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ANZCA Clinical Trials Network ...
ANZCA Clinical Trials Network clinical trials publications
• Publications of interest to the ANZCA Clinical Trials Network. Find out more: https://www.anzca.edu.au/ctn
#21
REVIEW
Nicola Disma, James D O'Leary, Andreas W Loepke, Ansgar M Brambrink, Karin Becke, Nicola G Clausen, Jurgen C De Graaff, Fang Liu, Tom G Hansen, Mary E McCann, Cynthia F Salorio, Sulpicio Soriano, Lena S Sun, Peter Szmuk, David O Warner, Laszlo Vutskits, Andrew J Davidson
All commonly used general anesthetics have been shown to cause neurotoxicity in animal models, including nonhuman primates. Opinion, however, remains divided over how cumulative evidence from preclinical and human studies in this field should be interpreted and its translation to current practices in pediatric anesthesia and surgery. A group of international experts in laboratory and clinical sciences recently convened in Genoa, Italy, to evaluate the current state of both laboratory and clinical research and discuss future directions for basic, translational, and clinical studies in this field...
September 2018: Paediatric Anaesthesia
#22
JOURNAL ARTICLE
Stephan A Schug, Julie Bruce
Risk stratification for the development chronic postsurgical pain is an important tool, which may permit preventive measures or appropriate advice for patients at high risk.
November 2017: Pain Reports
#23
JOURNAL ARTICLE
Leon N Warne, Stephan A Schug, Thierry Beths, Juliana T Brondani, Jennifer E Carter, B Duncan X Lascelles, Anthea L Raisis, Sheilah A Robertson, Paulo V M Steagall, Polly M Taylor, Ted Whittem, Sébastien H Bauquier
Introduction: This article reports the content validation of a Critical Appraisal Tool designed to Review the quality of Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain and provide guidance as to the strengths and weakness of findings. The CATRAS quality items encompass 3 domains: level of evidence, methodological soundness, and grading of the pain assessment tool. Objectives: To validate a critical appraisal tool for reviewing analgesia studies involving subjects incapable of self-reporting pain...
July 2018: Pain Reports
#24
JOURNAL ARTICLE
Carol L Hodgson, Kimberley J Haines, Michael Bailey, Jonathan Barrett, Rinaldo Bellomo, Tracey Bucknall, Belinda J Gabbe, Alisa M Higgins, Theodore J Iwashyna, Julian Hunt-Smith, Lynne J Murray, Paul S Myles, Jennie Ponsford, David Pilcher, Andrew A Udy, Craig Walker, Meredith Young, D J Jamie Cooper
PURPOSE: To determine predictors of inability to return to work due to health six-months after intensive care admission; and compare functional recovery between patients who had not returned to work and employed patients. METHODS: Participants were working adults admitted to ICU who received >24 h of mechanical ventilation. Outcomes included inability to return to work due to health at six-months post-ICU admission, disability, health status, anxiety, depression and post-traumatic stress...
August 13, 2018: Journal of Critical Care
#25
MULTICENTER STUDY
Duminda N Wijeysundera, Rupert M Pearse, Mark A Shulman, Tom E F Abbott, Elizabeth Torres, Althea Ambosta, Bernard L Croal, John T Granton, Kevin E Thorpe, Michael P W Grocott, Catherine Farrington, Paul S Myles, Brian H Cuthbertson
BACKGROUND: Functional capacity is an important component of risk assessment for major surgery. Doctors' clinical subjective assessment of patients' functional capacity has uncertain accuracy. We did a study to compare preoperative subjective assessment with alternative markers of fitness (cardiopulmonary exercise testing [CPET], scores on the Duke Activity Status Index [DASI] questionnaire, and serum N-terminal pro-B-type natriuretic peptide [NT pro-BNP] concentrations) for predicting death or complications after major elective non-cardiac surgery...
June 30, 2018: Lancet
#26
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Jan M Dieleman, Andrew Forbes, Stephane Heritier, Julian A Smith
BACKGROUND: Numerous studies have investigated high-dose corticosteroids in cardiac surgery, but with mixed results leading to ongoing variations in practice around the world. DECS-II is a study comparing high-dose dexamethasone with placebo in patients undergoing cardiac surgery. METHODS: We discuss the rationale for conducting DECS-II, a 2800-patient, pragmatic, multicenter, assessor-blinded, randomized trial in cardiac surgery, and the features of the DECS-II study design (objectives, end points, target population, based on practice preference with post-randomization consent, treatments, patient follow-up and analysis)...
October 2018: American Heart Journal
#27
JOURNAL ARTICLE
Priscilla H Yong, Laurence Weinberg, Niloufar Torkamani, Leonid Churilov, Raymond J Robbins, Ronald Ma, Rinaldo Bellomo, Que T Lam, James D Burns, Graeme K Hart, Jeremy F Lew, Johan Mårtensson, David Story, Andrew N Motley, Douglas Johnson, Jeffrey D Zajac, Elif I Ekinci
OBJECTIVE: Limited studies have examined the association between diabetes and HbA1c with postoperative outcomes. We investigated the association of diabetes, defined categorically, and the association of HbA1c as a continuous measure, with postoperative outcomes. RESEARCH DESIGN AND METHODS: In this prospective, observational study, we measured the HbA1c of surgical inpatients age ≥54 years at a tertiary hospital between May 2013 and January 2016. Patients were diagnosed with diabetes if they had preexisting diabetes or an HbA1c ≥6...
June 2018: Diabetes Care
#28
REVIEW
Chun Hin Angus Lee, Joseph C Kong, Hilmy Ismail, Bernhard Riedel, Alexander Heriot
BACKGROUND: Gas exchange-derived variables obtained from cardiopulmonary exercise testing allow objective assessment of functional capacity and hence physiological reserve to withstand the stressors of major surgery. Field walk tests provide an alternate means for objective assessment of functional capacity that may be cheaper and have greater acceptability, in particular, in elderly patients. OBJECTIVE: This systematic review evaluated the predictive value of cardiopulmonary exercise testing and field walk tests in surgical outcomes after colorectal surgery...
March 2018: Diseases of the Colon and Rectum
#29
REVIEW
Kate Leslie, James Sgroi
PURPOSE OF REVIEW: The purpose of this article is to review the practice of sedation for adults having gastrointestinal endoscopy in Australia and to compare it with practice in other countries. RECENT FINDINGS: The practice of sedation for endoscopy in Australia is dominated by anaesthesiologists, who have a preference for deep propofol-based sedation. The recent literature includes a number of guidelines for sedation developed by multidisciplinary groups, anaesthesiologists and gastroenterologists in Australia and other countries...
August 2018: Current Opinion in Anaesthesiology
#30
REVIEW
Paul S Myles
PURPOSE OF REVIEW: Perioperative studies increasingly report patient-centered outcomes, but few provide a valid, global measure of a patient's health status after surgery and anesthesia. This review considers three quality of recovery (QoR) scales. RECENT FINDINGS: The 9-item (QoR Score), 15-item (QoR-15), and 40-item (QoR-40) QoR scales have been extensively validated in perioperative settings, and have also been used as outcome measures in numerous surgery and anesthesia studies...
August 2018: Current Opinion in Anaesthesiology
#31
JOURNAL ARTICLE
Martin Bailey, Tomas Corcoran, Stephan Schug, Andrew Toner
Chronic postsurgical pain (CPSP) occurs in 12% of surgical populations and is a high priority for perioperative research. Systemic lidocaine may modulate several of the pathophysiological processes linked to CPSP. This systematic review aims to identify and synthesize the evidence linking lidocaine infusions and CPSP. The authors conducted a systematic literature search of the major medical databases from inception until October 2017. Trials that randomized adults without baseline pain to perioperative lidocaine infusion or placebo were included if they reported on CPSP...
September 2018: Pain
#32
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Philip Peyton, David Story, Chris Christophi, Kate Leslie, Shay McGuinness, Rachael Parke, Jonathan Serpell, Matthew T V Chan, Thomas Painter, Stuart McCluskey, Gary Minto, Sophie Wallace
BACKGROUND: Guidelines to promote the early recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery. However, the supporting evidence is limited, and there is concern about impaired organ perfusion. METHODS: In a pragmatic, international trial, we randomly assigned 3000 patients who had an increased risk of complications while undergoing major abdominal surgery to receive a restrictive or liberal intravenous-fluid regimen during and up to 24 hours after surgery...
June 14, 2018: New England Journal of Medicine
#33
JOURNAL ARTICLE
P S Myles, O Boney, M Botti, A M Cyna, T J Gan, M P Jensen, H Kehlet, A Kurz, G S De Oliveira, P Peyton, D I Sessler, M R Tramèr, C L Wu, Paul Myles, Michael Grocott, Bruce Biccard, Jane Blazeby, Oliver Boney, Matthew Chan, Elisabeth Diouf, Lee Fleisher, Cor Kalkman, Andrea Kurz, Ramani Moonesinghe, Duminda Wijeysundera
BACKGROUND: Maximising patient comfort during and after surgery is a primary concern of anaesthetists and other perioperative clinicians, but objective measures of what constitutes patient comfort in the perioperative period remain poorly defined. The Standardised Endpoints in Perioperative Medicine initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials. METHODS: We undertook a systematic review to identify measures of patient comfort used in the anaesthetic, surgical, and other perioperative literature...
April 2018: British Journal of Anaesthesia
#34
RANDOMIZED CONTROLLED TRIAL
W Scott Beattie, Duminda N Wijeysundera, Matthew T V Chan, Philip J Peyton, Kate Leslie, Michael J Paech, Daniel I Sessler, Sophie Wallace, Paul S Myles, W Galagher, C Farrington, A Ditoro, S Baulch, S Sidiropoulos, R Bulach, D Bryant, E O'Loughlin, V Mitteregger, S Bolsin, C Osborne, R McRae, M Backstrom, R Cotter, S March, B Silbert, S Said, R Halliwell, J Cope, D Fahlbusch, D Crump, G Thompson, A Jefferies, M Reeves, N Buckley, T Tidy, T Schricker, R Lattermann, D Iannuzzi, J Carroll, M Jacka, C Bryden, N Badner, M W Y Tsang, B C P Cheng, A C M Fong, L C Y Chu, E G Y Koo, N Mohd, L E Ming, D Campbell, D McAllister, S Walker, S Olliff, R Kennedy, A Eldawlatly, T Alzahrani, N Chua, R Sneyd, H McMillan, I Parkinson, A Brennan, P Balaji, J Nightingale, G Kunst, M Dickinson, B Subramaniam, V Banner-Godspeed, J Liu, A Kurz, B Hesler, A Y Fu, C Egan, A N Fiffick, M T Hutcherson, A Turan, A Naylor, D Obal, E Cooke
BACKGROUND: Globally, >300 million patients have surgery annually, and ≤20% experience adverse postoperative events. We studied the impact of both cardiac and noncardiac adverse events on 1-year disability-free survival after noncardiac surgery. METHODS: We used the study cohort from the Evaluation of Nitrous oxide in Gas Mixture of Anesthesia (ENIGMA-II) trial, an international randomized trial of 6992 noncardiac surgical patients. All were ≥45 years of age and had moderate to high cardiac risk...
November 2018: Anesthesia and Analgesia
#35
JOURNAL ARTICLE
T E F Abbott, T Ahmad, M K Phull, A J Fowler, R Hewson, B M Biccard, M S Chew, M Gillies, R M Pearse
BACKGROUND: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. METHODS: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use...
January 2018: British Journal of Anaesthesia
#36
RANDOMIZED CONTROLLED TRIAL
Daniel I Sessler, Christian S Meyhoff, Nicole M Zimmerman, Guangmei Mao, Kate Leslie, Skarlet M Vásquez, Packianathaswamy Balaji, Jesús Alvarez-Garcia, Alexandre B Cavalcanti, Joel L Parlow, Prashant V Rahate, Manfred D Seeberger, Bruno Gossetti, S A Walker, Rajendra K Premchand, Rikke M Dahl, Emmanuelle Duceppe, Reitze Rodseth, Fernando Botto, P J Devereaux
BACKGROUND: The relative contributions of intraoperative and postoperative hypotension to perioperative morbidity remain unclear. We determined the association between hypotension and a composite of 30-day myocardial infarction and death over three periods: (1) intraoperative, (2) remaining day of surgery, and (3) during the initial four postoperative days. METHODS: This was a substudy of POISE-2, a 10,010-patient factorial-randomized trial of aspirin and clonidine for prevention of myocardial infarction...
February 2018: Anesthesiology
#37
RANDOMIZED CONTROLLED TRIAL
Michelle M Graham, Daniel I Sessler, Joel L Parlow, Bruce M Biccard, Gordon Guyatt, Kate Leslie, Matthew T V Chan, Christian S Meyhoff, Denis Xavier, Alben Sigamani, Priya A Kumar, Marko Mrkobrada, Deborah J Cook, Vikas Tandon, Jesus Alvarez-Garcia, Juan Carlos Villar, Thomas W Painter, Giovanni Landoni, Edith Fleischmann, Andre Lamy, Richard Whitlock, Yannick Le Manach, Meylin Aphang-Lam, Juan P Cata, Peggy Gao, Nicolaas C S Terblanche, Pamidimukkala V Ramana, Kim A Jamieson, Amal Bessissow, Gabriela R Mendoza, Silvia Ramirez, Pierre A Diemunsch, Salim Yusuf, P J Devereaux
BACKGROUND: Uncertainty remains about the effects of aspirin in patients with prior percutaneous coronary intervention (PCI) having noncardiac surgery. OBJECTIVE: To evaluate benefits and harms of perioperative aspirin in patients with prior PCI. DESIGN: Nonprespecified subgroup analysis of a multicenter factorial trial. Computerized Internet randomization was done between 2010 and 2013. Patients, clinicians, data collectors, and outcome adjudicators were blinded to treatment assignment...
February 20, 2018: Annals of Internal Medicine
#38
JOURNAL ARTICLE
S Ramani Moonesinghe, Danny J N Wong, Laura Farmer, Richard Shawyer, Paul S Myles, Steve K Harris
INTRODUCTION: The admission of high-risk patients to critical care after surgery is a recommended standard of care. Nevertheless, poor compliance against this recommendation has been repeatedly demonstrated in large epidemiological studies. It is unclear whether this is due to reasons of capacity, equipoise, poor quality clinical care or because hospitals are working creatively to create capacity for augmented care on normal surgical wards. The EPIdemiology of Critical Care after Surgery study aims to address these uncertainties...
September 7, 2017: BMJ Open
#39
JOURNAL ARTICLE
Paul S Myles, Mark A Shulman, Stephane Heritier, Sophie Wallace, David R McIlroy, Stuart McCluskey, Isabella Sillar, Andrew Forbes
OBJECTIVE: To evaluate 'days at home up to 30 days after surgery' (DAH30 ) as a patient-centred outcome measure. DESIGN: Prospective cohort study. DATA SOURCE: Using clinical trial data (seven trials, 2109 patients) we calculated DAH30 from length of stay, readmission, discharge destination and death up to 30 days after surgery. MAIN OUTCOME: The association between DAH30 and serious complications after surgery. RESULTS: One or more complications occurred in 263 of 1846 (14...
August 18, 2017: BMJ Open
#40
RANDOMIZED CONTROLLED TRIAL
W Scott Beattie, Duminda N Wijeysundera, Matthew T V Chan, Philip J Peyton, Kate Leslie, Michael J Paech, P J Devereaux, Daniel I Sessler, Sophie Wallace, Paul S Myles
No abstract text is available yet for this article.
August 15, 2017: Journal of the American College of Cardiology
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