85 research outputs found

    Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

    Get PDF
    BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≄week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

    Political travel across the ‘Iron Curtain’ and Communist youth identities in West Germany and Greece in the 1970s and 1980s

    Get PDF
    This article explores tours through the Iron Curtain arranged by West German and Greek pro-Soviet Communist youth groups, in an attempt to shed light on the transformation of European youth cultures beyond the ‘Americanisation’ story. It argues that the concept of the ‘black box’, employed by Rob Kroes to describe the influence of American cultural patterns on Western European youth, also applies to the reception of Eastern Bloc policies and norms by the Communists under study. Such selective reception was part of these groups’ efforts to devise a modernity alternative to the ‘capitalist’ one, an alternative modernity which tours across the Iron Curtain would help establish. Nevertheless, the organisers did not wish such travel to help eliminate American/Western influences on youth lifestyles entirely: the article analyses the excursions’ aims with regard to two core components of youth lifestyles in Western Europe since the 1960s, which have been affected by intra-Western flows, the spirit of ‘doing one’s own thing’ and transformations of sexual practices. The article also addresses the experience of the travellers in question, showing that they felt an unresolved tension: the tours neither served as a means of Sovietisation nor as an impulse to develop an openly anti-Soviet stance.PostprintPeer reviewe

    Participation in Corporate Governance

    Full text link

    The Management of Information Resources-A Challenge for American Business

    No full text

    Managers, Computer Systems, and Productivity

    No full text

    IRIS

    No full text
    • 

    corecore