doi : 10.1016/S0007-0912(20)30967-3
Volume 126, Issue 1, January 2021, Page ii
Nicholas Levy, David A. Selwyn, Dileep N. Lobo
doi : 10.1016/j.bja.2020.08.021
Volume 126, Issue 1, January 2021, Pages 1-5
Steven M. Frank, Melissa M. Cushing
doi : 10.1016/j.bja.2020.09.009
Volume 126, Issue 1, January 2021, Pages 5-9
Patrick Meybohm, David M. Baron, Peter Kranke
doi : 10.1016/j.bja.2020.09.010
Volume 126, Issue 1, January 2021, Pages 9-11
Ciara Hanley, Jeannie Callum, Angela Jerath
doi : 10.1016/j.bja.2020.09.014
Volume 126, Issue 1, January 2021, Pages 12-17
Andrea Cortegiani, Anthony R. Absalom, Beverley J. Hunt
doi : 10.1016/j.bja.2020.10.003
Volume 126, Issue 1, January 2021, Pages 17-20
Andrew Norris, James Armstrong
doi : 10.1016/j.bja.2020.08.031
Volume 126, Issue 1, January 2021, Pages 20-22
Michael S. Kristensen, Wendy H. Teoh
doi : 10.1016/j.bja.2020.10.004
Volume 126, Issue 1, January 2021, Pages 22-27
Simon J. Davies, Gary Minto
doi : 10.1016/j.bja.2020.09.015
Volume 126, Issue 1, January 2021, Pages 27-30
Douglas J. Eleveld, Pieter J. Colin, Anthony R. Absalom, Michel M.R.F. Struys
doi : 10.1016/j.bja.2020.09.025
Volume 126, Issue 1, January 2021, Pages 31-34
Alex S. Evers
doi : 10.1016/j.bja.2020.08.008
Volume 126, Issue 1, January 2021, Pages 34-37
Robert D. Sanders, Cameron Casey, Yuri B. Saalmann
doi : 10.1016/j.bja.2020.08.017
Volume 126, Issue 1, January 2021, Pages 37-40
Christopher J. Edge, Robert Dickinson
doi : 10.1016/j.bja.2020.09.028
Volume 126, Issue 1, January 2021, Pages 41-43
Hanan A. Baker, Seyed A. Safavynia, Lisbeth A. Evered
doi : 10.1016/j.bja.2020.09.045
Volume 126, Issue 1, January 2021, Pages 44-47
Tyler T. Weiss, Flor Cerda, J. Brady Scott, Ramandeep Kaur, ... Jie Li
doi : 10.1016/j.bja.2020.09.042
Volume 126, Issue 1, January 2021, Pages 48-55
The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear.
W. Scott Beattie, Manoj Lalu, Matthew Bocock, Simon Feng, ... Mark Johnson
doi : 10.1016/j.bja.2020.09.023
Volume 126, Issue 1, January 2021, Pages 56-66
Adverse cardiovascular events are a leading cause of perioperative morbidity and mortality. The definitions of perioperative cardiovascular adverse events are heterogeneous. As part of the international Standardized Endpoints in Perioperative Medicine initiative, this study aimed to find consensus amongst clinical trialists on a set of standardised and valid cardiovascular outcomes for use in future perioperative clinical trials.
Bernd Saugel, Karim Kouz, Thomas W.L. Scheeren, Gillis Greiwe, ... Daniel de Backer
doi : 10.1016/j.bja.2020.09.049
Volume 126, Issue 1, January 2021, Pages 67-76
Pulse wave analysis (PWA) allows estimation of cardiac output (CO) based on continuous analysis of the arterial blood pressure (AP) waveform. We describe the physiology of the AP waveform, basic principles of PWA algorithms for CO estimation, and PWA technologies available for clinical practice.
Michael A. Gillies, Sadia Ghaffar, Iain K. Moppett, Annemarie B. Docherty, ... Timothy S. Walsh
doi : 10.1016/j.bja.2020.06.048
Volume 126, Issue 1, January 2021, Pages 77-86
The optimum transfusion strategy in patients with fractured neck of femur is uncertain, particularly if there is coexisting cardiovascular disease.
Alparslan Turan, Eva Rivas, Philip J. Devereaux, Mauro Bravo, ... Daniel I. Sessler
doi : 10.1016/j.bja.2020.08.054
Volume 126, Issue 1, January 2021, Pages 87-93
Myocardial infarction is the most common postoperative major vascular complication. Perioperative anaemia may contribute to cardiac supply–demand mismatch, and therefore myocardial injury. We therefore tested the hypothesis that the lowest in-hospital postoperative haemoglobin concentration is associated with a composite of non-fatal myocardial infarction and all-cause mortality within the first 30 days after noncardiac surgery.
Alparslan Turan, Barak Cohen, Eva Rivas, Liu Liu, ... Daniel I. Sessler
doi : 10.1016/j.bja.2020.08.056
Volume 126, Issue 1, January 2021, Pages 94-101
Myocardial injury after noncardiac surgery (MINS) is common, mostly silent, and a strong predictor of postoperative mortality. MINS appears to result from myocardial supply–demand mismatch. Recent data support restrictive perioperative transfusion strategies that can result in low postoperative haemoglobin concentrations. Whether low postoperative haemoglobin is associated with myocardial injury remains unknown. We therefore tested the hypothesis that anaemia is associated with an increased risk of myocardial injury in adults having noncardiac surgery.
Giovanna A.L. Lurati Buse, Christian Puelacher, Danielle Menosi Gualandro, Alessandro S. Genini, ... Daniel Rikli
doi : 10.1016/j.bja.2020.08.041
Volume 126, Issue 1, January 2021, Pages 102-110
Perioperative cardiovascular guidelines endorse functional capacity estimation, based on ‘cut-off’ daily activities for risk assessment and climbing two flights of stairs to approximate 4 metabolic equivalents. We assessed the association between self-reported functional capacity and postoperative cardiac events.
Piet A.H. Wyffels, Stefan De Hert, Patrick F. Wouters
doi : 10.1016/j.bja.2020.09.039
Volume 126, Issue 1, January 2021, Pages 111-119
Traditional formulas to calculate pulse pressure variation (PPV) cannot be used in patients with atrial fibrillation (AF). We have developed a new algorithm that accounts for arrhythmia-induced pulse pressure changes, allowing us to isolate and quantify ventilation-induced pulse pressure variation (VPPV). The robustness of the algorithm was tested in patients subjected to altered loading conditions. We investigated whether changes in VPPV imposed by passive leg raising (PLR) were proportional to the pre-PLR values.
Henrik Rüffert, B?rge Bastian, Diana Bendixen, Thierry Girard, ... D. ?t?p?nkov?
doi : 10.1016/j.bja.2020.09.029
Volume 126, Issue 1, January 2021, Pages 120-130
Malignant hyperthermia is a potentially fatal condition, in which genetically predisposed individuals develop a hypermetabolic reaction to potent inhalation anaesthetics or succinylcholine. Because of the rarity of malignant hyperthermia and ethical limitations, there is no evidence from interventional trials to inform the optimal perioperative management of patients known or suspected with malignant hyperthermia who present for surgery.
Suraj Pathak, Guido Olivieri, Walid Mohamed, Riccardo Abbasciano, ... Gavin J. Murphy
doi : 10.1016/j.bja.2020.06.064
Volume 126, Issue 1, January 2021, Pages 131-138
The aim of this systematic review was to summarise the results of randomised controlled trials (RCTs) that have evaluated pharmacological interventions for renoprotection in people undergoing surgery.
David W. Hewson, Jonathan G. Hardman, Nigel M. Bedforth
doi : 10.1016/j.bja.2020.07.053
Volume 126, Issue 1, January 2021, Pages 139-148
Patient-maintained propofol sedation (PMPS) is the delivery of procedural propofol sedation by target-controlled infusion with the patient exerting an element of control over their target-site propofol concentration.
Marius A. Roman, Riccardo G. Abbasciano, Suraj Pathak, Shwe Oo, ... Gavin J. Murphy
doi : 10.1016/j.bja.2020.04.087
Volume 126, Issue 1, January 2021, Pages 149-156
Patient blood management (PBM) interventions aim to improve clinical outcomes by reducing bleeding and transfusion. We assessed whether existing evidence supports the routine use of combinations of these interventions during and after major surgery.
Tom E.F. Abbott, Michael A. Gillies
doi : 10.1016/j.bja.2020.08.053
Volume 126, Issue 1, January 2021, Pages 157-162
Anaemia is a common finding in patients presenting for major elective surgery and is associated with poor outcomes including death and complications. Iron deficiency is the leading cause of perioperative anaemia.
Pavel S. Roshanov, John W. Eikelboom, Daniel I. Sessler, Clive Kearon, ... Philip J. Devereaux
doi : 10.1016/j.bja.2020.06.051
Volume 126, Issue 1, January 2021, Pages 163-171
We aimed to establish diagnostic criteria for bleeding independently associated with mortality after noncardiac surgery (BIMS) defined as bleeding during or within 30 days after noncardiac surgery that is independently associated with mortality within 30 days of surgery, and to estimate the proportion of 30-day postoperative mortality potentially attributable to BIMS.
Pavel S. Roshanov, Gordon H. Guyatt, Vikas Tandon, Flavia K. Borges, ... Philip J. Devereaux
doi : 10.1016/j.bja.2020.02.028
Volume 126, Issue 1, January 2021, Pages 172-180
Diagnostic criteria for Bleeding Independently associated with Mortality after noncardiac Surgery (BIMS) have been defined as bleeding that leads to a postoperative haemoglobin <70 g L?1, leads to blood transfusion, or is judged to be the direct cause of death. Preoperative prediction guides for BIMS can facilitate informed consent and planning of perioperative care.
Bernhard Riedel, Michael H-G. Li, C.H. Angus Lee, Hilmy Ismail, ... H.C. Wijeysundera
doi : 10.1016/j.bja.2020.06.016
Volume 126, Issue 1, January 2021, Pages 181-190
Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity.
Friederike C. Althoff, Abhishek Agnihotri, Stephanie D. Grabitz, Peter Santer, ... Matthias Eikermann
doi : 10.1016/j.bja.2020.08.057
Volume 126, Issue 1, January 2021, Pages 191-200
We tested the primary hypothesis that use of general anaesthesia vs sedation increases vulnerability to adverse discharge (in-hospital mortality or new discharge to a nursing facility) after endoscopic retrograde cholangiopancreatography (ERCP).
Stanislas Grassin-Delyle, Haleema Shakur-Still, Roberto Picetti, Lauren Frimley, ... Ian Roberts
doi : 10.1016/j.bja.2020.07.058
Volume 126, Issue 1, January 2021, Pages 201-209
Intravenous tranexamic acid (TXA) reduces bleeding deaths after injury and childbirth. It is most effective when given early. In many countries, pre-hospital care is provided by people who cannot give i.v. injections. We examined the pharmacokinetics of intramuscular TXA in bleeding trauma patients.
Alexandre Joosten, Dragos Chirnoaga, Philippe Van der Linden, Luc Barvais, ... Joseph Rinehart
doi : 10.1016/j.bja.2020.08.051
Volume 126, Issue 1, January 2021, Pages 210-218
Hypotension occurs frequently during surgery and may be associated with adverse complications. Vasopressor titration is frequently used to correct hypotension, but requires considerable time and attention, potentially reducing the time available for other clinical duties. To overcome this issue, we have developed a closed-loop vasopressor (CLV) controller to help correct hypotension more efficiently. The aim of this randomised controlled study was to evaluate whether the CLV controller was superior to traditional vasopressor management at minimising hypotension in patients undergoing abdominal surgery.
Benjamin F. Gruenbaum
doi : 10.1016/j.bja.2020.07.056
Volume 126, Issue 1, January 2021, Pages 219-229
In order to understand general anaesthesia and certain seizures, a fundamental understanding of the neurobiology of unconsciousness is needed. This review article explores similarities in neuronal and network changes during general anaesthesia and seizure-induced unconsciousness. Both seizures and anaesthetics cause disruption in similar anatomical structures that presumably lead to impaired consciousness.
Stephen H. Gregory, Christopher R. King, Arbi Ben Abdallah, Alex Kronzer, Troy S. Wildes
doi : 10.1016/j.bja.2020.08.026
Volume 126, Issue 1, January 2021, Pages 230-237
Preoperative cognitive dysfunction has been associated with adverse postoperative outcomes. There are limited data characterising the epidemiology of preoperative cognitive dysfunction in older surgical patients.
Katarina Varn?s, Sjoerd J. Finnema, Peter Johnstr?m, Ryosuke Arakawa, ... Lars Farde
doi : 10.1016/j.bja.2020.08.052
Volume 126, Issue 1, January 2021, Pages 238-244
The molecular actions underlying the clinical effects of inhaled anaesthetics such as sevoflurane and isoflurane are not fully understood. Unexpected observations in positron emission tomography (PET) studies with [11C]AZD9272, a metabotropic glutamate receptor 5 (mGluR5) radioligand with possible affinity for monoamine oxidase-B (MAO-B), suggest that its binding is sensitive to anaesthesia with sevoflurane. The objective of the present study was to assess the effects of sevoflurane anaesthesia on the binding of [11C]AZD9272 and of [11C]L-deprenyl-D2, a radioligand selective for MAO-B in non-human primates (NHPs).
Tamara Timic Stamenic, Simon Feseha, Francesca M. Manzella, Damon Wallace, ... Slobodan M. Todorovic
doi : 10.1016/j.bja.2020.07.022
Volume 126, Issue 1, January 2021, Pages 245-255
The mechanisms underlying the role of T-type calcium channels (T-channels) in thalamocortical excitability and oscillations in vivo during neurosteroid-induced hypnosis are largely unknown.
Federico Moro, Francesca Fossi, Aurora Magliocca, Rosaria Pascente, ... Elisa R. Zanier
doi : 10.1016/j.bja.2020.08.027
Volume 126, Issue 1, January 2021, Pages 256-264
Whilst there has been progress in supportive treatment for traumatic brain injury (TBI), specific neuroprotective interventions are lacking. Models of ischaemic heart and brain injury show the therapeutic potential of argon gas, but it is still not known whether inhaled argon (iAr) is protective in TBI. We tested the effects of acute administration of iAr on brain oedema, tissue micro-environmental changes, neurological functions, and structural outcome in a mouse model of TBI.
Alex Proekt, Max B. Kelz
doi : 10.1016/j.bja.2020.09.022
Volume 126, Issue 1, January 2021, Pages 265-278
Anaesthetic induction occurs at higher plasma drug concentrations than emergence in animal studies. Some studies find evidence for such anaesthetic hysteresis in humans, whereas others do not. Traditional thinking attributes hysteresis to drug equilibration between plasma and the effect site. Indeed, a key difference between human studies showing anaesthetic hysteresis and those that do not is in how effect-site equilibration was modelled. However, the effect-site is a theoretical compartment in which drug concentration cannot be measured experimentally. Thus, it is not clear whether drug equilibration models with experimentally intractable compartments are sufficiently constrained to unequivocally establish evidence for the presence or absence of anaesthetic hysteresis.
Dan Wang, Yongxin Guo, Huiming Li, Jiannan Li, ... Hailong Dong
doi : 10.1016/j.bja.2020.09.037
Volume 126, Issue 1, January 2021, Pages 279-292
The neuropeptide orexin promotes arousal from general anaesthesia, however the neuronal circuits that mediate this effect have not been defined. We investigated whether orexinergic neurones modulate the basal forebrain (BF) and locus coeruleus (LC) in emergence from anaesthesia.
Jonghae Kim, Hyung-Chul Lee, Sung-Hye Byun, Hyunyoung Lim, ... Eugene Kim
doi : 10.1016/j.bja.2020.07.060
Volume 126, Issue 1, January 2021, Pages 293-303
Emergence delirium (ED) in children after general anaesthesia causes significant distress in patients, their family members, and clinicians; however, electroencephalogram (EEG) markers predicting ED have not been fully investigated.
Karim S. Ladha, Alexander McLaren-Blades, Akash Goel, Michael J. Buys, ... Hance Clarke
doi : 10.1016/j.bja.2020.09.026
Volume 126, Issue 1, January 2021, Pages 304-318
In many countries, liberalisation of the legislation regulating the use of cannabis has outpaced rigorous scientific studies, and a growing number of patients presenting for surgery consume cannabis regularly. Research to date suggests that cannabis can impact perioperative outcomes. We present recommendations obtained using a modified Delphi method for the perioperative care of cannabis-using patients.
Filippo Sanfilippo, Davide Di Falco, Alberto Noto, Cristina Santonocito, ... Marinella Astuto
doi : 10.1016/j.bja.2020.07.059
Volume 126, Issue 1, January 2021, Pages 319-330
Weaning from mechanical ventilation is a challenging step during recovery from critical illness. Weaning failure or early reintubation are associated with increased morbidity and mortality, exposing patients to life-threatening complications. Cardiac dysfunction represents the most common cause of weaning failure. We conducted a systematic review and meta-analysis to evaluate the association between transthoracic echocardiographic parameters and weaning failure.
James Peyton, Raymond Park, Steven J. Staffa, Stefano Sabato, ... Rob Greenberg
doi : 10.1016/j.bja.2020.08.010
Volume 126, Issue 1, January 2021, Pages 331-339
The design of a videolaryngoscope blade may affect its efficacy. We classified videolaryngoscope blades as standard and non-standard shapes to compare their efficacy performing tracheal intubation in children enrolled in the Paediatric Difficult Intubation Registry.
David Faraoni, Irvin Gross, Aryeh Shander
doi : 10.1016/j.bja.2020.07.021
Volume 126, Issue 1, January 2021, Pages e1-e2
Marius A. Roman, Riccardo G. Abbasciano, Florence Y. Lai, Gavin J. Murphy
doi : 10.1016/j.bja.2020.08.039
Volume 126, Issue 1, January 2021, Pages e2-e4
Mazyar Javidroozi, Jean-Francois Hardy, Sherri Ozawa
doi : 10.1016/j.bja.2020.10.009
Volume 126, Issue 1, January 2021, Pages e4-e5
Marius A. Roman, Riccardo G. Abbasciano, Guiqing Yao, Gavin J. Murphy
doi : 10.1016/j.bja.2020.08.029
Volume 126, Issue 1, January 2021, Pages e6-e7
Kevin M. Trentino, Donat R. Spahn, Hamish S. Mace, Hans Gombotz, Axel Hofmann
doi : 10.1016/j.bja.2020.09.003
Volume 126, Issue 1, January 2021, Pages e7-e9
Kuo-Chuan Hung, I-Wen Chen, Chien-Ming Lin, Cheuk-Kwan Sun
doi : 10.1016/j.bja.2020.08.012
Volume 126, Issue 1, January 2021, Pages e9-e11
Friedrich Lersch, Darren Hight, Flavio Frohlich
doi : 10.1016/j.bja.2020.08.028
Volume 126, Issue 1, January 2021, Pages e11-e12
Werner Schmid, Peter Marhofer, Wolfgang Klug
doi : 10.1016/j.bja.2020.09.034
Volume 126, Issue 1, January 2021, Page e13
Thomas Fuchs-Buder
doi : 10.1016/j.bja.2020.09.016
Volume 126, Issue 1, January 2021, Pages e14-e15
Joseph Donnelly, Fabian Güiza, Bart Depreitere, Geert Meyfroidt, ... Peter Smielewski
doi : 10.1016/j.bja.2020.09.018
Volume 126, Issue 1, January 2021, Pages e15-e17
Ying-J. Du, Xin-Q. Zhang, Li-D. Liu, Jin-Y. Zhang, ... Gu-Y. Wang
doi : 10.1016/j.bja.2020.09.032
Volume 126, Issue 1, January 2021, Pages e17-e19
Lauren A. Wilson, Jashvant Poeran, Jiabin Liu, Haoyan Zhong, Stavros G. Memtsoudis
doi : 10.1016/j.bja.2020.10.001
Volume 126, Issue 1, January 2021, Pages e19-e21
Filippo Sanfilippo, Stefano Tigano, Alberto Morgana, Paolo Murabitol, Marinella Astuto
doi : 10.1016/j.bja.2020.10.002
Volume 126, Issue 1, January 2021, Pages e21-e25
Kuo-Chuan Hung, Jen-Yin Chen, Chun-Ning Ho, Cheuk-Kwan Sun
doi : 10.1016/j.bja.2020.10.005
Volume 126, Issue 1, January 2021, Pages e25-e27
Didier G. Ebo, Marie-Line Van der Poorten, Jessy Elst, Athina L. Van Gasse, ... Vito Sabato
doi : 10.1016/j.bja.2020.10.006
Volume 126, Issue 1, January 2021, Pages e27-e29
Steven B. Porter, Haoyan Zhong, Christopher B. Robards, Jiabin Liu, ... Stavros Memtsoudis
doi : 10.1016/j.bja.2020.10.007
Volume 126, Issue 1, January 2021, Pages e29-e31
Ari Ercole
doi : 10.1016/j.bja.2020.10.017
Volume 126, Issue 1, January 2021, Page e32
Hailin Zhao, Roger Davies, Daqing Ma
doi : 10.1016/j.bja.2020.09.031
Volume 126, Issue 1, January 2021, Pages e33-e35
Amit Jain, Massimo Lamperti, D. John Doyle
doi : 10.1016/j.bja.2020.10.010
Volume 126, Issue 1, January 2021, Pages e35-e38
Alexander Hall, Abhijoy Chakladar
doi : 10.1016/j.bja.2020.09.033
Volume 126, Issue 1, January 2021, Pages e38-e39
Robert ffrench-O'Carroll, Tara Feeley, Mong Hoi Tan, Claire Magner, ... Shauna Delaney
doi : 10.1016/j.bja.2020.09.040
Volume 126, Issue 1, January 2021, Pages e39-e41
Steve Harris, Ed Palmer, Kevin Fong
doi : 10.1016/j.bja.2020.10.008
Volume 126, Issue 1, January 2021, Pages e42-e44
Alessia Longobardo, Cecilia Montanari, Robert Shulman, Suzanne Benhalim, ... Nishkantha Arulkumaran
doi : 10.1016/j.bja.2020.10.011
Volume 126, Issue 1, January 2021, Pages e44-e46
Romain Pirracchio, Orestes Mavrothalassitis, Michael Mathis, Sachin Kheterpal, Matthieu Legrand
doi : 10.1016/j.bja.2020.10.013
Volume 126, Issue 1, January 2021, Pages e46-e48
Anna Ascott, Paul Crowest, Eleanor de Sausmarez, Mansoor Khan, Abhijoy Chakladar
doi : 10.1016/j.bja.2020.10.016
Volume 126, Issue 1, January 2021, Pages e48-e49
Nicolaas H. Sperna Weiland, Roberto A.A.L. Traversari, Jante S. Sinnige, Frank van Someren Gréve, ... Markus W. Hollmann
doi : 10.1016/j.bja.2020.10.018
Volume 126, Issue 1, January 2021, Pages e49-e52
Gertrude J. Nieuwenhuijs-Moeke, Vincent B. Nieuwenhuijs, Marc A.J. Seelen, Stefan P. Berger, ... Michel M.R.F. Struys
doi : 10.1016/j.bja.2020.10.024
Volume 126, Issue 1, January 2021, Pages 340-341
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