Technical and clinical evaluation of a closed loop TIVA system with SEDLine TM spectral density monitoring: Multicentric prospective cohort study
ConclusionsThe closed loop total intravenous anesthesia system with SEDLine developed by the authors was used without major complication and appear to be feasible its use in clinical performance. (Source: Perioperative Medicine)
Source: Perioperative Medicine - January 8, 2020 Category: Surgery Source Type: research
A significant proportion of venous thromboembolism events in general surgical patients occurs after discharge: analysis of the ACS-NSQIP Essentials database
ConclusionThis is the first paper to report on this high post-discharge incidence of VTE in general surgical patients and to recommend continuation of VTE prophylaxis in the post-discharge period. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 12, 2019 Category: Surgery Source Type: research
Cannabis-based medicines and the perioperative physician
We present a summary of the pharmacology of cannabis-based medicines including anaesthetic interactions and implications, to assist colleagues encountering these medicines in clinical practice. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 5, 2019 Category: Surgery Source Type: research
Compliance, adherence and effectiveness of a community-based pre-operative exercise programme: a pilot study
ConclusionThis community-based pre-operative exercise programme showed acceptable compliance and adherence rates, and significantly increased upper and lower body strength and HRQoL. Pre-operative exercise training should be considered as early as possible in the surgical-oncology pathway and respected within patient scheduling. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 1, 2019 Category: Surgery Source Type: research
Focused cardiac ultrasound in preoperative assessment: the perioperative provider ’s new stethoscope?
AbstractFocused cardiac ultrasound (FoCUS) —a simplified, qualitative version of echocardiography—is a well-established tool in the armamentarium of critical care and emergency medicine. This review explores the extent to which FoCUS could also be used to enhance the preoperative physical examination to better utilise resources and ident ify those who would benefit most from detailed echocardiography prior to surgery. Among the range of pathologies that FoCUS can screen for, the conditions it provides the most utility in the preoperative setting are left ventricular systolic dysfunction (LVSD) and, in certain circumsta...
Source: Perioperative Medicine - November 21, 2019 Category: Surgery Source Type: research
Standard coagulation assays alone are not sufficient to exclude surgically relevant rivaroxaban plasma concentrations
ConclusionAlthough a moderate correlation of RXA plasma concentration with PT/Quick, INR, and aPTT was observed, standard coagulation assays are not sufficient to exclude surgically relevant RXA plasma concentrations. (Source: Perioperative Medicine)
Source: Perioperative Medicine - November 19, 2019 Category: Surgery Source Type: research
The role of cardiac rehabilitation using exercise to decrease natriuretic peptide levels in non-surgical patients: a systematic review
AbstractExercise is recommended in patients with cardiac failure. In the perioperative patient, exercise is also gaining popularity as a form of prehabilitation. In this meta-analysis, we examine if exercise is able to reduce natriuretic peptide levels. Natriuretic peptide (NP) has strong prognostic ability in identifying patients who will develop adverse postoperative cardiovascular outcomes. The protocol was registered with PROSPERO (CRD42017051468). The database search included MEDLINE (PubMed), CINAHL (EBSCO host), EMBASE (EBSCO host), ProQuest, Web of Science, and Cochrane database. The primary outcomes were to determ...
Source: Perioperative Medicine - November 17, 2019 Category: Surgery Source Type: research
Large volume infusions of hydroxyethyl starch during cardiothoracic surgery may be associated with postoperative kidney injury: propensity-matched analysis
ConclusionsIntraoperative use of HES was not associated with postoperative AKI following CPB. However, administration of large volumes of HES may be associated with kidney-related adverse clinical outcomes. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 30, 2019 Category: Surgery Source Type: research
Correction to: Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India
Following publication of the original article (Machowska et al. 2019), the authors provided new footnotes for Table 1 and Table 2. The complete tables and updated footnotes are supplied below. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 27, 2019 Category: Surgery Source Type: research
Primer on adult patient satisfaction in perioperative settings
AbstractThe topic of patient satisfaction has gained increasing importance over the past decade. Due to the impact of patient satisfaction on health care quality, understanding factors that predict satisfaction is vital. The purpose of this review is to examine the literature and identify factors related to patient perioperative satisfaction as well as predictive variables that, if modified, can enhance satisfaction scores of patients undergoing surgery. Our review reports that patient satisfaction scores are affected by modifiable factors such as clinician-patient communication, information provision to patients, and oper...
Source: Perioperative Medicine - September 18, 2019 Category: Surgery Source Type: research
Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India
Conclusions and recommendationsHigh prescribing of antibiotics in all four selected diagnoses groups was observed at both hospitals. In spite of the recommended single-dose PAP, antibiotics were mainly prescribed for longer durations. The unrecommended use of antibiotics is a risk factor for the development of AMR. Improving the quality of antibiotic prescribing by a stewardship program focusing on the development and implementation of local prescribing guidelines is needed. (Source: Perioperative Medicine)
Source: Perioperative Medicine - September 9, 2019 Category: Surgery Source Type: research
Impact of an enhanced recovery pathway on length of stay and complications in elective radical cystectomy: a before and after cohort study
ConclusionsOur data support the use of an ERAS pathway for radical cystectomy and add to the increasing body of literature supporting enhanced recovery over a wide variety of procedures.Trial registrationNot applicable. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 21, 2019 Category: Surgery Source Type: research
A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)
ConclusionsHaemodynamic optimisation including blood pressure management in high-risk patients undergoing repair of a hip fracture did not result in a statistically significant reduction in complications; however, a potential reduction in length of stay was seen.Trial registrationA randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trialNCT02382185). (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 7, 2019 Category: Surgery Source Type: research
Perioperative fluid management: moving toward more answers than questions —a commentary on the RELIEF study
AbstractPerioperative fluid and hemodynamic management have been much-debated topics over the last few years. Recently, a number of large trials have been published to help inform this debate. The Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery (RELIEF) study is the largest trial to date of perioperative fluid management. The 3000-patient trial comparing 2 different fluid regimes showed that a restrictive fluid regimen during and up to 24 h after surgery was associated with an increase in acute kidney injury (AKI). This result is at odds with a recent trend to a more restrictive fluid approach durin...
Source: Perioperative Medicine - July 14, 2019 Category: Surgery Source Type: research
Data integrity issues: catalyst for a more robust approach to research on perioperative oxygen therapy?
(Source: Perioperative Medicine)
Source: Perioperative Medicine - July 3, 2019 Category: Surgery Source Type: research
