In a commentary appearing in this week's Journal of the American Medical Association, heart specialists at the University of Michigan Health System make a plea for clarity on the best approach for prescribing beta blockers before surgery.
It's not unusual for patients to suffer a cardiac event during surgery, and in theory, beta blockers will reduce the risk by slowing the heartbeat, reducing blood vessel constriction, lowering demand of the heart muscle for oxygen, and generally relieving stress on the heart. However, a one-size-fits-all approach for prescribing beta blockers can harm patients at low-risk for having a heart attack.
Future clinical studies using clear models of dose, duration and implementation could provide answers for doctors about the role of pre-surgery beta blockers, according to the U-M commentary.
Because of important design, treatment and analytical variations, previous clinical trials are hard to interpret.
For instance, the 2001 DECREASE I study included high-risk patients with known coronary blockages who faced high risk surgery. Importantly, the beta blockers were given based on individual heart rate and blood pressure. In contrast, the recent 2008's POISE study included a mixed group of patients undergoing major non-cardiac surgery and took a long-acting drug.
Given these important differences, the studies have not offered clear answers about who should get beta blockers, what the starting dose should be and how doses should be adjusted for patients.
"The time has come for clarity across perioperative beta blocker studies," the U-M authors write.
Authors: Vineet Chopra, M.D., a hospitalist at U-M Health System and clinical assistant professor of internal medicine at the U-M Medical School and Kim A. Eagle, M.D., director of the U-M Cardiovascular Center and the Albion Walter Hewlett Professor of Internal Medicine.
Reference: Journal of the American Medical Association, Vol. 303, No. 6, Feb. 10, 2010.
Funding: NoneResources: U-M Cardiovascular Center
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.
In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...
A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.
By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...
Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...
For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.
In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...
Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale
Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...
15.02.2018 | Event News
13.02.2018 | Event News
12.02.2018 | Event News
23.02.2018 | Physics and Astronomy
23.02.2018 | Health and Medicine
23.02.2018 | Physics and Astronomy