scholarly journals Guidelines for enhanced recovery after cardiac surgery. Consensus document of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE) and Perfusionists (AEP)

2020 ◽  
pp. 5-77
Author(s):  
Juan Antonio Margarit ◽  
Maria Azucena Pajares ◽  
Carlos Garcia Camacho ◽  
Mario Castaño Ruiz ◽  
Maria Gómez ◽  
...  

The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.

Perfusion ◽  
2020 ◽  
pp. 026765912096783
Author(s):  
Sashini Iddawela ◽  
Priti Swamy ◽  
Sajid Member ◽  
Amer Harky

Objective: The systematic review aims to investigate the effect of sampling source on activated clotting time (ACT) measurement within cardiovascular surgery and cardiac catheterisation. It also examines the evidence surrounding novel clot assessment techniques and associated sampling variation. Methods: A comprehensive electronic search was conducted using PubMed, MEDLINE, Scopus, Cochrane database, and Google Scholar until 20th June 2020. All studies reporting sampling source variability of ACT in cardiac surgery, vascular surgery and cardiac catheterisation were included. Results: Fourteen studies were included in the systematic review. Inconsistent reports of variability were seen in cardiac surgery and cardiac catheterisation. There were no studies directly examining ACT variability in vascular surgery. Novel clot assessment techniques have been validated in cardiac surgery, but measurements vary depending on sampling source. Conclusion: Sampling source should be kept consistent to facilitate effective haemostatic strategies. More research is needed regarding variability in vascular surgery and novel clot assessment techniques.


2021 ◽  
Vol 5 (2) ◽  
pp. 129-136
Author(s):  
Irene Kida Minja ◽  
Edda Tandi Lwoga

Purpose of this systematic review was to bring together studies of evidence-based practice among dentists in low- and middle-income countries, where its use has been reported to be limited. The protocol was registered in PROSPERO. Methodology: We searched the evidence (in English only) from medical databases including PubMed, EBSCO, The Cochrane Library, CINAHL, ScienceDirect, HINARI summon, and SCOPUS and Web of Science via Research4Life, grey literature, hand search from relevant articles, and augmented results on Google scholar.Published reports were retrieved from relevant websites and organizations. Studies included those that looked at key factors that facilitate or hinder Evidence Based Dentistry (EBD), as well as outcomes in terms of: knowledge, attitudes and skills of EB practice among dentists; and the methodology used and their relevance in future EBD strategies.Main focus was on dentists, as practitioners and faculty members. Studies on students and non-dental personnel were excluded.Findings:A total of 4568 records were retrieved and five potentially relevant articles were selected after title/abstract screening. Two articles were excluded after full text screening, and therefore Three papers were included in this review. The studies report limited knowledge,unsatisfactory attitude towards EBD and lowpractice of EBD and use of scientific evidence databases. None of the studies reported implementation of EBD nor evaluation thereof. The main barriers that constrained application of EBD ranged from lack of interest to infrastructural limitations. Originality: The current review showed that there is a need to strategised implementation of EBD in this region.


2021 ◽  
Author(s):  
David Makowski ◽  
Simona Bosco ◽  
Mathilde Chen ◽  
Ana Montero-Castaño ◽  
Marta Pérez-Soba ◽  
...  

Identifying sustainable agricultural practices to support policy development requires a rigorous synthesis of scientific evidence based on experiments carried out around the world. In agricultural science, meta-analyses (MAs) are now commonly used to assess the impact of farming practices on a variety of outcomes, including crop and livestock productions, biodiversity, greenhouse gas emissions, nitrate leaching, soil organic carbon, based on a large number of experimental data. MA has become a gold standard method for quantitative research synthesis, and the growing number of MAs available can potentially be used to inform decisions of policy makers. However, published MAs are heterogeneous both in content and quality, and a framework is needed to help scientists to report the results and quality levels of MAs in a rigorous and transparent manner. Such a framework must be implementable quickly - within weeks - to be operational and compatible with the time constraints of modern policymaking processes. In this paper, we propose a methodological framework for assessing the impacts of farming practices based on a systematic review of published MAs. The framework includes four main steps: (1) literature search of existing MAs, (2) screening and selection of MAs, (3) data extraction and quality assessment, and (4) reporting. Three types of reports are generated from the extracted data: individual reports summarizing the contents of each MA (MA summary reports), reports summarizing each of the impacts of a given farming practice on a specific environmental, climate mitigation, or production outcome (single-impact reports), and report summarizing all the impacts of a given farming practice on all the outcomes considered (general report). All these reports present the quality levels of the MAs examined on the basis of 16 quality criteria. The proposed framework is semi-automatic in the sense that the skeletons of the reports are generated automatically from the spreadsheet used for the data extraction and quality assessment. This semi-automatic procedure allows scientific experts to reduce the time needed in the reporting step. Since 2020, the proposed framework was successfully applied by a group of scientific experts to support decisions of EU policy makers, and examine a large diversity of single farming practices (e.g. nitrification inhibitors, biochar, liming) and cropping systems (e.g. organic systems, agroforestry) in a relatively short period of time. It provides an operational tool for scientists who want to supply policymakers with scientific evidence based on large numbers of experiments, in a timely and reproducible manner.


2020 ◽  
Vol 66 (suppl 2) ◽  
pp. 136-142
Author(s):  
Laura Faustino Gonçalves ◽  
Ana Inês Gonzales ◽  
Fernanda Soares Aurélio Patatt ◽  
Karina Mary de Paiva ◽  
Patrícia Haas

SUMMARY OBJECTIVE To present scientific evidence based on a systematic literature review (PRISMA) evaluating the association of Kawasaki Disease (DK) and COVID-19 in children. METHODS For the selection of studies, a combination based on the Medical Subject Heading Terms (MeSH) was used. The Medline (Pubmed), LILACS, SciELO, COCHRANE, and BIREME databases were used. The search period for the articles comprised the last 10 years (2010 to 2020). RESULTS 840 articles with potential for inclusion were retrieved, one of which met the inclusion criteria and the guiding question that consisted of evaluating the association of Kawasaki disease and COVID-19 in children. CONCLUSION A significant increase in the incidence of Kawasaki-type diseases after the onset of the epidemic has been reported, suggesting an association between the COVID-19 epidemic and the high incidence of a severe form of KD. However, further studies are needed to conduct an investigation of the association between these two diseases.


Perfusion ◽  
2021 ◽  
pp. 026765912198895
Author(s):  
Yi Zhang ◽  
Jun Heng Chong ◽  
Amer Harky

Background and Aim: Enhanced Recovery After Surgery (ERAS) protocols are a series of perioperative interventions well-established in improving the care and outcomes of patients. With recent emergence of studies on its implementation in cardiac surgery, this paper represents the first systematic review on current evidence of ERAS efficacy in this field. Methods: Two reviewers independently searched through Pubmed, Cochrane, Google Scholar, Web of Science, Embase and Scopus. Comparative studies with controls that described the implementation of ERAS in all types of cardiac operations from 2001 to 2020 were included. Data extracted included patient demographics, components of ERAS protocol described, types of cardiac surgery, and postoperative outcomes. Results: In the final analysis, nine studies were included, of which there were one randomized controlled trial (RCT), one quasi-experiment and seven retrospective/prospective studies. Significant improvement in hospital and ICU length of stay, as well as reduction in postoperative opioid consumption were demonstrated. No increase in postoperative complications were reported. Conclusion: ERAS in cardiac surgery has shown to be potentially safe and effective in improving certain postoperative outcomes. However, the evidence is limited by the lack of high-quality RCTs. We also found the lack of practice of class 1 recommended interventions set forth by the ERAS Cardiac Society. Furthermore, majority of studies only evaluated the immediate postoperative outcomes of patients, and not the long-term outcomes. RCTs that fully implement measures recommended by the ERAS Cardiac Society, with assessments on both immediate and long-term outcomes, are warranted.


2021 ◽  
Vol 3 (3(September-December)) ◽  
Author(s):  
Jose Roberto Tude Melo ◽  
Marcelo Liberato Coelho Mendes de Carvalho

Introduction: Prognostic models are statistical models that combine two or more items of patient data to predict clinical outcomes. Objective: Identify prognostic models of mortality developed and published in the medical literature for possible applicability in children and adolescents victims of severe traumatic brain injury (TBI). Methods: Systematic review in the Medline electronic database (PubMed platform) of scientific articles published from 2006 (year of publication of the last systematic review on prognostic models for TBI before 2017) until July 29, 2017. Results: Ten studies on prognostic models of mortality in children and adolescents victims of severe TBI were identified for final inclusion in the review. There were eight development and two validation studies conducted in different countries. Conclusion: The analysis of this systematic review makes it possible to conclude that the ten prognostic models included in the final sample provide health professionals with a scientific evidence-based understanding of the severity of pediatric victims of severe TBI. This systematic review is classified as presenting 2A and 1 level of evidence (systematic review of homogeneous cohorts), according to the 2009 and 2011 classifications, respectively, of the Oxford Center for Evidence-Based Medicine


Author(s):  
María Santamaría González ◽  
María Ángels Ruiz Mínguez ◽  
María Monsalud Arrebola Ramírez ◽  
Xavier Filella Pla ◽  
María José Torrejón Martínez ◽  
...  

Abstract Objectives Clinical practice guidelines (CPGs) are recommendations based on a systematic review of scientific evidence that are intended to help healthcare professionals and patients make the best clinical decisions. CPGs must be evidence-based and are designed by multidisciplinary teams. The purpose of this study is to assess the topics related to the clinical laboratory addressed in CPGs and evaluate the involvement of laboratory professionals in the CPG development process. Methods A total of 16 CPGs recommended by the Spanish Society of Laboratory Medicine and/or retrieved from PubMed-Medline were included. A review of the information provided in CPGs about 80 topics related to the clinical laboratory was performed. The authorship of laboratory professionals was assessed. Results On average, the 16 CPGs addressed 49% (standard deviation [SD]: 11%) of the topics evaluated in relation to the clinical laboratory. By order of frequency, CPGs contained information about 69% of postanalytical variables (SD: 20%); 52% of preanalytical variables (SD: 11%); and 43% of the analytical variables studied (SD: 18%). Finally, half the CPGs included a laboratory professional among its authors. Conclusions CPGs frequently failed to provide relevant laboratory-related information. Laboratory professionals were co-authors in only half the CPGs. There is scope for improvement, and laboratory professionals should be included in multidisciplinary teams involved in the development of CPGs.


2010 ◽  
Vol 25 (5) ◽  
pp. 586-595 ◽  
Author(s):  
Abdullah A. Alghamdi ◽  
Steve K. Singh ◽  
Barbara C. S. Hamilton ◽  
Mrinal Yadava ◽  
Helen Holtby ◽  
...  

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