Malignant hyperthermia (MH) is a rare pharmacogenetic condition with substantial morbidity and mortality. The current gold standard for diagnosis, caffeine-halothane contracture testing (CHCT), is invasive, costly, and available only at a single centre in Canada. Genetic testing offers a less invasive alternative, but access remains inconsistent across Canadian provinces. We sought to evaluate the cost-consequences and diagnostic wait times of a genetics-first vs biopsy-first strategy for MH susceptibility. We conducted a retrospective cost-consequence analysis of 1,208 patients referred to the Canadian Malignant Hyperthermia Investigation Unit (2015–2024) with a personal or family history suggestive of MH, and their first-degree relatives. We compared the direct, indirect, and societal costs of the Ontario genetics-first approach with those of a hypothetical biopsy-first approach used in other provinces. We analyzed diagnostic timelines using Kaplan–Meier survival analyses. In the genetics-first strategy, 7.2
Postoperative hypotension can be caused by vasodilation, myocardial dysfunction, severe hypovolemia, and obstruction. We sought to estimate the effects of these causes on the incidence of hypotension after major vascular surgery. We conducted a single-centre prospective cohort study of male and female adult patients undergoing major vascular surgery. We conducted point-of-care ultrasound and sidestream darkfield microscopy imaging to detect vasodilation, myocardial dysfunction, severe hypovolemia, and obstruction. The primary outcome was hypotension (systolic blood pressure < 90 mm Hg or a vasopressor infusion) within 24 hr of surgery. We recruited 100 patients, of whom 89 had data available for analysis. Hypotension occurred in 20 participants (23
Canada faces mounting anesthesia workforce pressures, particularly in rural and smaller urban centres. Understanding residents’ motivations regarding practice setting, research, and fellowship training is essential for workforce planning. We aimed to update a 2015 national survey to characterize current preferences and temporal shifts among Canadian anesthesiology residents. We conducted an anonymous, cross-sectional survey of residents in accredited Canadian anesthesiology programs (November–December 2024) using Research Electronic Data Capture. Items addressed demographics, practice setting, research experience and intentions, and fellowship plans. Selected responses were compared with 2015 survey items using Chi square tests and odds ratios with 95
