The physiologic responses to a fluid bolus administration in old and young healthy adults
ConclusionOlder adults show a less reactive CFC to a fluid bolus, which could reduce blood to tissue transport of fluid. Diastolic dysfunction likely contributes to fluid maldistribution in older adults. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 16, 2022 Category: Surgery Source Type: research
Effect of goal-directed haemodynamic therapy guided by non-invasive monitoring on perioperative complications in elderly hip fracture patients within an enhanced recovery pathway
ConclusionsThe use of GDHT decreases intraoperative complications and postoperative cardiovascular, respiratory and infectious but not postoperative renal complications. This strategy was associated with a shorter hospital stay and increased 1-year survival.Trial registrationClinicalTrials.govNCT02479321. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 10, 2022 Category: Surgery Source Type: research
The Perioperative Quality Improvement Programme (PQIP patient study): protocol for a UK multicentre, prospective cohort study to measure quality of care and outcomes after major surgery
AbstractIntroductionMajor surgery accounts for a substantial proportion of health service activity, due not only to the primary procedure, but the longer-term health implications of poor short-term outcome. Data from small studies or from outside the UK indicate that rates of complications and failure to rescue vary between hospitals, as does compliance with best practice processes. Within the UK, there is currently no system for monitoring postoperative complications (other than short-term mortality) in major non-cardiac surgery. Further, there is variation between national audit programmes, in the emphasis placed on qual...
Source: Perioperative Medicine - August 9, 2022 Category: Surgery Source Type: research
The prevalence of perioperative iron deficiency anaemia in women undergoing caesarean section —a retrospective cohort study
ConclusionOver one in three women were iron deficient at their first hospital appointment. 62% of women with moderate anaemia (Hb 80 –109 g/L) also had iron deficiency. At least four in 10 women were anaemic (Hb< 130 g/L) on hospital discharge. Less than half of the women with anaemia were treated. Our data suggests that 30% of postoperative anaemia may be prevented with intensive treatment of iron deficiency in early pregnancy. Large prospective studies, are needed to determine outcomes after caesarean section in women, stratified by preoperative Hb and ferritin levels. The prevalence of anaemia in our data suggests ...
Source: Perioperative Medicine - August 4, 2022 Category: Surgery Source Type: research
Postoperative fasting is associated with longer ICU stay in oncologic patients undergoing elective surgery
This study evaluates the consequence of fasting time on the surgical outcomes of cancer patients undergoing elective surgeries.MethodsProspective cohort, evaluating two categories of patients according to postoperative fasting: less than or greater than 24 h. Outcomes: Hospitalization time, 28-day mortality, ICU stay and infection rates.DiscussionWe included 109 patients (57% men, 60 ± 15 years, BMI: 26 ± 5 kg/m2, SAPS3 43 ± 12), hepatectomy was the most frequent surgery (13.8%), and colon and rectum were the most common neoplasia (18.3%). The ICU stay was longer in postoperative fasting> 24 h (5.5 [4 –8.25] vs. 3 ...
Source: Perioperative Medicine - August 2, 2022 Category: Surgery Source Type: research
Erector spinae plane block for postoperative analgesia for above-the-knee amputation: a case report
ConclusionWhile data on ESP at the thoracic level is well described, less is known about the expected coverage for lumbar ESP. This case suggests that at the level of L3, there is sufficient dermatomal spread for an AKA. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 29, 2022 Category: Surgery Source Type: research
Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block
ConclusionCompared with the TPVB, TTP-PECS can provide better postoperative analgesia in patients undergoing MRM, simultaneously reduce the inflammatory response, and prompt early recovery. These results suggest that TTP-PECS is an attractive alternative to TPVB for postoperative analgesia of modified radical mastectomy. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 27, 2022 Category: Surgery Source Type: research
Feasibility of a tele-prehabilitation program in high-risk patients with colon or rectal cancer undergoing elective surgery: a feasibility study
ConclusionsTele-prehabilitation seems feasible in high-risk patients with colorectal cancer, but efforts should be made to further improve adherence to physical exercise training intensity. More research is needed to establish the (cost-)effectiveness of tele-prehabilitation regarding preoperative improvements in preoperative aerobic fitness and postoperative reduction of complications.Trial registrationISRCTN,ISRCTN64482109. Registered 09 November 2021 - Retrospectively registered. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 26, 2022 Category: Surgery Source Type: research
Intraoperative mild hyperoxia may be associated with improved survival after off-pump coronary artery bypass grafting: a retrospective observational study
ConclusionsMaintaining intraoperative PaO2 at 150 –250 mmHg was associated with a lower risk of mortality after OPCAB than PaO2 at< 150 mmHg and at> 250 mmHg. Future randomised trials are required to confirm if mildly increasing arterial oxygen tension during OPCAB to 150 –250 mmHg improves postoperative outcomes. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 19, 2022 Category: Surgery Source Type: research
Proof-of-concept for intervention to prevent post-operative ileus in patients undergoing ileostomy formation
ConclusionsThis pilot intervention shows promise for reduction in POI in patients with newly created ileostomies. Additional assessment is needed to confirm these initial findings. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 12, 2022 Category: Surgery Source Type: research
Adherence to published guidelines for perioperative care of the elderly: a survey of Scottish anaesthetic departments
ConclusionsElderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 5, 2022 Category: Surgery Source Type: research
The application of full-size three-dimensional individual printed model combined with three-dimensional digital demonstration can facilitate patient ’s preoperative comprehension to robotic-assisted laparoscopic partial nephrectomy
ConclusionThe application of 3D-IPM presentation combined with 3D-IDM demonstration can improve the preoperative comprehension of patient and CAIFM to RALPN with more direct-viewing and verisimilar presentation, and can be used in RALPN patient education for increasing patients ’ and their families’ cognitive empowerment. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 28, 2022 Category: Surgery Source Type: research
Evaluating a pre-surgical health optimisation programme: a feasibility study
ConclusionsUse of routinely collected data to evaluate health optimisation programmes is feasible though demanding. Indications of the positive effects of health optimisation interventions from this study and existing literature suggest that the challenge of programme evaluation should be prioritised; longer-term evaluation of costs and outcomes is warranted to inform health optimisation policy development. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 23, 2022 Category: Surgery Source Type: research
A comparison of ClearSight noninvasive cardiac output and pulmonary artery bolus thermodilution cardiac output in cardiac surgery patients
ConclusionsCSCO and TDCO agreed with a low systematic bias. Besides, mean PE was well below the pre-defined 30%. Hemodynamic stability only had a small impact on the analysis. We conclude that CSCO is equivalent to TDCO in cardiac surgery patients.The trial was retrospectively registered in ClinicalTrials.gov, identifierNCT03807622; January 17, 2019 (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 9, 2022 Category: Surgery Source Type: research
Effect of age and gender on pre-operative cardiovascular risk assessment
ConclusionThis study extends the validation of the newly derived AUB-HAS2 Cardiovascular Risk Index to different age and gender subgroups with very good discriminative power. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 2, 2022 Category: Surgery Source Type: research
