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Sibilio S, Koziarz A, McClure G, Alsagheir A, Alradaddi H, Lengyel A, Reza S, Um K, MacIsaac S, Mendoza P, Paparella D, El-Hamamsy I, Parry D, Belley-Côté E, Whitlock R. OUTCOME AFTER ROSS PROCEDURE IN ADULT PATIENTS: A SYSTEMATIC REVIEW, META-ANALYSIS AND MICROSIMULATION. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Spence J, Belley-Côté E, Jacobsohn E, Syed S, Whitlock R, Lee S, Bangdiwala S, Arora R, Sarkaria A, MacIsaac S, Girling L, LeManach Y, Lamy A, Devereaux P, Connolly S. BENZODIAZEPINE-FREE CARDIAC ANESTHESIA FOR REDUCTION OF DELIRIUM (B-FREE): A TWO-CENTRE PILOT STUDY TO DETERMINE THE FEASIBILITY OF A MULTI-CENTRE, RANDOMIZED, CLUSTER CROSSOVER TRIAL. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Spence J, Belley-Cote E, Jacobsohn E, Syed S, Whitlock R, Lee SF, Bangdiwala S, Arora R, Sarkaria A, MacIsaac S, Girling L, Lemanach Y, Lamy A, Devereaux PJ, Connolly S. P836Benzodiazepine-free cardiac anesthesia for reduction of delirium (B-Free): a two-centre pilot study to determine the feasibility of a multi-centre, randomized, cluster crossover trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Spence
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - E Belley-Cote
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - E Jacobsohn
- St. Boniface General Hospital, Department of Anesthesia, Winnipeg, Canada
| | - S Syed
- McMaster University, Department of Anesthesia, Hamilton, Canada
| | - R Whitlock
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - S F Lee
- Population Health Research Institute, Hamilton, Canada
| | - S Bangdiwala
- Population Health Research Institute, Hamilton, Canada
| | - R Arora
- Institute of Cardiovascular Sciences, Department of Surgery, Section of Cardiac Surgery, Winnipeg, Canada
| | - A Sarkaria
- Population Health Research Institute, Hamilton, Canada
| | - S MacIsaac
- Population Health Research Institute, Hamilton, Canada
| | - L Girling
- St. Boniface General Hospital, Department of Anesthesia, Winnipeg, Canada
| | - Y Lemanach
- McMaster University, Department of Anesthesia, Hamilton, Canada
| | - A Lamy
- Population Health Research Institute, Hamilton, Canada
| | - P J Devereaux
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - S Connolly
- Population Health Research Institute, Hamilton, Canada
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Hull RD, Pineo GF, MacIsaac S. Low-molecular-weight heparin prophylaxis: preoperative versus postoperative initiation in patients undergoing elective hip surgery. Thromb Res 2001; 101:V155-62. [PMID: 11342095 DOI: 10.1016/s0049-3848(00)00387-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Administration of low-molecular-weight heparin prophylaxis in elective hip implant patients commonly begins 12 h preoperatively in European practices to optimize effectiveness, and 12 to 24 h postoperatively in North American practices to optimize safety. A meta-analysis comparing these two treatment regimes revealed that preoperative initiation demonstrated greater efficacy and superior safety for patients (10.0% rate of total deep-vein thrombosis vs. 15.3%, P = .023). In addition to the pre/postsurgical debate, proximity of initiation of low-molecular-weight heparin in relation to surgery is an issue of critical importance. Recent studies revealed that beginning therapy immediately within 2 h preoperatively or 6 h postoperatively dramatically decreased the risk of venous thrombosis. An investigation of low-molecular-weight heparin prophylaxis initiated 2 h before elective hip surgery or approximately 6 h after surgery compared with warfarin sodium revealed that total and proximal deep-vein thrombosis rates were reduced in patients receiving low-molecular-weight heparin compared with warfarin. The frequencies of deep-vein thrombosis for patients receiving preoperative and postoperative dalteparin vs. warfarin for all deep-vein thrombosis were 36 of 337 (10.7%, P < .001) and 44 of 336 (13.1%, P < .001) vs. 81 of 338 (24.0%); and for proximal deep-vein thrombosis were 3 of 354 (0.8%, P = .035) and 3 of 358 (0.8%, P = .033) vs. 11 of 363 (3.0%). Relative risk reductions for the dalteparin groups vs. warfarin ranged from 45% to 72%. In this case, low-molecular-weight heparin administered in close proximity to surgery provided superior efficacy over warfarin. Major bleeding was significantly increased with the preoperative regimen but not the postoperative regimen.
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Affiliation(s)
- R D Hull
- University of Calgary, Calgary, Alberta, Canada.
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