Publications by authors named "T Hubble"

Background: General anesthesia during pregnancy is not uncommon, for example, for trauma surgery, cerclage, or cesarean delivery. Current recommendations are to maintain maternal partial pressure of carbon dioxide in arterial blood (paCO2) at 30 mm Hg, which is based solely on the average maternal paCO2 in awake pregnant women. However, there is no evidence that this target, compared to other targets, would enable optimal conditions for the fetus during general anesthesia.

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Introduction: Intra-abdominal drains are often placed in emergency gastrointestinal surgery procedures with the aim to prevent the formation of intra-abdominal collections (IAC) and aid in their early detection. However, the evidence for this is debated. This scoping review aims to evaluate the current evidence for their use in this setting.

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Introduction: Birth before arrival is associated with maternal morbidity and neonatal morbidity and mortality. Yet, timely risk stratification remains challenging. Our objective was to identify risk factors for birth before arrival which may be determined at the first antenatal appointment.

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Article Synopsis
  • Brain development starts at about 3 weeks of pregnancy and continues to refine until around age 20, with the most significant weight gain in the brain occurring at birth.
  • Exposure to general anaesthesia, either before or after birth, can disrupt neuronal firing and may harm brain development, a condition known as "anaesthesia-induced neurotoxicity."
  • The article reviews research on this topic from 1999 to present, discussing the mechanisms of neurotoxicity and comparing various animal models used in preclinical studies.
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Preclinical research concerning anaesthesia-induced neurotoxicity was initiated in 1999. A decade later, the earliest clinical observational data showed mixed results in neurodevelopmental outcomes following anaesthesia exposure at a young age. Hence to date, preclinical studies remain the cornerstone of research in this field, primarily because of the vulnerability of clinical observational studies to confounding bias.

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