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  1. Article ; Online: Intraoperative haemodynamic optimisation using the Hypotension Prediction Index and its impact on tissular perfusion

    Javier Ripollés-Melchor / Ane Abad-motos / Juan Victor Lorente / Ignacio Jimenez / Alejandra Becerra / Wilbert Wesselink / Francesca Reguant / Irene Mojarro / Maria de los Angeles Fuentes / Elizabeth Agudelo / Francisco Herrero-Machancoses / Paula Callejo / Joan Bosch / Manuel Ignacio Monge

    BMJ Open, Vol 12, Iss

    a protocol for a randomised controlled trial

    2022  Volume 6

    Keywords Medicine ; R
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  2. Article ; Online: Early Surgery with Neuraxial Anaesthesia in Patients on Chronic Antiplatelet Therapy with a Proximal Femur Fracture

    Rafael Anaya / Mireia Rodriguez / Angélica Millan / Francesca Reguant / Jordi Llorca / Patricia Guilabert / Ana Ruiz / Percy-Efrain Pantoja / José María Gil / Victoria Moral / Angela Merchán-Galvis / Maria Jose Martinez-Zapata / on behalf of the AFFEcT Study Group

    Journal of Clinical Medicine, Vol 10, Iss 5371, p

    Multicentric Randomised Clinical Trial

    2021  Volume 5371

    Abstract: Background: Patients with proximal femur fracture on antiplatelet treatment benefit from early surgery. Our goal was to perform early surgery under neuraxial anaesthesia when indicated by the platelet function test. Methods: We conducted a multicentre ... ...

    Abstract Background: Patients with proximal femur fracture on antiplatelet treatment benefit from early surgery. Our goal was to perform early surgery under neuraxial anaesthesia when indicated by the platelet function test. Methods: We conducted a multicentre randomised open-label parallel clinical trial. Patients were randomised to either early platelet function-guided surgery (experimental group) or delayed surgery (control group). Early surgery was programmed when the functional platelet count (as measured by Plateletworks) was >80 × 10 9 /L. The primary outcome was the emergency admission-to-surgery interval. Secondary outcomes were platelet function, postoperative bleeding, medical and surgical complications, and mortality. Results: A total of 156 patients were randomised, with 78 in each group, with a mean (SD) age of 85.96 (7.9) years, and 67.8% being female. The median (IQR) time to surgery was 2.3 (1.5–3.7) days for the experimental group and 4.9 (4.4–5.6) days for the control group. One-third of patients did not achieve the threshold functional platelet count on the first day of admission, requiring more than one test. There was no difference in clinical outcomes between groups. Conclusions: A strategy individualised according to the platelet function test shortens the time to proximal femur fracture surgery under neuraxial anaesthesia in patients on chronic antiplatelet treatment. Better powered randomised clinical trials are needed to further evaluate the clinical impact and safety of this strategy.
    Keywords femur fracture ; antiplatelet drugs ; randomized clinical trial ; Medicine ; R
    Subject code 610 ; 616
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Evaluation of a strategy to shorten the time to surgery in patients on antiplatelet therapy with a proximal femur fracture (AFFEcT Study): Study protocol for a multicenter randomized controlled clinical trial.

    Rafael, Anaya / Mireia, Rodriguez / José María, Gil / Victoria, Moral / Angélica, Millan / Noèlia, Vilalta / Erica, Claudia / Rosa María, Antonijoan / Francesca, Reguant / Patricia, Guilabert / Domingo, Blanco / José, Mateo / Angela, Merchán-Galvis / Maria Jose, Martinez-Zapata

    Medicine

    2019  Volume 98, Issue 19, Page(s) e15514

    Abstract: Introduction: Patients with femur fracture benefit from early surgery. Recent reports suggest that regional anesthesia may be superior to general anesthesia in these patients. Early surgery under spinal anesthesia could be performed safely by ... ...

    Abstract Introduction: Patients with femur fracture benefit from early surgery. Recent reports suggest that regional anesthesia may be superior to general anesthesia in these patients. Early surgery under spinal anesthesia could be performed safely by determining platelet function in patients receiving antiplatelet agents.
    Methods: Multicenter, randomized, open-label, parallel clinical trial expected to include 156 patients ≥ 18 years of age under chronic treatment with antiplatelet agents who develop a proximal femur fracture.
    Exclusion criteria: presence of multiple or pathological fractures, current treatment with vitamin K antagonists or new oral anticoagulants, and congenital or acquired coagulopathy.Patients will be randomized to eitherThe primary endpoint is time (hours) from admission to surgery. Secondary endpoints include: platelet function; postoperative bleeding; medical-surgical complications; perioperative and 1-year mortality; quality of life; length of hospital stay; cost-effectiveness; and cost-utility. Follow-up assessments will be performed during hospital admission and at 1, 6, and 12 months after surgery.
    Potential impact of the study: The determination of platelet function at admission to the emergency department in patients with femoral fracture receiving antiplatelet therapy may permit earlier surgery under spinal anesthesia, thus shortening the hospital stay and reducing the risk of complications. These advantages associated with early surgery could positively impact patient well-being and also reduce treatment-related healthcare costs.
    Ethics and dissemination: The study has been approved by the ethics committees at all participating centers. Their results will be disseminated in congresses and published in peer reviewed journals.
    MeSH term(s) Humans ; Anesthesia, Spinal ; Clinical Protocols ; Fracture Fixation, Internal ; Hip Fractures/surgery ; Platelet Aggregation Inhibitors ; Platelet Function Tests ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic
    Chemical Substances Platelet Aggregation Inhibitors
    Language English
    Publishing date 2019-05-10
    Publishing country United States
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000015514
    Database MEDical Literature Analysis and Retrieval System OnLINE

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