Postoperative care and analgesia in vascular surgery

Abstract: Patients undergoing major vascular surgery are at high risk for myocardial infarction, renal failure, respiratory complications and death. Invasive procedures confer greater risk of complication, with patients undergoing open aortic surgery being at highest risk. Reduction of myocardial oxygen demand is key: stabilizing cardiovascular parameters, maintaining normothermia, adequate volume resuscitation and effective analgesia. Preoperative risk reduction strategies including aspirin, β-blockers and statin therapies are critical, and should be continued in the postoperative period. Maintaining a high index of suspicion for procedure-specific complications will reduce morbidity and mortality in these patients.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Authors: Tags: Vascular Anaesthesia Source Type: research

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In conclusion, high-dose NR induces the onset of WAT dysfunction, which may in part explain the deterioration of metabolic health. Towards a Rigorous Definition of Cellular Senescence https://www.fightaging.org/archives/2019/11/towards-a-rigorous-definition-of-cellular-senescence/ The accumulation of lingering senescent cells is a significant cause of aging, disrupting tissue function and generating chronic inflammation throughout the body. Even while the first senolytic drugs capable of selectively destroying these cells already exist, and while a number of biotech companies are working on the productio...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
Jiangshan J. Shen1,2,3, Yong-Fei Wang1† and Wanling Yang1* 1Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong 2Collaborative Innovation Center for Birth Defect Research and Transformation of Shandong Province, Jining Medical University, Jining, China 3Lupus Research Institute, Affiliated Hospital of Jining Medical University, Jining, China Despite sex being an important epidemiological and physiological factor, not much is known about how sex works to interact with genotypes to result in different phenotypes. Both messen...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Publication date: Available online 5 April 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Shaun McMahon, Rachael L. BirdAbstractPatients undergoing major vascular surgery are high risk for myocardial infarction, renal failure, respiratory complications and death. Invasive procedures confer greater risk of complication, with patients undergoing open aortic surgery being at highest risk. Endovascular procedures are less invasive, yet not devoid of potentially serious complications. Reduction of myocardial oxygen demand is key: stabilizing cardiovascular parameters, maintaining normothermia, adequate volume re...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA. METHODS:: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. We then age and sex matched 34,446 non-statin users who underwent THA. Baseline comorbidities and postoperative complications were obtained and assessed via standard descriptive statistics. RESULTS:: The statin users had more preoperative comorbidities including congestive heart failure, valvular heart disease, pulmonary and renal disease, diabetes, hyperte...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
Authors: Nardin M, Verdoia M, Barbieri L, De Luca G, Novara Atherosclerosis Study Group (NAS) Abstract Platelets represent one of the main actors involved in pathogenesis of coronary artery disease (CAD). Mean platelet volume (MPV) has been proposed as marker of platelet reactivity and thrombotic risk. However, still debated is whether higher MPV constitutes an independent determinant of CAD or just the consequence of an association with several cardiovascular risk factors. Therefore, the aim of the present study was to assess the impact of metabolic syndrome (MetS), on MPV and its relationship with angiographicall...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
ConclusionsMultimorbidity among patients with AMI was common, and conferred an accumulative increased risk of death. Three multimorbidity phenotype clusters that were significantly associated with loss in life expectancy were identified and should be a concomitant treatment target to improve cardiovascular outcomes. Trial registrationClinicalTrials.gov NCT03037255.
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research
While statins are widely accepted as a keystone for secondary prevention of cardiovascular disease in the general population, statin treatment in chronic renal failure is still debated. Statins have shown no benefit on cardiovascular outcomes in 4D, AURORA, and SHARP trials conducted in patients on dialysis. However, no study has yet compared statin treatment after acute myocardial infarction in end-stage renal disease (ESRD) patients. Statin treatment significantly decreases overall mortality in ESRD patients with acute myocardial infarction compared to the non-statin group.
Source: Atherosclerosis - Category: Cardiology Authors: Tags: Editorial Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
This study will report and summarise adverse outcomes among adult patients with MetS undergoing surgery across a range of surgical specialties. Developing insights into outcomes of this population of interest is necessary to develop guidelines towards better management of surgical patients with metabolic syndrome.Systematic review registrationPROSPEROCRD42016051071
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
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