These results are different from the published results on which the NICE guidelines were based; however, the evidence base in children is small. There is currently insufficient evidence to support the use of ultrasound guidance for central venous catheterization in children.
We have undertaken a prospective, randomized study to determine the incidence of postoperative nausea and vomiting during intensive care stay after cardiac surgery, and to study the effect of addition of droperidol to an infusion of morphine used for postoperative analgesia. Data from 398 patients were examined. The use of droperidol reduced complaints of nausea from 92 of 198 (46.5%) to 46 of 200 (23%) and episodes of retching or vomiting from 73 of 198 (36.9%) to 44 of 200 (22%). The number of patients requiring rescue antiemetic medication was also reduced significantly from 100 of 198 (50.5%) of those who did not receive droperidol to 44 of 200 (22%) of those given droperidol. Mean duration of intubation was 4.9 h and was unaffected by the use of droperidol. Droperidol had no effect on mean length of stay in the recovery unit.
Objectives: To identify clinical and procedural practice predictors of avoidable complications during transcatheter aortic valve replacement (TAVR). Background: TAVR is evolving as a viable strategy for treatment of aortic stenosis (AS). Vascular complications, major bleeding, or pericardial tamponade may be influenced by procedural practice. Methods: The Oxford TAVR (OxTAVI) prospective registry was retrospectively analyzed to identify predictors of avoidable procedural complications in a contemporary cohort of transfemoral TAVR between January 2015 and September 2018. The primary endpoint was defined as a hierarchic composite of in-hospital mortality, pericardial effusion/cardiac tamponade, major bleeding, and vascular access complications. Individual components of the primary endpoint have been analyzed separately. Results: Five-hundred-twenty-nine patients underwent transfemoral TAVR using contemporary techniques during the study period and were enrolled in the OxTAVI registry. Female sex and high frailty were associated with a higher risk of death, major bleeding, vascular complication or pericardial tamponade. The use of ultrasound (US) guidance for vascular access management was independently associated with a reduced composite primary endpoint (OR = 0.35,
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