Environmental impact of commonly used anaesthetic agents: systematic literature review with narrative synthesis.

Background: Increasing awareness of the potential environmental impact of volatile anaesthetic agents has stimulated increased use of total i.v. anaesthesia.

Preoperative activation of the renin-angiotensin system and myocardial injury in noncardiac surgery: exploratory mechanistic analysis of the SPACE randomised controlled trial.

Background: Hypertension therapy in older adults is often suboptimal, in part because of inadequate suppression of the renin-angiotensin-aldosterone system (RAAS). We hypothesised that distinct endotypes of RAAS activation before noncardiac surgery are associated with increased risk of myocardial injury.

Methods: This was a prespecified exploratory analysis of a multicentre randomised controlled trial (ISRCTN17251494) which randomised patients ≥60 yr old undergoing elective noncardiac surgery to either continue or stop RAAS inhibitors (determined by pharmacokinetic profiles).

Association between multimorbidity and quality of life after hip replacement surgery: analysis of routinely collected patient-reported outcomes.

Background: Total hip replacement surgery is performed to improve quality of life (QoL). We explored the association between multimorbidity and change in QoL after total hip replacement.

Methods: Analysis of patients included in the NHS England hip replacement Patient Reported Outcome Measures (PROMs) database with complete preoperative from 3 to 6 months postoperative EQ-5D QoL data from April 2013 to March 2018.

Use of Internal Bracing in Multi-ligamentous Knee Injury Reconstruction: A Systematic Review.

Background: Multi-ligament Knee Injuries (MLKI) are often caused by a high-energy impact resulting in dislocation of the knee joint. Given the higher degree of instability associated with these MLKIs, surgical fixation with adjunctive internal bracing and the use of suture augmentation have been proposed with the intention of better restoring knee stability and improving the long-term outcomes of surgery. This systematic review seeks to appraise the current literature in relation to the role of internal bracing in the management of MLKI.

Peripherally administered vasopressors in critically ill adult patients: A survey of UK healthcare professional practices, attitudes and experiences.

Background: Peripherally administered vasopressor infusions are used to support critically ill patients. The Intensive Care Society recently published guidelines supporting their use. Preliminary evidence suggests variability in peripheral vasopressor infusion use.