympathetic activity and dominance of cardiac-vagal activity. These autonomic responses under dexmedetomidine sedation may attenuate cardiovascular reflex responses to temporal reduction in a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aep210
更新日期:2009-10-01 00:00:00
abstract::The kinetics of morphine were studied during balanced anaesthesia in 10 patients undergoing lower abdominal or body surface surgery, and compared with those obtained in nine awake patients receiving morphine i.v. for the relief of chronic non-cancer pain. All patients received morphine sulfphate pentahydrate 10 mg i.v...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.1.22
更新日期:1989-01-01 00:00:00
abstract::We have compared, in a randomized, double-blind study, the pharmacokinetics of ropivacaine and bupivacaine during labour. Total and free plasma concentrations of ropivacaine and bupivacaine were measured after the first of two extradural doses. The main dose was 20 mg (test dose) and 30 mg, with a top-up dose of 25 mg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/79.5.558
更新日期:1997-11-01 00:00:00
abstract::We investigated in 60 patients scheduled for elective aorto-coronary bypass grafting if loud sounds by themselves can induce cardiovascular responses and if these could be related to mid-latency auditory evoked potentials (MLAEP). Anaesthesia was induced in group I (n = 20) with flunitrazepam-fentanyl 0.01 mg kg-1 and...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/72.3.307
更新日期:1994-03-01 00:00:00
abstract::Intraoperative awareness, with or without recall, continues to be a topic of clinical significance and neurobiological interest. In this article, we review evidence pertaining to the incidence, sequelae, and prevention of intraoperative awareness. We also assess which aspects of the complication are well understood (i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev034
更新日期:2015-07-01 00:00:00
abstract::In a prospective, randomized, double-blind clinical study, we have studied 100 children, aged 2-12 yr, to compare halothane and sevoflurane in outpatient dental anaesthesia. All patients were unpremedicated and received inhalation induction using nitrous oxide in oxygen supplemented with either halothane (maximum insp...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/79.3.280
更新日期:1997-09-01 00:00:00
abstract::The effects of different premedication (i.m. and i.v.) on the usefulness of midazolam or thiopentone as induction agents for minor surgery was studied in 194 women undergoing either dilatation and curettage or explorative fractionate curettage. Midazolam appeared to produce light sedation which required powerful preme...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/54.5.507
更新日期:1982-05-01 00:00:00
abstract::Haemodynamic effects may occur after stellate ganglion block (SGB) arising from autonomic imbalance and local anaesthetic infiltration to barosensitive areas. We report seven patients who developed severe hypertension (systolic arterial pressure >200 mm Hg) after SGB in our pain clinic service. We postulate that diffu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei134
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Parecoxib, a cyclo oxygenase-2 inhibiting non-steroidal anti-inflammatory drug, has been widely used for postoperative analgesia. Our aim was to quantify the benefit of a single dose after coronary artery bypass grafting. METHODS:The investigation was carried out as a randomized double blind placebo control...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aei298
更新日期:2006-02-01 00:00:00
abstract::We have studied the effects of mivacurium after induction of anaesthesia with alfentanil-propofol in healthy adult oral surgical patients. Anaesthesia was maintained with nitrous oxide and 0.75% (end-tidal) enflurane in oxygen after nasotracheal intubation. Recordings were made of the rectified compound adductor polli...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/67.3.289
更新日期:1991-09-01 00:00:00
abstract::We report the successful preoperative control and anaesthetic management of severe hypertension in a 7-month-old baby with nephroblastoma and increased renin activity. The strategy for selection of appropriate antihypertensive pharmacological agents and the anaesthetic implications and management of the condition are ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.2.206
更新日期:1992-08-01 00:00:00
abstract::In this report we present the case of a 77-yr-old man who underwent resection of the upper lobe of the left lung for a carcinoma, six weeks after percutaneous transluminal coronary angioplasty (PTCA) with stenting of the left anterior descending (LAD) and circumflex coronary arteries. Antiplatelet therapy with clopido...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh110
更新日期:2004-05-01 00:00:00
abstract::Patients with renal failure and undergoing a cadaver renal transplant were found to have plasma concentrations of laudanosine, following the administration of a single bolus dose of atracurium 0.5 mg kg-1, higher than those found in patients without renal failure. Since laudanosine is a known central nervous system st...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.11.1049
更新日期:1985-11-01 00:00:00
abstract::The induction dose requirements of propofol were compared in three age groups in 300 unpremedicated healthy Chinese children: group A, younger than 2 yr (n = 48); group B, 2-5 yr (n = 117); group C, 6-12 yr (n = 135). Patients in each group were allocated randomly to receive one of eight doses of propofol (1.2, 1.4, 1...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/68.1.64
更新日期:1992-01-01 00:00:00
abstract::The effect of alfentanil on sympathetic reflexes evoked by supramaximal electrical stimulation of the radial nerve has been observed in five dogs anaesthetized with alpha-chloralose, paralysed with suxamethonium and artificially ventilated. In five dogs during the infusion of alfentanil at a rate of 20 micrograms kg-1...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/61.4.441
更新日期:1988-10-01 00:00:00
abstract::We have estimated the effect of omitting antagonism of neuromuscular block on postoperative nausea and vomiting. A systematic search (MEDLINE, EMBASE, Biological Abstracts, Cochrane library, reference lists and hand searching; no language restriction, up to March 1998) was performed for relevant randomized controlled ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/82.3.379
更新日期:1999-03-01 00:00:00
abstract::The oxygen delivery (DO2) and consumption (VO2) relationship in brain-dead organ donors is unknown. Therefore, in a prospective study, we determined the DO2/VO2 relationship in 21 consecutive brain-dead patients. Patients were allocated to one of two groups, according to plasma lactate concentration: normal (group NL,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.6.783
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:In this randomized, double-blind study, the effects of thoracic and lumbar epidural anaesthesia on the induction doses (IDs) and maintenance doses (MDs) of propofol during bispectral index (BIS) guided total i.v. anaesthesia were compared. METHODS:Fifty-four patients (three groups, n=18 each) undergoing uro...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen160
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:The Alaris AEP monitor(TM) (Alaris, UK, version 1.4) is the first commercially available auditory evoked potential (AEP) monitor designed to estimate the depth of anaesthesia. It generates an "Alaris AEP index" (AAI), which is a dimensionless number scaled from 100 (awake) to 0. This study was designed to co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg189
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Propofol and sevoflurane are suitable agents for maintenance of anaesthesia during neurosurgical procedures. We have prospectively compared these agents in combination with the short-acting opioid, remifentanil. METHODS:Fifty unpremedicated patients undergoing elective craniotomy received remifentanil 1 mic...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aei141
更新日期:2005-06-01 00:00:00
abstract::Progressive obstruction of an axillary vein following an axillary approach to brachial plexus blockade is described. At surgical exploration, the axillary vein was narrowed with an aneurysm of its wall. It is likely that, during the performance of the block, the needle penetrated the adventitia of the vein, causing a ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.9.1051
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Platelet inhibition is mandatory therapy after percutaneous coronary intervention (PCI). Withdrawal of oral antiplatelet agents has been linked to increased incidence of postoperative adverse cardiac events in post-PCI patients having non-cardiac surgery (NCS). There is limited knowledge of temporal changes ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/bja/aev556
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The esCCO monitor (ECG- estimated Continuous Cardiac Output, Nihon Kohden(®)) is a new non-invasive tool for estimating cardiac output (CO). It derives CO from the pulse wave transit time (PWTT) estimated by the ECG and the plethysmographic wave. An initial calibration is needed to refine the relation linkin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes298
更新日期:2012-12-01 00:00:00