Evaluation of fluid responsiveness with dynamic superior vena cava collapsibility index in mechanically ventilated patients
ConclusionsThe SVC-CI and SVV can predict fluid responsiveness effectively in mechanically ventilated patients. And SVC-CI is superior in predicting fluid responsiveness compared with SVV. TheE/e’ ratio and CVP cannot predict FR effectively.Trial registrationChinese clinical trial registry (ChiCTR2000034940). (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 10, 2023 Category: Surgery Source Type: research
The incidence of postoperative vasopressor usage: protocol for a prospective international observational cohort study (SQUEEZE)
DiscussionWhile in cardiac surgery, clinical trials have informed the choice of vasopressors used to treat postoperative vasoplegia; there remains equipoise over the best approach in non-cardiac surgery. Our study will represent the first large-scale assessment of the use of vasopressors after non-cardiac surgery. These data will inform future studies, including trials of different vasopressors and potential management options to improve outcomes and reduce resource use after surgery.Trial registrationClinicalTrials.gov Identifier: NCT03805230, 15 January 2019. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 24, 2023 Category: Surgery Source Type: research
Knowledge of surgical informed consent and associated factors among patients undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Ethiopia, 2020: an institutional based cross-sectional study
ConclusionThe overall level of knowledge regarding informed consent for surgerywas significantly lower than that of other national and international figures. Patient satisfaction and patientto provider relationships were associated with knowledge of surgical informed consent. Adequate information should provide before surgery to improve patients ’ knowledge regarding surgical informed consent and to improve the consent process to make it better suited to fit the needs of all patients. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 16, 2023 Category: Surgery Source Type: research
Sex differences in myocardial injury after non-cardiac surgery and postoperative mortality
ConclusionThe incidence of MINS was lower in women than in men. In patients with MINS, female sex may be associated with a survival benefit. Further studies are needed to confirm these findings. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 16, 2023 Category: Surgery Source Type: research
Safety profile of a multimodal fail-safe model to minimize postoperative complications in oncologic colorectal resections —a cohort study
ConclusionWe report an effective multimodal fail-safe protocol for colorectal cancer during the pre-, peri-, and postoperative period. The fail-safe model showed less postoperative complications even for low rectal anastomosis. This approach can be adapted as a structured protocol during the perioperative care of patients for colorectal surgery.Trial registrationThis study was registered in the German Clinical Trial Register (Study ID:DRKS00023804). (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 11, 2023 Category: Surgery Source Type: research
The safety of perioperative dexamethasone with antiemetic dosage in surgical patients with diabetes mellitus: a systematic review and meta-analysis
ConclusionDexamethasone could increase blood glucose by only 2.014 mmol/L (36.252 mg/dL) of peak glucose level within 24 hours of surgery in surgery patients with DM, the increase of glucose level at each time point perioperatively was even lower, and had no effect on wound healing. Thus, dexamethasone with a single dose could be safely used for PONV prophyl axis in diabetic patients.Trial registrationThe protocol of this systematic review was registered in INPLASY with the registration number INPLASY202270002. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 8, 2023 Category: Surgery Source Type: research
Beyond guideline knowledge: a theory-based qualitative study of low-value preoperative testing
ConclusionsWe identified key factors that anesthesiologists, internists, nurses, and surgeons believe influence preoperative test ordering for patients undergoing low-risk surgeries. These beliefs highlight the need to shift away from knowledge-based interventions and focus instead on understanding local drivers of behaviour and target change at the individual, team, and institutional levels. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 2, 2023 Category: Surgery Source Type: research
General Anesthetics in CAncer REsection Surgery (GA-CARES) randomized multicenter trial of propofol vs volatile inhalational anesthesia: protocol description
DiscussionEnrollment has been completed (n = 1804) and the study is in the follow-up phase. This unfunded, pragmatic trial, uses a novel approach for data collection focusing on electronic sources.Trial registrationRegistered (NCT03034096) on January 27, 2017, prior to consent of the first patient on January 31, 2017. (Source: Perioperative Medicine)
Source: Perioperative Medicine - January 11, 2023 Category: Surgery Source Type: research
Magnitude of early postoperative hypoxemia and its associated factors among adult patients who undergo emergency surgery under general anesthesia at Jimma Medical Center, Jimma, Southwest Ethiopia, 2021: a prospective observational study
ConclusionThe magnitude of EPH among patients who have undergone emergency surgery was high and thus recommended that oxygen should be provided timely to decrease it. Identified risk factors were night-time ended anesthesia, ASA III, age greater than 55, surgery duration greater than 2 h, hypotension, muscular strength score zero, and preoperative oxygen saturation less than 95%. This study found anesthesia ended during early morning favors early morning early postoperative hypoxemia (EMEPH). To avert EMEPH, the anesthetist should avoid factors that favor the circadian rhythm of the lung-based early morning anesthesia au...
Source: Perioperative Medicine - January 3, 2023 Category: Surgery Source Type: research
Residual gastric volume after 3 h of the ingestion of an oral supplement containing carbohydrates alone or associated with whey protein: a randomized crossover pilot study
ConclusionThe GRV after 3 h of the ingestion of either WP + CHO or CHO oral supplement returns to basal fast condition implying that gastric emptying after this interval of time is significantly completed.Trial registrationRegistered and posted on the ClinicalTrials.gov public website with Identifier: NCT05573854. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 27, 2022 Category: Surgery Source Type: research
Perioperative management of surgical orthodontic treatment in a patient with glucose transporter 1 deficiency: report of a case and review of the literature
ConclusionSurgical orthodontic treatment in GLUT1 deficiency can be performed relatively safely by maintaining the diet, taking measures against epilepsy and vomiting, and using antimicrobial agents in close collaboration with pediatricians, anesthesiologists, pharmacists, and nutritionists. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 16, 2022 Category: Surgery Source Type: research
Preparing for participation in the centers for Medicare and Medicaid Services ’ bundle care payment initiative—advanced for major bowel surgery
ConclusionsOur study highlights the importance of reducing readmissions as a central component of improving care for bowel surgery bundled payment patients. Preventing such readmissions requires accurate identification of patients at high risk of readmission; however, current risk prediction models lack the adaptability necessary for this task. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 9, 2022 Category: Surgery Source Type: research
An algorithm based on the postoperative decrease of albumin ( ΔAlb) to anticipate complications after liver surgery
ConclusionsΔAlb appeared as a promising predictor independently associated with the risk of complication after liver surgery. The study presents a novel decision-tree based on ΔAlb to anticipate complications. (Source: Perioperative Medicine)
Source: Perioperative Medicine - November 9, 2022 Category: Surgery Source Type: research
The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study
ConclusionsThe 2-channel PCA showed better patient satisfaction with higher QoR-40 during the recovery compared with the 1-channel PCA. Better satisfaction was associated with lower nausea and reduced rescue antiemetics by maintaining the infusion of adjuvant analgesic agents and antiemetic agents constantly by utilizing dual channels.Trial registrationRegistered atClinicalTrials.gov,NCT04082039 on 9 September 2019. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 12, 2022 Category: Surgery Source Type: research
Early postoperative serum aspartate aminotransferase for prediction of post-hepatectomy liver failure
ConclusionsEarly warning from elevated serum AST on POD1, before a definitive diagnosis of PHLF is made on POD5, can help alert physicians that a patient is at risk, meaning that active management and vigilant monitoring can be initiated as soon as possible. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 7, 2022 Category: Surgery Source Type: research
