Under controlled experimental conditions, CO is associated with excellent agreement and good trending ability when compared with the gold standard CO. In the paediatric clinical setting, CO performs well; by contrast, CO, an operator- and anatomy-dependent technology, appears less reliable than CO.

SummaryIn 2016 the World Health Organization recommended intra‐operative ventilation with 80% inspired oxygen to reduce surgical site infection rates, based upon a meta‐analysis of 15 randomised controlled trials, of which two were by Mario Schietroma's research group. Five trials by this group have been retracted for duplication, plagiarism, statistical error and lack of ethical approval. We analysed 40 papers by this group: 24 randomised controlled trials (5064 participants) and 16 observational studies (1847 patients). There was evidence that data integrity was compromised in 38 out of the 40 analysed papers. The distribution of baseline characteristics in randomised controlled trials was unlikely, p = 1.5 × 10−8: continuous variables within trials were heterogeneous, p = 1.9 × 10−9, and categorical variables were homogeneous, p = 8.5 × 10−20. Effects of interventions varied less than expected between studies: for categorical variables, for instance postoperative wound infection, p < 1 × 10−7, and for continuous variables, for instance HLA‐DR concentration, p = 0.00001. Of 184 calculable p values, for baseline variables or results, 179 (98%) were incorrect, ranging from three orders of magnitude too small to 10 orders of magnitude too large. Twenty‐one graphs occurred 81 times in 23 out of 40 papers. Liberal peri‐operative oxygen did not reduce surgical site infection in a meta‐analysis of 20 trials that excluded seven trials by Mario Schietroma and colleagues (odds ratio (95%CI) 0.89 (0.73‐1.08); p = 0.23). An update by the World Health Organization has now excluded trials of liberal oxygen by Schietroma's group, four of which have not been retracted. We conclude that Mario Schietroma's work should not inform practice until investigated.

A 27-year-old female with Eisenmenger's syndrome underwent closure of a patent ductus arteriosus, closure of a perimembranous ventricular septal defect and mid muscular defect and bilateral lung transplantation. Her immediate postoperative course was complicated by severe right ventricular outflow tract (RVOT) obstruction resulting in hemodynamic collapse, a condition described as suicide right ventricle. The patient was placed on central Veno-Arterial Extra-Corporeal Membrane Oxygenation as a bridge to the relief of RVOT obstruction which included a right ventricular outflow muscle resection and a right ventricle outflow tract patch. The patient made an uneventful recovery.

There have been few cases of cold burn related to the exposure of liquid petroleum gas (LPG). We present the case of a young woman exposed to LPG while refueling her car who sustained partial thickness burns to the dorsum of her hand. Contact with LPG leaking from a pressurized system causes tissue damage because of cold injury. Immediate management of LPG is extrapolated from the management of frostbite. The increasing use of LPG mandates an awareness of prevention strategies and management principles in the setting of adverse events.

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