Cardiac arrest in older adult patients
Purpose of review
To describe the epidemiology, prognostication, and treatment of out- and in-hospital cardiac arrest (OHCA and IHCA) in elderly patients.
Recent findings
Elderly patients undergoing cardiac arrest (CA) challenge the appropriateness of attempting cardiopulmonary resuscitation (CPR). Current literature suggests that factors traditionally associated with survival to hospital discharge and neurologically intact survival after CA cardiac arrest in general (e.g. presenting ryhthm, bystander CPR, targeted temperature management) may not be similarly favorable in elderly patients. Alternative factors me...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: GERIATRIC ANESTHESIA: Edited by Leanne Groban Source Type: research
Elderly hip fracture patients: surgical timing and factors to consider
Purpose of review
Hip fractures of the elderly population are a common trauma and numbers are increasing due to ageing societies. Although this is an ordinary low energy impact injury and surgical repair techniques show good results, the perioperative course is characterized by an unparalleled disproportionate perioperative morbidity and mortality.
Recent findings
Most studies focus on outcome-related data. Little is known on how to prevent and treat adverse sequelae, ranging from mild physical challenges to neurobiological disorders and death.
Summary
Although the contribution of the anaesthetic techniqu...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: GERIATRIC ANESTHESIA: Edited by Leanne Groban Source Type: research
Postoperative delirium – treatment and prevention
Purpose of review
Postoperative delirium (POD) is one of the most severe complications after surgery.
The consequences are dramatic: longer hospitalization, a doubling of mortality and almost all cases develop permanent, yet subtle, cognitive deficits specific to everyday life. Actually, no global guideline with standardized concepts of management exists. Advances in prevention, diagnosis and treatment can improve recognition and risk stratification of delirium and its consequences.
Recent findings
Management of POD is a multiprofessional approach and consists of different parts: First, the detection of high-...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: GERIATRIC ANESTHESIA: Edited by Leanne Groban Source Type: research
Editorial: Anesthesia for the older surgical patient: beyond standard care?
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: GERIATRIC ANESTHESIA: Edited by Leanne Groban Source Type: research
Prevent deterioration and long-term ventilation: intensive care following thoracic surgery
Purpose of review
Patients with indication for lung surgery besides the pulmonary pathology often suffer from independent comorbidities affecting several other organ systems. Preventing patients from harmful complications due to decompensation of underlying organ insufficiencies perioperatively is pivotal. This review draws attention to the peri- and postoperative responsibility of the anaesthetist and intensivist to prevent patients undergoing lung surgery deterioration.
Recent findings
During the last decades we had to accept that ‘traditional’ intensive care medicine implying deep sedation, controlled ven...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Torsten Loop Source Type: research
Minimizing postoperative pulmonary complications in thoracic surgery patients
Purpose of review
Quantification and optimization of perioperative risk factors focusing on anesthesia-related strategies to reduce postoperative pulmonary complications (PPCs) after lung and esophageal surgery.
Recent findings
There is an increasing amount of multimorbid patients undergoing thoracic surgery due to the demographic development and medical progress in perioperative medicine. Nevertheless, the rate of PPCs after thoracic surgery is still up to 30–50% with a significant influence on patients’ outcome. PPCs are ranked first among the leading causes of early mortality after thoracic surgery. Altho...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Torsten Loop Source Type: research
Transesophageal echocardiography for perioperative management in thoracic surgery
Purpose of review
Perioperative transesophageal echocardiography (TEE) is most often employed during cardiac surgery. This review will summarize some of the recent findings relevant to TEE utilization during thoracic surgical procedures.
Recent findings
Hemodynamic monitoring is a key component of goal-directed fluid therapy, which is also becoming more common for management of thoracic surgical procedures. Although usually not required for the anesthetic management of common thoracic surgeries, TEE is frequently used during lung transplantation and pulmonary thromboendarterectomy. Few clinical studies support c...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Torsten Loop Source Type: research
To tube or not to tube: a skeptic's guide to nonintubated thoracic surgery
Purpose of review
The aim of this review is to provide an overview of the rationale and evidence for nonintubated thoracic surgery and guide clinicians, considering the implementation of nonintubated thoracic surgery, to find an anesthetic approach suitable for their department.
Recent findings
Based on physiologic considerations alone, nonintubated thoracic surgery would be expected to be an advantageous concept in thoracic anesthesia, especially in patients at high risk for pulmonary complications. Currently existing evidence, however, does not support these claims. Although the feasibility and safety have bee...
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Torsten Loop Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - January 18, 2021 Category: Anesthesiology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Use of cannabis and cannabinoids in palliative care setting
Purpose of review
Cannabis products have been used for various ailments since ancient times. But their use diminished in the medical community due to the legal and social concerns of substance abuse. With evolving evidence of their use in alleviating various symptoms, resurgence of interest in their medicinal use is seen in the past decade.
Recent findings
Clinical evidence for cannabis products in treating various ailments has been far from robust. Their use is based on anecdotal and low-quality evidence. This review attempts to revisit the recent medical literature available on the merits and demerits of cannabinoid...
Source: Current Opinion in Anaesthesiology - October 29, 2020 Category: Anesthesiology Tags: PAIN MEDICINE: Edited by Salahadin Abdi Source Type: research
Anesthetic considerations in medical cannabis patients
Purpose of review
Growing numbers of patients, consuming cannabinoids admitted to surgery, create a challenge to anesthesia providers. This review provides a summary of recent literature related to cannabis and anesthesia, with specific recommendations to the anesthetic management of medical cannabis consumers.
Recent findings
At present, cannabis has found its way to public consensus in many countries and is penetrating slower to different medical fields. We relate and discuss recent findings investigating effects of cannabis consumption on the various aspects including perioperative measures, post-operative pain, PO...
Source: Current Opinion in Anaesthesiology - October 29, 2020 Category: Anesthesiology Tags: PAIN MEDICINE: Edited by Salahadin Abdi Source Type: research
Update on cannabis and cannabinoids for cancer pain
Purpose of review
The prevalence of cancer pain will continue to rise as pain is common among the survivorship and general cancer population. As interest in cannabis and cannabinoids for medicinal use including pain management continues to rise, there is growing need to update and review the current state of evidence for their use. The literature was searched for articles in English with key words cannabis, cannabinoids, and cancer pain. The sources of articles were PubMed, Embase, and open Google search.
Recent findings
In a double-blind randomized placebo-controlled trial including a 3-week treatment period of nabix...
Source: Current Opinion in Anaesthesiology - October 29, 2020 Category: Anesthesiology Tags: PAIN MEDICINE: Edited by Salahadin Abdi Source Type: research
Editorial: Cannabis and cannabinoids for pain: a long way to go (or not): time will tell
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - October 29, 2020 Category: Anesthesiology Tags: PAIN MEDICINE: Edited by Salahadin Abdi Source Type: research
Measuring and monitoring perioperative patient safety: a basic approach for clinicians
Purpose of review
Recent research points to considerable rates of preventable perioperative patient harm and anaesthesiologists’ concerns about eroding patient safety. Anaesthesia has always been at the forefront of patient safety improvement initiatives. However, factual local safety improvement requires local measurement, which may be afflicted by barriers to data collection and improvement activities. Because many of these barriers are related to mandatory reporting, the focus of this review is on measurement methods that can be used by practicing anaesthesiologists as self-improvement tools, even independently from...
Source: Current Opinion in Anaesthesiology - October 29, 2020 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Keith J. Ruskin Source Type: research
The Bowtie diagram: a simple tool for analysis and planning in anesthesia
Purpose of review
The purpose is to show the advantages of a Bowtie diagram as a versatile tool for displaying and understanding the evolvement and management of critical incidents.
Recent findings
The Bowtie diagram has been used recently in anesthesia to depict critical incidents having been used in high-risk industries for several decades. This diagram displays the progression from latent factors to potential harm in five steps.
Summary
The Bowtie diagram combines the features of a fault tree and an event tree with the adverse event, known as the Top Event separating the two sections. The fault tree is similar i...
Source: Current Opinion in Anaesthesiology - October 29, 2020 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Keith J. Ruskin Source Type: research
