The effect of requesting a reason for non-adherence to a guideline in a long running automated reminder system for PONV prophylaxis.

Background: Automated reminders are employed frequently to improve guideline adherence, but limitations of automated reminders are becoming more apparent. We studied the reasons for non-adherence in the setting of automated reminders to test the hypothesis that a separate request for a reason in itself may further improve guideline adherence.

Methods: In a previously implemented automated reminder system on prophylaxis for postoperative nausea and vomiting (PONV), we included additional automated reminders requesting a reason for non-adherence.

Lowering blood glucose during hip surgery does not influence coagulation activation.

Background: Hyperglycaemia during and after hip surgery is associated with coagulation activation and an increased risk of venous thromboembolism. Whether lowering of glucose levels during hip surgery diminishes coagulation activation is unknown. We investigated the efficacy of the human GLP-1 analogue liraglutide to lower glucose during and after hip surgery and studied its influence on coagulation activation.

Automated reminders increase adherence to guidelines for administration of prophylaxis for postoperative nausea and vomiting.

Background And Objective: Correct identification of patients at high risk for postoperative nausea and vomiting (PONV), prescription of PONV prophylaxis and correct administration of medication are all important for effective PONV prophylaxis. This has been acknowledged by development of guidelines throughout the world. We studied the effect of introducing patient-specific automated reminders on timely administration of PONV prophylaxis medication during general anaesthesia.

Decision support increases guideline adherence for prescribing postoperative nausea and vomiting prophylaxis.

Background: Guidelines for postoperative nausea and vomiting (PONV) prevention are implemented widely but their effectiveness may be limited by poor adherence. We hypothesized that the use of an electronic decision support (DS) system would significantly improve guideline adherence.

Methods: Medical information of all patients undergoing elective surgery in our regional teaching hospital is routinely entered in an anesthesia information management system at the preoperative screening clinic.

Calcium channel blockade with felodipine does not affect metabolic coronary vasodilation in patients with coronary artery disease.

The effect of calcium channel blockers may affect the feedback mechanism between myocardial metabolic activity and coronary blood flow. To test this hypothesis the effect of calcium channel blockade on metabolic coronary flow regulation was studied. In 10 patients with stable coronary artery disease, coronary sinus blood flow and myocardial oxygen supply and consumption (MVO2) were measured both at sinus rhythm and during atrial pacing (30 beats/min above sinus rate), at control and during infusion of felodipine, a vasoselective dihydropyridine.