Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review
ConclusionThis review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 6, 2021 Category: Surgery Source Type: research
Meta-analysis of AKI to CKD transition in perioperative patients
ConclusionsWe conclude that studies conducted in perioperative and nonperioperative patient populations suggest similar risk of development of CKD after AKI. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 29, 2021 Category: Surgery Source Type: research
The effects of neoadjuvant chemoradiotherapy and an in-hospital exercise training programme on physical fitness and quality of life in locally advanced rectal cancer patients: a randomised controlled trial (The EMPOWER Trial)
ConclusionA 9-week exercise prehabilitation programme significantly improved fitness following NCRT. These findings have informed the WesFit trial (NCT03509428) which is investigating the effects of community-based multimodal prehabilitation before cancer surgery.Trial registrationClinicalTrials.govNCT01914068. Registered 1 August 2013. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 22, 2021 Category: Surgery Source Type: research
Surgery school —who, what, when, and how: results of a national survey of multidisciplinary teams delivering group preoperative education
ConclusionIt is recommended that teams work with patients when designing surgery schools and use evidence-based behavior change frameworks and techniques to inform their content. There is a need for high-quality research studies to determine the clinical effectiveness of this type of education intervention. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 15, 2021 Category: Surgery Source Type: research
The hidden secrets of a neutral pH —blood gas analysis of postoperative patients according to the Stewart approach
ConclusionsMetabolic disturbances, characterized mainly by the presence of lowered SIDa, increased AG, and hypoalbuminemia, are frequent in our population with apparent neutral acid-base balance based on pH and base excess. These changes on the morning after surgery are associated with increased length of stay. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 8, 2021 Category: Surgery Source Type: research
A U.S. survey of pre-operative carbohydrate-containing beverage use in colorectal enhanced recovery after surgery (ERAS) programs
ConclusionsThis survey finds a high use of CHO-containing beverages in colorectal ERAS programs. More than half of all programs administer a CHO-containing beverage to patients with diabetes, and surprisingly, there is significant use of simple carbohydrate beverages in patients with diabetes receiving insulin. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 28, 2021 Category: Surgery Source Type: research
Perioperative use of serum creatinine and postoperative acute kidney injury: a single-centre, observational retrospective study to explore physicians ’ perception and practice
ConclusionPO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients.Trial registrationClinicalTrials.gov,NCT04341974. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 25, 2021 Category: Surgery Source Type: research
Hydroxyethyl starch 130/0.4 for volume replacement therapy in surgical patients: a systematic review and meta-analysis of randomized controlled trials
ConclusionsThis systematic review and meta-analysis suggests that the use of HES 130/0.4 for volume replacement therapy compared with other fluids resulted in no significant difference in postoperative mortality or kidney dysfunction among surgical patients. Given the absent evidence of confirmed benefit and the potential trend of increased kidney injury, we cannot recommend the routine clinical use of HES 130/0.4 for volume replacement therapy in surgical patients from the perspective of benefit/risk profile. However, the results need to be interpreted with caution due to the limited sample size, and further well-powered ...
Source: Perioperative Medicine - May 11, 2021 Category: Surgery Source Type: research
The association between residual neuromuscular blockade (RNMB) and critical respiratory events: a prospective cohort study
ConclusionThis research showed that RNMB is a significant contributing factor to the development of critical respiratory events during PACU stay. Therefore, routine quantitative neuromuscular monitoring is recommended to reduce the incidence of RNMB. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 4, 2021 Category: Surgery Source Type: research
Types of surgical patients enrolled in enhanced recovery after surgery (ERAS) programs in the USA
ConclusionsERAS has expanded to a large extent outside of the colorectal surgery service line with increases notable in orthopedic surgery, obstetric/gynecology, surgical oncology, and urology procedures. Institutions with a higher number of ORs and the presence of an anesthesia and/or surgery residency program are associated with an increased number of ERAS programs. (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 27, 2021 Category: Surgery Source Type: research
The effect of systemic lidocaine on post-operative opioid consumption in ambulatory surgical patients: a meta-analysis of randomized controlled trials
ConclusionOur results suggest that intraoperative systemic lidocaine as treatment for postoperative pain has a moderate opioid-sparing effect in post anesthesia care unit with limited effect at 24 h after ambulatory surgery. Moreover, the opioid-sparing effect did not impact the analgesia or the presence of nausea and vomiting immediately or 24 h after surgery. Clinical trials with larger sample sizes are necessary to further confirm the short-term analgesic benefit of systemic lidocaine following ambulatory surgery.Trial registrationPROSPERO (CRD42019142229) (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 13, 2021 Category: Surgery Source Type: research
Can a deep learning model based on intraoperative time-series monitoring data predict post-hysterectomy quality of recovery?
ConclusionsDeep learning based on intraoperative time-series monitoring data can predict post-hysterectomy quality of recovery. The use of intraoperative monitoring data for outcome prediction warrants further investigation.Trial registrationThis trial (Identifier:NCT03641625) was registered at ClinicalTrials.gov by the principal investigator, Lingzhong Meng, on August 22, 2018. (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 6, 2021 Category: Surgery Source Type: research
Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials
ConclusionsThe results of this systematic review can be used to upgrade current guideline statements to agrade A recommendation supporting anoral protein-containing diet commenced before the end of postoperative day 1 after elective lower gastrointestinal surgery in adults. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 23, 2021 Category: Surgery Source Type: research
Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?
ConclusionsData recorded by the wearable device was able to consistently approximate CPET results, both with and without the addition of patient reported activity measures via IPAQ scores. This highlights the potential utility of wearable devices in formal assessment of physical functioning and suggests they could play a larger role in pre-operative risk assessment.EthicsThis study entitled “uSing wearable TEchnology to Predict perioperative high-riSk patient outcomes (STEPS)” gained favourable ethical opinion on 24 January 2017 from the Welsh Research Ethics Committee 3 reference number 17/WA/0006. It was registered o...
Source: Perioperative Medicine - March 16, 2021 Category: Surgery Source Type: research
Prevalence of IgM and IgG antibodies to SARS-CoV-2 in health care workers at a tertiary care New York hospital during the Spring COVID-19 surge
ConclusionsDespite exposure to COVID-19 patients, the prevalence of antibodies in our HCW was similar to what has been reported for the general population of New York State (14%) and for another New York HCW cohort (13.7%). Health care workers with higher exposure rates were not more likely to have been infected with COVID-19. Therefore, these data suggest that infection of HCW may result from exposure in the community rather than at work.Trial registrationThis investigator-initiated study was observational; therefore, no registration was required. Not applicable. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 2, 2021 Category: Surgery Source Type: research
