Preoperative high dose of dexamethasone in emergency laparotomy: #RCT ➡️doi.org/10.1093/bjs/znae130 In this #RCT of 120 patients undergoing emergency laparotomy 🔥preoperative 1 mg/kg dexamethasone significantly ⬇️ inflammation and is associated with improved recovery and postoperative morbidity and mortality The results of this trial provide the first evidence of a potential therapeutic benefit of high-dose intravenous dexamethasone in emergency laparotomy Great work by Mirjana Cihoric, Henrik Kehlet, Morten L Lauritsen, Jakob Højlund, Katrine Kanstrup, Sofia Kärnsund, Nicolai B Foss #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @ksoreide @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @asgbi @eurohernias @SEIQuirurgica @ESCP_tweets @YouESCP #SoMe4Trauma #emgensurg @WSESurgery @NELANews #EmLap @ASGBI_MA #some4peds #emergency #acutecare #ileus

Is very high-dose dexamethasone necessary to achieve these beneficial outcomes? ➡️bjsacademy.com/author-respon… The recent article by Cihoric et al. makes a substantial contribution to better understanding of the effects of high-dose dexamethasone (1 mg/kg) in emergency laparotomy surgery, specifically reporting significant reductions in inflammatory markers The study’s secondary endpoints of decreased complications, lower 90-day mortality and improved functional outcomes are also promising We advocate that managing the inflammatory response and protecting the microcirculation are key therapeutic targets, and corticosteroid therapy has demonstrated potential benefits in elective and emergency surgery. Read the original paper doi.org/10.1093/bjs/znae130 #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @ksoreide @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol #SoMe4Trauma #emgensurg @WSESurgery #emergency #acutecare #ileus @NELANews #EmLap @ASGBI_MA