Preface
Publication date: Available online 18 May 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Steve Coppens (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - May 18, 2019 Category: Anesthesiology Source Type: research

Ultrasound guided ankle block. History revisited
Publication date: Available online 7 May 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Delbos Alain, Marty Philippe, Chassery Clément, Rontes Olivier, Steve Coppens (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - May 8, 2019 Category: Anesthesiology Source Type: research

What the anaesthesiologist needs to know about heart-lung interactions
Publication date: Available online 7 May 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Simon T. Vistisen, Johannes N. Enevoldsen, Jacob Greisen, Peter Juhl-OlsenAbstractThe impact of positive pressure ventilation extends the effect on lungs and gas exchange, because the altered intrathoracic pressure conditions influence determinants of cardiovascular function. These mechanisms are called heart-lung interactions, which conceptually can be divided into two components (1) The positive airway pressure’s effect on the cardiovascular system, which may be more or less pronounced under various ...
Source: Best Practice and Research Clinical Anaesthesiology - May 8, 2019 Category: Anesthesiology Source Type: research

Perioperative Blood Pressure Monitoring
Publication date: Available online 7 May 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Joshua K. Roach, Robert H. ThieleAbstractArterial blood pressure monitoring is a major part of the decision-making process for every anesthetic. It is important to recognize the advantages, disadvantages, and limitations of available measurement modalities as well as have some understanding of the engineering principles on which these measurements are based. Oscillometry is by far the most common modality used, but is limited by its intermittent nature and inaccuracy during hypotension and hypertension. Arte...
Source: Best Practice and Research Clinical Anaesthesiology - May 8, 2019 Category: Anesthesiology Source Type: research

In search of the holy grail: poisons and extended release local anesthetics
Publication date: Available online 30 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Steve J.R. Coppens, Zoriana Zawodny, Geertrui Dewinter, Arne Neyrinck, Angela Lucia Balocco, Steffen RexAbstractRegional anesthesia has been advocated as adjunct to a multimodal analgesia regimen. The limited duration of action of available local anesthetics limits their application. Catheters, perineural or IV adjuvants or repetition of blocks are modalities available to prolong the analgesic benefit of LRA. All of these approaches have their shortcomings. New extended release local anesthetic formulatio...
Source: Best Practice and Research Clinical Anaesthesiology - May 1, 2019 Category: Anesthesiology Source Type: research

Closed-Loop Hemodynamic Management
Publication date: Available online 27 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brenton Alexander, Joseph Rinehart, Maxime Cannesson, Jacques Duranteau, Alexandre JoostenAbstractAs the operating room and intensive care settings become increasingly complex the required vigilance practitioners must dedicate to a wide array of clinical systems has increased concordantly. The resulting shortage of available attention to these various clinical tasks creates a vacuum for the introduction of systems that can administer well established goal-directed therapies without significant provider fe...
Source: Best Practice and Research Clinical Anaesthesiology - April 28, 2019 Category: Anesthesiology Source Type: research

Novel nerve imaging and regional anesthesia, bio-impedance and the future
Publication date: Available online 23 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brian D. O’Donnell, Frank LoughnaneAbstractUltrasound technology has transformed the practice of regional anaesthesia. Anaesthesiologists routinely use real-time images to guide needle and local anaesthetic placement adjacent to nerves. It is widely accepted that the era of ultrasonography has improved peripheral nerve block success rates and lessened the dose of local anaesthetic required to achieve success. Contemporary reports of harm in relation to nerve injury or local anaesthetic systemic toxi...
Source: Best Practice and Research Clinical Anaesthesiology - April 24, 2019 Category: Anesthesiology Source Type: research

Perioperative Hemodynamic Management 4.0
Publication date: Available online 24 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Frederic Michard, Matthieu Biais, Suzana M. Lobo, Emmanuel FutierSummaryPostoperative complications within 30 days represent the third leading cause of death in the world. Multiple solutions have been proposed to tackle the clinical and economic burden of postoperative complications. They include the optimal fluid and hemodynamic management of patients undergoing major surgery. A better understanding of cardiovascular physiology and technological improvements are responsible for the evolution of periopera...
Source: Best Practice and Research Clinical Anaesthesiology - April 24, 2019 Category: Anesthesiology Source Type: research

Fascia iliaca compartment blocks: different techniques and review of the literature
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Matthias Desmet, Angela Lucia Balocco, Vincent Van BelleghemAbstractThe fascia iliaca compartment block has been promoted as a valuable regional anesthesia and analgesia technique for lower limb surgery. Numerous studies have been performed but the evidence on the true benefits of the fascia iliaca compartment block is still limited. Recent anatomical, radiological and clinical research have demonstrated the limitations of the landmark infra-inguinal technique. Nevertheless, this technique is still valuab...
Source: Best Practice and Research Clinical Anaesthesiology - April 18, 2019 Category: Anesthesiology Source Type: research

Predicting hypotension in perioperative and intensive care medicine
Publication date: Available online 16 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Bernd Saugel, Karim Kouz, Phillip Hoppe, Kamal Maheshwari, Thomas W.L. ScheerenAbstractBlood pressure is the main determinant of organ perfusion. Hypotension is common in patients having surgery and in critically ill patients. The severity and duration of hypotension is associated with hypoperfusion and organ dysfunction. Hypotension is mostly treated reactively after low blood pressure values have already occurred. However, prediction of hypotension before it becomes clinically apparent would allow the c...
Source: Best Practice and Research Clinical Anaesthesiology - April 16, 2019 Category: Anesthesiology Source Type: research

Percutaneous Peripheral Nerve Stimulation and Other Alternatives for Perineural Catheters for Postoperative Analgesia
Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Rodney A. Gabriel, Brian M. IlfeldAbstractA perineural catheter with a continuous infusion of local anesthetic is an excellent option for postoperative analgesia; however, its limitations include limited duration of action (i.e. 3 – 7 days) as well as a risk of infection and dislodgement. Furthermore, these blocks may cause dense sensory and motor blockade that under certain circumstances may not be ideal. There is novel evidence that ultrasound-guided percutaneous peripheral nerve stimulation (pPNS)...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Pressure monitoring: the evidence so far
Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Milly Rambhia, Jeff GadsdenAbstractNerve injury is a relatively rare, but devastating complication of peripheral nerve blockade (PNB). Monitoring injection pressure during PNB is one method advocated to prevent injury by detecting needle tip placement in a non-compliant position (intraneural or abutting the epineurium). Animal studies show that gross neural damage and clinical injury are associated with injection pressures exceeding 15-20 psi. In contrast, pressures
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Thoracic wall blocks: from paravertebral to retrolaminar to serratus to erector spinae and back again – a review of the evidence
Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ki Jinn ChinAbstractA multitude of thoracic wall blocks have been described, including parasternal-intercostal plane, Pecs I and II, serratus anterior plane, paraspinal-intercostal plane, erector spinae plane blocks, and retrolaminar blocks. They are almost all fascial plane blocks, relying on passive spread of local anesthetic to target nerves within the plane or in adjacent tissue compartments. They have emerged as attractive alternatives to thoracic paravertebral and epidural blocks, due to their relati...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Updates on Multimodal Analgesia and Regional Anesthesia for Total Knee Arthroplasty Patients
Publication date: Available online 6 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brandon S. Kandarian, Nabil M. Elkassabany, Mallika Tamboli, Edward R. MarianoAbstractThe subspecialty of regional anesthesiology and acute pain medicine (RAAPM) is in a position to lead changes that may impact the current opioid crisis. At the hospital level, RAAPM experts can implement evidence-based multimodal analgesic clinical pathways featuring regional anesthesia. Multimodal analgesia consists of using two or more analgesic modalities targeting pain pathways at various levels to improve pain control...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Breast surgery and regional anaesthesia
Publication date: Available online 6 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Simon FitzGerald, Peter M. Odor, Ann Barron, Amit PawaAbstractRegional anaesthesia techniques are an important adjunct to perioperative care of breast surgery patients. This chapter focuses on the practical application, evidence base and advantages of peripheral nerve block regional anaesthesia in the anaesthetic management of patients undergoing breast surgery. Functional anatomy and fascial plane blocks are discussed alongside paravertebral and paraspinal techniques. Guidance on the performance the range...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Measuring and Monitoring Cognition in the Postoperative Period
Publication date: Available online 18 January 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Lucy H. Piggin, Stanton P. NewmanAbstractIt is common for patients of all ages to experience some degree of cognitive disturbance following surgery. In most cases, impairment appears mild and is restricted to the acute post-operative period, resolving steadily and speedily. In a small number of cases, however, deficits may be more pronounced and/or endure for longer periods, significantly delaying recovery and increasing the risk of serious clinical complications. The ability to accurately measure posto...
Source: Best Practice and Research Clinical Anaesthesiology - January 20, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: September–December 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issues 3–4Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - December 4, 2018 Category: Anesthesiology Source Type: research

Preface to patient centered clinical anaesthesiology
Publication date: September–December 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issues 3–4Author(s): Colin Royse (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - December 4, 2018 Category: Anesthesiology Source Type: research

The future of recovery – Integrated, digitalised and in real time
Publication date: Available online 10 April 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrea Bowyer, Colin RoyseTraditional perioperative risk prediction recovery identifies patient populations at risk of suboptimal recovery but not individual patients in whom this actually occurs and in whom timely intervention is beneficial. Patient-focused recovery emphasises a return to a semblance of normality and an ability to perform activities previously undertaken. A patient's sense of self-efficacy and engagement in their own care positively influences functional improvement and emotive recovery....
Source: Best Practice and Research Clinical Anaesthesiology - November 12, 2018 Category: Anesthesiology Source Type: research

A matter of perspective – Objective versus subjective outcomes in the assessment of quality of recovery
Publication date: Available online 10 April 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrea Bowyer, Colin RoyseCurrent post-operative recovery assessment exists as a dichotomy, maintaining objectivity whilst providing relevance to patient-centred care. Both objective and subjective measures are utilised in modern recovery assessment and are best viewed as complimentary. At institutional and provider levels, performance indicators are utilised as surrogates for quality of recovery but only if these indicators are assessed in the clinical context from which they are derived. Patient-reporte...
Source: Best Practice and Research Clinical Anaesthesiology - November 12, 2018 Category: Anesthesiology Source Type: research

Approaches to the measurement of post-operative recovery
Publication date: Available online 11 April 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrea Bowyer, Colin RoyseModern recovery assessment has progressed from that which addressed purely physiological restitution in the immediate post-operative period to that which is a multi-dimensional construct existing as a continuum and which follows a predictable trajectory. Recovery tools differ in their derivation, validation and scope of assessment. Importantly, few are validated for repeat measures, an aspect crucial when assessing the temporal nature of modern recovery. Recovery can be assessed ...
Source: Best Practice and Research Clinical Anaesthesiology - November 12, 2018 Category: Anesthesiology Source Type: research

The patient's surgical journey and consequences of poor recovery
Publication date: Available online 26 June 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Colin F. RoyseQuality of recovery is a multidimensional construct that affects individual patients in different ways and during different time periods. The evaluation of quality of recovery requires patient-reported outcome measurement tools that are sensitive in detecting change with time and are preferably objective rather than subjective by nature. Current surgical outcomes are still predominantly focused on the avoidance of complications and reduced cost. The new era of ‘value-based care’ i...
Source: Best Practice and Research Clinical Anaesthesiology - November 12, 2018 Category: Anesthesiology Source Type: research

Defining quality of recovery – What is important to patients?
Publication date: Available online 6 August 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jaume Borrell-Vega, Michelle L. Humeidan, Sergio D. BergesePostoperative recovery is a complex process with several interrelated domains. Traditionally, the absence of negative physiological symptoms like nausea and pain, along with avoidance of major postoperative complications, has been the standard set by clinicians and hospitals for a satisfactory postoperative recovery. Nonetheless, evidence from recent studies reports these items to be the least important from the patient point of view. Effective co...
Source: Best Practice and Research Clinical Anaesthesiology - November 12, 2018 Category: Anesthesiology Source Type: research

Pharmacogenomics, precision medicine, and implications for anesthesia care
Publication date: June 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 2Author(s): Alan D. Kaye, Thomas Mahakian, Aaron J. Kaye, Andrew A. Pham, Brendon M. Hart, Sonja Gennuso, Elyse M. Cornett, Rodney A. Gabriel, Richard D. UrmanThe study of how individual genetic differences, known as polymorphisms, change the pharmacokinetics and pharmacodynamics of drugs is called pharmacogenomics. As the field of pharmacogenetics grows and continues to identify genetic polymorphisms, it is promising that the unmet need in this patient population may soon be addressed with personalized drug therapy b...
Source: Best Practice and Research Clinical Anaesthesiology - October 14, 2018 Category: Anesthesiology Source Type: research

Procedure-Specific Pain Management (PROSPECT) – An update
Publication date: June 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 2Author(s): Brian Lee, Stephan A. Schug, Girish P. Joshi, Henrik Kehlet, Helene Beloeil, Francis Bonnet, Patricia Lavand’Homme, Philipp Lirk, Esther Pogatzki-Zahn, Johan Raeder, Narinder Rawal, Marc van der VeldePost-operative pain management protocols may be optimised by examining procedure-specific evidence and outcomes. This recognition led to the formation of the PROcedure-SPECific Pain ManagemenT (PROSPECT) collaboration of anaesthesiologists and surgeons. The aim of PROSPECT is to provide practical and evi...
Source: Best Practice and Research Clinical Anaesthesiology - October 14, 2018 Category: Anesthesiology Source Type: research

What is new in the battle against postoperative nausea and vomiting?
Publication date: June 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 2Author(s): Vahé S. Tateosian, Katelynn Champagne, Tong J. GanThe issue of postoperative nausea and vomiting (PONV) still poses a significant burden on our patients. Although rarely associated with a life-threatening condition, it is consistently considered as one of the most undesirable side effects of surgery and anesthesia. There are well-established risk factors for the development of PONV that include patient-related factors, anesthetic technique, use of volatile anesthetics, use of nitrous oxide, duration...
Source: Best Practice and Research Clinical Anaesthesiology - October 14, 2018 Category: Anesthesiology Source Type: research

New anticoagulants, reversal agents, and clinical considerations for perioperative practice
We describe the different categories of drugs, e.g., antiplatelet, anticoagulant, and thrombolytic, with particular emphasis on the new drugs that have been introduced into the market. These agents can be evaluated by a number of methods including low-, medium-, or high-risk procedures and guidelines and best practice standards that have been published regarding the amount of time to wait after stopping the medication and before performing a procedure, e.g., the American Society of Regional Anesthesia and Pain Medicine recommendations. The present investigation will also describe new reversal agents for anticoagulants and ...
Source: Best Practice and Research Clinical Anaesthesiology - October 14, 2018 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: June 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 2Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - October 14, 2018 Category: Anesthesiology Source Type: research

Perioperative Pharmacology - New Evidence, Agents, and Concepts Impacting Perioperative Practice
Publication date: Available online 14 September 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Richard D. Urman (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - September 14, 2018 Category: Anesthesiology Source Type: research

Newer Propofol, Ketamine, and Etomidate Derivatives and Delivery Systems Relevant to Anesthesia Practice
Publication date: Available online 23 August 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): N. Hulsman, M.W. Hollmann, B. PreckelAbstractDrug discovery is the cornerstone of developments in the field of anesthesia. Each year new drugs enter the market and possibly change clinical practice. The development of new anesthetics can be divided into two groups. One strategy is the discovery of a new type of drugs, a unique molecular structure with better clinical properties and lesser side effects than the already existing drugs. Another strategy is changing the molecular structure of current clinica...
Source: Best Practice and Research Clinical Anaesthesiology - August 24, 2018 Category: Anesthesiology Source Type: research

Cognitive Self-Assessment Scales in Surgical Settings: Acceptability and Feasibility
Publication date: Available online 9 August 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): N. Stoicea, K.N. Koehler, D.W. Scharre, S.D. BergeseAbstractPreexisting cognitive impairment is associated with poorer surgical outcomes, longer hospital stays, and increased morbidity and mortality. This necessitates the use of screening tools to evaluate preoperative cognitive status in elderly surgical patients. Given the growing population of older adults and increased prevalence of cognitive impairment, it is necessary to investigate whether staff administered or self-administered cognitive screening...
Source: Best Practice and Research Clinical Anaesthesiology - August 9, 2018 Category: Anesthesiology Source Type: research

Pharmacogenomics, Precision Medicine, and Implications on Anesthesia Care
Publication date: Available online 6 August 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Alan D. Kaye, Thomas Mahakian, Aaron J. Kaye, Andrew A. Pham, Brendon M. Hart, Sonja Gennuso, Elyse M. Cornett, Rodney Gabriel, Richard D. UrmanAbstractThe study of how individual genetic differences known as polymorphisms change the pharmacokinetics and pharmacodynamics of drugs is pharmacogenomics. As the field of pharmacogenetics grows and continues to identify genetic polymorphisms, it is promising that the unmet need in this patient population may soon be addressed with personalized drug therapy base...
Source: Best Practice and Research Clinical Anaesthesiology - August 7, 2018 Category: Anesthesiology Source Type: research

Defining quality of recovery-What Is Important to Patients?
Publication date: Available online 6 August 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jaume Borrell-Vega, Clinical Research, Michelle L. Humeidan, Sergio D. BergeseAbstractPostoperative recovery is a complex process with several interrelated domains. Traditionally, the absence of negative physiologic symptoms like nausea and pain, along with avoidance of major post-operative complications, has been the bar set by clinicians and hospitals for a satisfactory postoperative recovery. Nonetheless, evidence from recent studies report these items to be the least important from the patient point o...
Source: Best Practice and Research Clinical Anaesthesiology - August 7, 2018 Category: Anesthesiology Source Type: research

New antihypertensive medications and clinical implications
This article also describes new antihypertensive agents currently available or under development that could impact perioperative management. (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - August 2, 2018 Category: Anesthesiology Source Type: research

Improving female physician's careers in academic medicine: Chances and challenges
Publication date: March 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 1Author(s): Bettina Pfleiderer, Marina Bortul, Silvia Palmisano, Sibyll Rodde, Joachim HasebrookUniversity hospitals are involved in the care of critically ill patients, pregraduate and postgraduate education, and medical research with an increasing demand on physicians due to a higher burden of disease. The number of female physicians is increasing; however, young female physicians are less willing to work at university hospitals under the given conditions. They often do not find appropriate working conditions in mo...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2018 Category: Anesthesiology Source Type: research

Moving towards a competence centre for geriatric medicine and care: Quality management and human resource management as major support factors
Publication date: March 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 1Author(s): Kerstin Löffler, Judith Goldgruber, Gerd HartingerChanged employment models, an ageing workforce and demands of new generations are challenging healthcare facilities to go down new paths. Never before have well-qualified staff been as highly sought after within the medical and nursing care sector as they are today.For many years, the Geriatric Health Care Centres of the city of Graz (GGZ)—a large regional health care provider with more than 650 staff across five locations—has focused a lo...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2018 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: March 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 1Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2018 Category: Anesthesiology Source Type: research

Integrating cross-border emergency medicine systems: Securing future preclinical medical workforce for remote medical services
Publication date: March 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issue 1Author(s): Tomasz Ucinski, Grzegorz Dolata, Robert Hełminiak, Lutz Fischer, Steffen Fleßa, Bernhard Brehmer, Armin Viert, Volker Grundmann, Sebastian Rehberg, Kathrin Krügel, Maud Partecke, Peter Brinkrolf, Klaus Hahnenkamp, Konrad MeissnerThe European Union intends to enable its citizens to interact across borders in relevant areas of society and culture to further integrate neighboring regions. Medicine has not been at the core of recent EU-funded efforts in central Europe, partially due to significant...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2018 Category: Anesthesiology Source Type: research

Pathophysiology of AKI
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Marlies Ostermann, Kathleen LiuAcute kidney injury (AKI) is common in the perioperative and intensive care setting. Although AKI is usually multifactorial, haemodynamic instability, sepsis and drug toxicity are commonly implicated. Independent of the exact aetiology, several different pathophysiologic processes occur simultaneously and in sequence, including endothelial dysfunction, alteration of the microcirculation, tubular injury, venous congestion and intrarenal inflammation. A multitude of differ...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Keyword index
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Acute kidney injury in pediatric patients
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): David M. Kwiatkowski, Scott M. SutherlandAcute kidney injury (AKI) is highly prevalent among hospitalized children, especially those who are critically ill. The incorporation of pediatric elements into consensus definitions has led to a greater understanding of pediatric AKI epidemiology, risk factors, and outcomes. The best available data suggest that AKI occurs in 5% and 27% of non-critically ill and critically ill children, respectively. Additionally, AKI and fluid overload are independently associ...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Sequelae of AKI
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Samir S. Patel, Carlos E. Palant, Vrinda Mahajan, Lakhmir S. ChawlaLarge epidemiologic studies in a variety of patient populations reveal increased morbidity and mortality that occur months to years after an episode of acute kidney injury (AKI). Even milder forms of AKI have increased associated morbidity and mortality. Residual confounding may account for these findings, but considering the huge number of individuals afflicted with AKI, the sequelae of AKI may be a very large public health burden. AK...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Renal recovery
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Ivan Göcze, Christina Wiesner, Hans J. Schlitt, Tobias BerglerRecovery patterns after acute kidney injury (AKI) have increasingly become the focus of research, because currently available preventive measures and specific therapeutic intervention are limited. Moreover, changes in renal functional reserve are recognized as a “hidden” indicator of kidney susceptibility to either acute kidney injury or chronic kidney disease. Understanding these phenomena and their association with outcom...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Renal replacement therapy and anticoagulation
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Timo Brandenburger, Thomas Dimski, Torsten Slowinski, Detlef Kindgen-MillesToday, up to 20% of all intensive care unit patients require renal replacement therapy (RRT), and continuous renal replacement therapies (CRRT) are the preferred technique. In CRRT, effective anticoagulation of the extracorporeal circuit is mandatory to prevent clotting of the circuit or filter and to maintain filter performance. At present, a variety of systemic and regional anticoagulation modes for CRRT are available. Worldw...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Epidemiology of cardiac surgery-associated acute kidney injury
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Eric A.J. Hoste, Wim VandenbergheAcute kidney injury (AKI) is defined by the KDIGO definition into 3 stages on basis of an increase in serum creatinine or a period of oliguria. AKI is defined as rapid reversal when the episode is 48 h or less. When AKI persists for 7 days or longer, the term acute kidney disease is used. Subclinical AKI is defined by increased concentration of an AKI biomarker, without meeting the KDIGO definition for AKI. In contrast to this, functional AKI is defined by the KDI...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Prevention of acute kidney injury
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Melanie Meersch, Stephanie Volmering, Alexander ZarbockAcute kidney injury is a prevalent but underdiagnosed complication that is associated with increased in-hospital morbidity and mortality. The importance of this complication is being increasingly recognized. The lack of timely diagnostic methods and effective preemptive and therapeutic strategies make its perioperative management challenging. To reduce the incidence of acute kidney injury, it is crucial to focus the resources on high-risk patients...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Impact of e-alert systems on the care of patients with acute kidney injury
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Crystal M. Breighner, Kianoush B. KashaniWith the recent advancement in electronic health record systems and meaningful use of information technology incentive programs (i.e., the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health Act, and the Centers for Medicare & Medicaid Services), interest in clinical decision support systems has risen. These systems have been used to examine a variety of different syndromes with variable reported effect...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Impact of volume status and volume therapy on the kidney
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): David A. Roberts, Andrew D. ShawVolume resuscitation to correct hypotension in surgical and critically ill patients is a common practice. Available evidence suggests that iatrogenic volume overload is associated with worse outcomes in established acute kidney injury. Intraoperative arterial hypotension is associated with postoperative renal dysfunction, and prompt correction with fluid management protocols that combine inotrope infusions with volume therapy targeted to indices of volume responsiveness...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

Biomarkers in acute kidney injury (AKI)
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Su Hooi Teo, Zoltán Huba EndreAcute kidney injury is common in critically ill patients and portends a significant impact on mortality, progressive chronic kidney disease, and cardiovascular disease and mortality. Though most physicians alter therapy depending on changes in serum creatinine, this often represents delayed intervention. Various AKI biomarkers have been discovered and validated to improve timely detection, differentiation and stratification into risk groups for progressive renal de...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research

The macro- and microcirculation of the kidney
Publication date: September 2017Source: Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 3Author(s): Philippe Guerci, Bulent Ergin, Can InceAcute kidney injury (AKI) remains one of the main causes of morbidity and mortality in the intensive care medicine today. Its pathophysiology and progress to chronic kidney disease is still under investigation. In addition, the lack of techniques to adequately monitor renal function and microcirculation at the bedside makes its therapeutic resolution challenging. In this article, we review current concepts related to renal hemodynamics compromise as being the eve...
Source: Best Practice and Research Clinical Anaesthesiology - July 10, 2018 Category: Anesthesiology Source Type: research