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3 results on '"Galas, F"'

2. Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial

Author

Rebeca Boltes Cecatto, Linamara Rizzo Battistella, Evgeny Fominskiy, Giovanni Landoni, Julia Tizue Fukushima, Eduardo A Osawa, Ludhmila Abrahão Hajjar, L. de Almeida, E.P.M. de Almeida, J. P. de Almeida, C.M.M. de Brito, M Pe Diz, Luciana Barrio Lara Cavichio, F Galas, U. Ribeiro-Jr, de Almeida, E. P. M, de Almeida, J. P, Landoni, Giovanni, Galas, F. R. B. G, Fukushima, J. T, Fominskiy, E, de Brito, C. M. M, Cavichio, L. B. L, de Almeida, L. A. A, Ribeiro Jr, U, Osawa, E. A, Diz, M. P. E, Cecatto, R. B, Battistella, L. R, and Hajjar, L. A.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, 030230 surgery, law.invention, rehabilitation, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Medicine, Aerobic exercise, Humans, postoperative complication, Single-Blind Method, Aged, Rehabilitation, Exercise Tolerance, exercise, business.industry, Incidence (epidemiology), Absolute risk reduction, Middle Aged, Confidence interval, Exercise Therapy, Clinical trial, Anesthesiology and Pain Medicine, Treatment Outcome, early ambulation, 030220 oncology & carcinogenesis, Abdominal Neoplasms, Physical therapy, Number needed to treat, Feasibility Studies, Female, business, neoplasm, Program Evaluation
Abstract

Background Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme. Methods We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge. Results A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P=0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9–38.6] and a number needed to treat of 5 (95% CI 3–17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises. Conclusions An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear. Clinical trial registration NCT01693172.

Published
2017

3. Liberal transfusion strategy improves survival in perioperative but not in critically ill patients. A meta-analysis of randomised trials.

Author

Fominskiy E, Putzu A, Monaco F, Scandroglio AM, Karaskov A, Galas FR, Hajjar LA, Zangrillo A, and Landoni G

Subjects
Critical Care statistics & numerical data, Humans, Perioperative Care statistics & numerical data, Survival Analysis, Treatment Outcome, Blood Transfusion statistics & numerical data, Critical Care methods, Critical Illness mortality, Perioperative Care methods, Perioperative Care mortality, Randomized Controlled Trials as Topic
Abstract

Background: Guidelines support the use of a restrictive strategy in blood transfusion management in a variety of clinical settings. However, recent randomized controlled trials (RCTs) performed in the perioperative setting suggest a beneficial effect on survival of a liberal strategy. We aimed to assess the effect of liberal and restrictive blood transfusion strategies on mortality in perioperative and critically ill adult patients through a meta-analysis of RCTs., Methods: We searched PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, Transfusion Evidence Library, and Google Scholar up to 27 March 2015, for RCTs performed in perioperative or critically ill adult patients, receiving a restrictive or liberal transfusion strategy, and reporting all-cause mortality. We used a fixed or random-effects model to calculate the odds ratio (OR) and 95% confidence interval (CI) for pooled data. We assessed heterogeneity using Cochrane's Q and I(2) tests. The primary outcome was all-cause mortality within 90-day follow-up., Results: Patients in the perioperative period receiving a liberal transfusion strategy had lower all-cause mortality when compared with patients allocated to receive a restrictive transfusion strategy (OR 0.81; 95% CI 0.66‒1.00; P=0.05; I(2)=25%; Number needed to treat=97) with 7552 patients randomized in 17 trials. There was no difference in mortality among critically ill patients receiving a liberal transfusion strategy when compared with the restrictive transfusion strategy (OR 1.10; 95% CI 0.99‒1.23; P=0.07; I(2)=34%) with 3469 patients randomized in 10 trials., Conclusion: According to randomized published evidence, perioperative adult patients have an improved survival when receiving a liberal blood transfusion strategy., (© The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Published
2015
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