Search

Your search keyword '"Beilstein, C"' showing total 21 results
Start Over Author "Beilstein, C"
21 results on '"Beilstein, C"'

1. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., R Lifford, R., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Riedel, Bernhard, Li, Michael H-G., Lee, C.H. Angus, Ismail, Hilmy, Cuthbertson, Brian H., Wijeysundera, Duminda N., and Ho, Kwok M.

Published
2021
Full Text
View/download PDF

2. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Cuthbertson, B.H., Wijeysundera, D.N., Pearse, R.M., Myles, P.S., Abbott, T.E.F., Shulman, M.A., Torres, E., Ambosta, A., Melo, M., Mamdani, M., Thorpe, K.E., Wallace, S., Farrington, C., Croal, B.L., Grocott, M.P.W., Granton, J.T., Oh, P., Thompson, B., Levett, D., Hillis, G., Beattie, W.S., Wijeysundera, H.C., Wijeysundera, Duminda N., Beattie, W. Scott, Hillis, Graham S., Abbott, Tom E.F., Shulman, Mark A., Ackland, Gareth L., Mazer, C. David, Myles, Paul S., Pearse, Rupert M., Cuthbertson, Brian H., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., and Lifford, R.

Published
2020
Full Text
View/download PDF

3. Association of preoperative anaemia with cardiopulmonary exercise capacity and postoperative outcomes in noncardiac surgery: a substudy of the Measurement of Exercise Tolerance before Surgery (METS) Study

Author

Myles, P.S., Shulman, M.A., Wallace, S., Farrington, C., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Wijeysundera, D.N., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Granton, J.T., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Croal, B.L., Lum, M., Martin, D., James, S., Filipe, H., Pinto, M., Kynaston, S., Pearse, R.M., Abbott, T.E.F., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Cuthbertson, B.H., Torres, E., Ambosta, A., Melo, M., Mamdani, M., Thorpe, K.E., Grocott, M.P.W., Hillis, G., Wijeysundera, H.C., Bartoszko, J., and Laupacis, A.

Published
2019
Full Text
View/download PDF

4. Inter-observer reliability of preoperative cardiopulmonary exercise test interpretation: a cross-sectional study

Author

Abbott, T., MacDonald, N., Gooneratne, M., Raj, A., Rooms, M., Nicol, M., Koutra, M., Halworth, S., Wilkins, K., Nevin, D., Gaultry, E., Otto, J., Bell, D., Hardy, M., Prabhu, P., Ravishankar, R., Correia, J., Beilstein, C., Greaves, K., James, S., Tighe, H., Perks, J., Pennington, J., Pritchard, A., Moxon, P., Brown, K., Swart, M., Carlisle, J., Abbott, T.E.F., McNeill, J., Lee, A., Levett, D.Z.H., and Grocott, M.P.W.

Published
2018
Full Text
View/download PDF

5. Impact of analgesic techniques on early quality of recovery after prostatectomy: a 3-arm, randomised trial

Author

Beilstein, C M, Huber, M, Furrer, M A, Löffel, L M, Wüthrich, P Y, and Engel, D

Subjects
610 Medizin und Gesundheit
Abstract

BACKGROUND Prostatectomy is associated with relevant acute postoperative pain. Optimal analgesic techniques to minimise pain and enhance recovery are still under investigation. We aimed to compare the effect of three different analgesic techniques on quality of recovery. METHODS This investigator-initiated, prospective, randomised, three-arm, parallel group, active controlled, interventional superiority trial was performed in a Swiss teaching hospital from 2018-2021. Consecutive patients undergoing open or robotic-assisted radical prostatectomy were randomised to spinal anaesthesia (SSS, bupivacaine 0.5% + fentanyl), bilateral transversus abdominis plane block (TAP, ropivacaine 0.375% + clonidine) or systemic administration of lidocaine (SA, lidocaine 1%) in addition to general anaesthesia. Primary outcome was Quality of Recovery 15 (QoR-15) score on postoperative day one compared to baseline. Secondary outcomes were QoR-15 at discharge, postoperative nausea and vomiting, pain scores, return of gastrointestinal function and use of rescue analgesia. RESULTS From 133 patients, 40 received spinal anaesthesia, 45 TAP block and 48 systemic analgesia. QoR-15 scores did not differ on day 1 (P=0.301) or at discharge (P=0.309) when compared to baseline. QoR-15 changes where similar in all groups. At discharge, median QoR-15 scores were considered as good (>122) in all groups: SSS 134 [IQR 128 to 138]; TAP 129 [IQR 122 to 136] and SA 128 [IQR 123 to 136]. There were no significant differences in the other secondary outcomes. CONCLUSIONS Quality of recovery on postoperative day one compared to baseline did not differ if spinal anaesthesia, TAP block or systemic administration of lidocaine was added to general anaesthesia.

Published
2022
Full Text
View/download PDF

6. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Wijeysundera, DN, Beattie, WS, Hillis, GS, Abbott, TEF, Shulman, MA, Ackland, GL, Mazer, CD, Myles, PS, Pearse, RM, Cuthbertson, BH, Measurement of Exercise Tolerance before Surgery Study Investiga, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, Gutierrez Del Arroyo, A, Raj, A, Lifford, R, International and National Coordinators, Central Project Office Operations Committee, CPET Methods Committee, Outcome Adjudication Committee, and International Steering Committee

Abstract

BACKGROUND: The Duke Activity Status Index (DASI) questionnaire might help incorporate self-reported functional capacity into preoperative risk assessment. Nonetheless, prognostically important thresholds in DASI scores remain unclear. We conducted a nested cohort analysis of the Measurement of Exercise Tolerance before Surgery (METS) study to characterise the association of preoperative DASI scores with postoperative death or complications. METHODS: The analysis included 1546 participants (≥40 yr of age) at an elevated cardiac risk who had inpatient noncardiac surgery. The primary outcome was 30-day death or myocardial injury. The secondary outcomes were 30-day death or myocardial infarction, in-hospital moderate-to-severe complications, and 1 yr death or new disability. Multivariable logistic regression modelling was used to characterise the adjusted association of preoperative DASI scores with outcomes. RESULTS: The DASI score had non-linear associations with outcomes. Self-reported functional capacity better than a DASI score of 34 was associated with reduced odds of 30-day death or myocardial injury (odds ratio: 0.97 per 1 point increase above 34; 95% confidence interval [CI]: 0.96-0.99) and 1 yr death or new disability (odds ratio: 0.96 per 1 point increase above 34; 95% CI: 0.92-0.99). Self-reported functional capacity worse than a DASI score of 34 was associated with increased odds of 30-day death or myocardial infarction (odds ratio: 1.05 per 1 point decrease below 34; 95% CI: 1.00-1.09), and moderate-to-severe complications (odds ratio: 1.03 per 1 point decrease below 34; 95% CI: 1.01-1.05). CONCLUSIONS: A DASI score of 34 represents a threshold for identifying patients at risk for myocardial injury, myocardial infarction, moderate-to-severe complications, and new disability.

Published
2020

7. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Riedel, Bernhard, primary, Li, Michael H-G., additional, Lee, C.H. Angus, additional, Ismail, Hilmy, additional, Cuthbertson, Brian H., additional, Wijeysundera, Duminda N., additional, Ho, Kwok M., additional, Wallace, S., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Au, S., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, J.K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Lum, M., additional, Martin, D., additional, S James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Stephens, R.C.M., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, R Lifford, R., additional, Melo, M., additional, Mamdani, M., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2021
Full Text
View/download PDF

9. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Wijeysundera, Duminda N., primary, Beattie, W. Scott, additional, Hillis, Graham S., additional, Abbott, Tom E.F., additional, Shulman, Mark A., additional, Ackland, Gareth L., additional, Mazer, C. David, additional, Myles, Paul S., additional, Pearse, Rupert M., additional, Cuthbertson, Brian H., additional, Myles, P.S., additional, Shulman, M.A., additional, Wallace, S., additional, Farrington, C., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Wijeysundera, D.N., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Croal, B.L., additional, Lum, M., additional, Martin, D., additional, James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Pearse, R.M., additional, Abbott, T.E.F., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Stephens, R.C.M., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, Lifford, R., additional, Cuthbertson, B.H., additional, Torres, E., additional, Ambosta, A., additional, Melo, M., additional, Mamdani, M., additional, Thorpe, K.E., additional, Grocott, M.P.W., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2020
Full Text
View/download PDF

11. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: A secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Riedel, B., Li, M.H-G, Lee, C.H.A., Ismail, H., Cuthbertson, B.H., Wijeysundera, D.N., Ho, K.M., Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Riedel, B., Li, M.H-G, Lee, C.H.A., Ismail, H., Cuthbertson, B.H., Wijeysundera, D.N., Ho, K.M., Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Melo, M., Mamdani, M., Hillis, G., and Wijeysundera, H.C.

Abstract

Background 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. Methods In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg −1 min −1 and peak oxygen consumption (VO 2 peak) >16 ml kg −1 min −1, cut-points that represent a reduced risk of postoperative complications. Results Five questions were identified to have dominance in predicting AT>11 ml kg −1 min −1 and VO 2 peak>16 ml.kg −1min −1. These items were included in the M-DASI-5Q and retained utility in predicting AT>11 ml.kg −1.min −1 (area under the receiver-operating-characteristic [AUROC]-AT: M-DASI-5Q=0.67 vs original 12-question DASI=0.66) and VO 2 peak (AUROC-VO2 peak: M-DASI-5Q 0.73 vs original 12-question DASI 0.71). Conversely, in a sensitivity analysis we removed one potentially sensitive question related to the ability to have sexual relations, and the ability of the remaining four questions (M-DASI-4Q) to predict an adequate functional threshold remained no worse than the original 12-question DASI model. Adding a dynamic component to the M-DASI-4Q by assessing the chronotropic response to exercise improved its ability to discriminate between those with VO 2 peak>16 ml.kg −1.min −1 and VO 2 peak<16 ml.kg −1.min −1. Conclusions The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management.

Published
2020

12. Association of preoperative anaemia with cardiopulmonary exercise capacity and postoperative outcomes in noncardiac surgery: a substudy of the Measurement of Exercise Tolerance before Surgery (METS) Study

Author

Bartoszko, J., primary, Thorpe, K.E., additional, Laupacis, A., additional, Wijeysundera, D.N., additional, Myles, P.S., additional, Shulman, M.A., additional, Wallace, S., additional, Farrington, C., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Croal, B.L., additional, Lum, M., additional, Martin, D., additional, James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Pearse, R.M., additional, Abbott, T.E.F., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, Lifford, R., additional, Cuthbertson, B.H., additional, Torres, E., additional, Ambosta, A., additional, Melo, M., additional, Mamdani, M., additional, Grocott, M.P.W., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2019
Full Text
View/download PDF

13. Heart rate recovery and morbidity after noncardiac surgery: Planned secondary analysis of two prospective, multi-centre, blinded observational studies

Author

Bianchi, C, Ackland, GL, Abbott, TEF, Minto, G, Clark, M, Owen, T, Prabhu, P, May, SM, Reynolds, JA, Cuthbertson, BH, Wijesundera, D, Pearse, RM, Myles, PS, Shulman, MA, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Mazer, CD, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Wijeysundera, DN, Beattie, WS, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, del Arroyo, AG, Raj, A, Lifford, R, King, A, Pollak, C, Williams, C, Patrick, A, West, C, Vickers, E, Green, R, Jones, A, Otto, J, Lach, A, Whittle, J, Paredes, LG, Toner, A, Williams, A, Pradhu, P, Hull, D, Montague, L, Bianchi, C, Ackland, GL, Abbott, TEF, Minto, G, Clark, M, Owen, T, Prabhu, P, May, SM, Reynolds, JA, Cuthbertson, BH, Wijesundera, D, Pearse, RM, Myles, PS, Shulman, MA, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Mazer, CD, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Wijeysundera, DN, Beattie, WS, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, del Arroyo, AG, Raj, A, Lifford, R, King, A, Pollak, C, Williams, C, Patrick, A, West, C, Vickers, E, Green, R, Jones, A, Otto, J, Lach, A, Whittle, J, Paredes, LG, Toner, A, Williams, A, Pradhu, P, Hull, D, and Montague, L

Abstract

BACKGROUND: Impaired cardiac vagal function, quantified preoperatively as slower heart rate recovery (HRR) after exercise, is independently associated with perioperative myocardial injury. Parasympathetic (vagal) dysfunction may also promote (extra-cardiac) multi-organ dysfunction, although perioperative data are lacking. Assuming that cardiac vagal activity, and therefore heart rate recovery response, is a marker of brainstem parasympathetic dysfunction, we hypothesized that impaired HRR would be associated with a higher incidence of morbidity after noncardiac surgery. METHODS: In two prospective, blinded, observational cohort studies, we established the definition of impaired vagal function in terms of the HRR threshold that is associated with perioperative myocardial injury (HRR ≤ 12 beats min-1 (bpm), 60 seconds after cessation of cardiopulmonary exercise testing. The primary outcome of this secondary analysis was all-cause morbidity three and five days after surgery, defined using the Post-Operative Morbidity Survey. Secondary outcomes of this analysis were type of morbidity and time to become morbidity-free. Logistic regression and Cox regression tested for the association between HRR and morbidity. Results are presented as odds/hazard ratios [OR or HR; (95% confidence intervals). RESULTS: 882/1941 (45.4%) patients had HRR≤12bpm. All-cause morbidity within 5 days of surgery was more common in 585/822 (71.2%) patients with HRR≤12bpm, compared to 718/1119 (64.2%) patients with HRR>12bpm (OR:1.38 (1.14-1.67); p = 0.001). HRR≤12bpm was associated with more frequent episodes of pulmonary (OR:1.31 (1.05-1.62);p = 0.02)), infective (OR:1.38 (1.10-1.72); p = 0.006), renal (OR:1.91 (1.30-2.79); p = 0.02)), cardiovascular (OR:1.39 (1.15-1.69); p<0.001)), neurological (OR:1.73 (1.11-2.70); p = 0.02)) and pain morbidity (OR:1.38 (1.14-1.68); p = 0.001) within 5 days of surgery. CONCLUSIONS: Multi-organ dysfunction is more common in surgical patients with cardiac vagal dys

Published
2019

17. Opioid-Free Anesthesia for Open Radical Cystectomy Is Feasible and Accelerates Return of Bowel Function: A Matched Cohort Study.

Author

Burkhard JP, Jardot F, Furrer MA, Engel D, Beilstein C, and Wuethrich PY

Abstract

The aim of this study was to evaluate the feasibility of opioid-free anesthesia (OFA) in open radical cystectomy (ORC) with urinary diversion and to assess the impact on recovery of gastrointestinal function. We hypothesized that OFA would lead to earlier recovery of bowel function. A total of 44 patients who underwent standardized ORC were divided into two groups (OFA group vs. control group). In both groups, patients received epidural analgesia (OFA group: bupivacaine 0.25%, control group: bupivacaine 0.1%, fentanyl 2 mcg/mL, and epinephrine 2 mcg/mL). The primary endpoint was time to first defecation. Secondary endpoints were incidence of postoperative ileus (POI) and incidence of postoperative nausea and vomiting (PONV). The median time to first defecation was 62.5 h [45.8-80.8] in the OFA group and 118.5 h [82.6-142.3] ( p < 0.001) in the control group. With regard to POI (OFA group: 1/22 patients (4.5%); control group: 2/22 (9.1%)) and PONV (OFA group: 5/22 patients (22.7%); control group: 10/22 (45.5%)), trends but no significant results were found ( p = 0.99 and p = 0.203, respectively). OFA appears to be feasible in ORC and to improve postoperative functional gastrointestinal recovery by halving the time to first defecation compared with standard fentanyl-based intraoperative anesthesia.

Published
2023
Full Text
View/download PDF

19. Relationship between norepinephrine dose, tachycardia and outcome in septic shock: A multicentre evaluation.

Author

Domizi R, Calcinaro S, Harris S, Beilstein C, Boerma C, Chiche JD, D'Egidio A, Damiani E, Donati A, Koetsier PM, Madden MP, McAuley DF, Morelli A, Pelaia P, Royer P, Shankar-Hari M, Wickboldt N, Zolfaghari P, and Singer M

Subjects
Adult, Aged, Critical Care, Europe, Female, Humans, Intensive Care Units, Male, Middle Aged, Norepinephrine administration & dosage, Regression Analysis, Resuscitation, Retrospective Studies, Sensitivity and Specificity, Treatment Outcome, Vasoconstrictor Agents administration & dosage, Norepinephrine therapeutic use, Shock, Septic drug therapy, Shock, Septic mortality, Tachycardia drug therapy, Tachycardia mortality, Vasoconstrictor Agents therapeutic use
Abstract

Purpose: Septic shock is associated with massive release of endogenous catecholamines. Adrenergic agents may exacerbate catecholamine toxicity and contribute to poor outcomes. We sought to determine whether an association existed between tachycardia and mortality in septic shock patients requiring norepinephrine for more than 6 h despite adequate volume resuscitation., Materials and Methods: Multicentre retrospective observational study on 730 adult patients in septic shock consecutively admitted to eight European ICUs between 2011 and 2013. Three timepoints were selected: T1 (first hour of infusion of norepinephrine), Tpeak (time of highest dose during the first 24 h of treatment), and T24 (24-h post-T1). Binary logistic regression models were constructed for the three time-points., Results: Overall ICU mortality was 38.4%. Mortality was higher in those requiring high-dose (≥0.3 mcg/kg/min) versus low-dose (<0.3 mcg/kg/min) norepinephrine at T1 (53.4% vs 30.6%; p < 0.001) and T24 (61.4% vs 20.4%; p < 0.0001). Patients requiring high-dose with concurrent tachycardia had higher mortality at T1; in the low-dose group tachycardia was not associated with mortality. Resolving tachycardia (from T1 to T24) was associated with lower mortality compared to patients where tachycardia persisted (27.8% vs 46.4%; p = 0.001)., Conclusions: Use of high-dose norepinephrine and concurrent tachycardia are associated with poor outcomes in septic shock., Competing Interests: Declaration of Competing Interest On behalf of all authors, the corresponding author states that there is no conflict of interest., (Copyright © 2020. Published by Elsevier Inc.)

Published
2020
Full Text
View/download PDF

20. Chronotropic incompetence and myocardial injury after noncardiac surgery: planned secondary analysis of a prospective observational international cohort study.

Author

Abbott TEF, Pearse RM, Beattie WS, Phull M, Beilstein C, Raj A, Grocott MPW, Cuthbertson BH, Wijeysundera D, and Ackland GL

Subjects
Aged, Australia, Canada, Cohort Studies, Female, Heart Failure diagnosis, Humans, Male, Middle Aged, New Zealand, Postoperative Complications diagnosis, Preoperative Care, Prospective Studies, United Kingdom, Exercise Test, Heart Failure physiopathology, Heart Rate physiology, Postoperative Complications physiopathology, Surgical Procedures, Operative
Abstract

Background: Physiological measures of heart failure are common in surgical patients, despite the absence of a diagnosis. Heart rate (HR) increases during exercise are frequently blunted in heart failure (termed chronotropic incompetence), which primarily reflects beta-adrenoreceptor dysfunction. We examined whether chronotropic incompetence was associated with myocardial injury after noncardiac surgery., Methods: This was a predefined analysis of an international cohort study where participants aged ≥40 yr underwent symptom-limited cardiopulmonary exercise testing before noncardiac surgery. Chronotropic incompetence was defined as the ratio of increase in HR during exercise to age-predicted maximal increase in HR <0.6. The primary outcome was myocardial injury within 3 days after surgery, defined by high-sensitivity troponin assays >99th centile. Explanatory variables were biomarkers for heart failure (ventilatory efficiency slope [minute ventilation/carbon dioxide production] ≥34; peak oxygen consumption ≤14 ml kg -1 min -1 ; HR recovery ≤6 beats min -1 decrease 1 min post-exercise; preoperative N-terminal pro-B-type natriuretic peptide [NT pro-BNP] >300 pg ml -1 ). Myocardial injury was compared in the presence or absence of sympathetic (i.e. chronotropic incompetence) or parasympathetic (i.e. impaired HR recovery after exercise) thresholds indicative of dysfunction. Data are presented as odds ratios (ORs) (95% confidence intervals)., Results: Chronotropic incompetence occurred in 396/1325 (29.9%) participants; only 16/1325 (1.2%) had a heart failure diagnosis. Myocardial injury was sustained by 162/1325 (12.2%) patients. Raised preoperative NT pro-BNP was more common when chronotropic incompetence was <0.6 (OR: 1.57 [1.11-2.23]; P=0.011). Chronotropic incompetence was not significantly associated with myocardial injury (OR: 1.05 [0.74-1.50]; P=0.78), independent of rate-limiting therapy. HR recovery <12 beats min -1 decrease after exercise was associated with myocardial injury in the presence (OR: 1.62 [1.05-2.51]; P=0.03) or absence (OR: 1.60 [1.06-2.39]; P=0.02) of chronotropic incompetence., Conclusions: Chronotropic incompetence is common in surgical patients. In contrast to parasympathetic dysfunction which was associated with myocardial injury, preoperative chronotropic incompetence (suggestive of sympathetic dysfunction) was not associated with postoperative myocardial injury., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2019
Full Text
View/download PDF

21. Landmarks in route learning by girls and boys.

Author

Beilstein CD and Wilson JF

Subjects
Child, Child, Preschool, Cues, Female, Humans, Male, Mental Recall, Problem Solving, Attention, Child Development, Gender Identity, Orientation
Abstract

Previous research on route learning has shown that men learn routes faster and with fewer errors than women. The same patterns have also been found for girls and boys. In this study, 19 children of ages 5 to 6 years, 26 children of ages 7 to 9 years, and 22 children of ages 10 to 12 years were presented a route learning task. The children were randomly assigned to either the Landmark group in which they were required to learn a route on a map that included landmarks or the No-landmark group in which they learned a route on a map without landmarks. Significant main effects were found for age and sex. Older children learned the route faster and with fewer errors than younger children. Boys made significantly fewer errors and took less time and fewer trials to reach criterion in learning the route regardless of whether landmarks were present or not. The role of landmarks in route learning needs to be further clarified.

Published
2000
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results