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REVIEW
David Santiago Giraldo Gutiérrez, Juan José Velásquez Gutiérrez, Joaquín Octavio Ruiz-Villa
Hemodynamic optimization is vital in high risk surgical patients or in high risk surgical procedures. The main objective of hemodynamic management is to maintain tissue perfusion and preserve aerobic metabolism through a cardiac output coupled with the metabolic demand. The technologies used for cardiac output monitoring use special techniques (e.g. lithium dilution or transpulmonary thermodilution) or implementation of dedicated devices with considerable rates of potential complications (pulmonary artery catheter)...
2021: Anaesthesiology Intensive Therapy
#2
REVIEW
Nathaniel R Smilowitz, Jeffrey S Berger
IMPORTANCE: Perioperative cardiovascular complications occur in 3% of hospitalizations for noncardiac surgery in the US. This review summarizes evidence regarding cardiovascular risk assessment prior to noncardiac surgery. OBSERVATIONS: Preoperative cardiovascular risk assessment requires a focused history and physical examination to identify signs and symptoms of ischemic heart disease, heart failure, and severe valvular disease. Risk calculators, such as the Revised Cardiac Risk Index, identify individuals with low risk (<1%) and higher risk (≥1%) for perioperative major adverse cardiovascular events during the surgical hospital admission or within 30 days of surgery...
July 21, 2020: JAMA
#3
REVIEW
Robert H Thiele, Marcel E Durieux
Qualitative arterial waveform analysis has been in existence for millennia; quantitative arterial waveform analysis techniques, which can be traced back to Euler's work in the 18th century, have not been widely used by anesthesiologists and other clinicians. This is likely attributable, in part, to the widespread use of the sphygmomanometer, which allows the practitioner to assess arterial blood pressure without having to develop a sense for the higher-order characteristics of the arterial waveform. The 20-year delay in the development of devices that measure these traits is a testament to the primitiveness of our appreciation for this information...
October 2011: Anesthesia and Analgesia
#4
REVIEW
Ruben Peralta, Hassan Al Thani, Sandro Rizoli
PURPOSE OF REVIEW: Coagulopathy is the derangement of hemostasis that in surgical patients may result in excessive bleeding, clotting or no measurable effect. The purpose of this review is to provide an overview of the most current evidence and practical approach to trauma- and drug-induced coagulopathy in surgical patients. RECENT FINDINGS: Early identification and timely correction of coagulopathy in surgical patients with significant bleeding is paramount to prevent death and other consequences of hemorrhage...
December 2019: Current Opinion in Critical Care
#5
REVIEW
Francis Veyckemans
Although poorly described in textbooks and rarely a topic of lecture, tracheal extubation is a critical phase of anesthetic care. It should therefore be carefully planned taking into account simple physiology-based principles to maintain the upper airway patent and avoid lung de-recruitment, but also the pharmacology of all anesthetic agents used. Although the management of most of its complications can be learned in a clinical simulation environment, the basic techniques can so far only be taught at the bedside, in the operating room...
March 2020: Paediatric Anaesthesia
#6
REVIEW
Matthew T V Chan, Traci L Hedrick, Talmage D Egan, Paul S García, Susanne Koch, Patrick L Purdon, Michael A Ramsay, Timothy E Miller, Matthew D McEvoy, Tong J Gan
Electroencephalographic (EEG) monitoring to indicate brain state during anesthesia has become widely available. It remains unclear whether EEG-guided anesthesia influences perioperative outcomes. The sixth Perioperative Quality Initiative (POQI-6) brought together an international team of multidisciplinary experts from anesthesiology, biomedical engineering, neurology, and surgery to review the current literature and to develop consensus recommendations on the utility of EEG monitoring during anesthesia. We retrieved a total of 1023 articles addressing the use of EEG monitoring during anesthesia and conducted meta-analyses from 15 trials to determine the effect of EEG-guided anesthesia on the rate of unintentional awareness, postoperative delirium, neurocognitive disorder, and long-term mortality after surgery...
May 2020: Anesthesia and Analgesia
#7
JOURNAL ARTICLE
Jasmeet Soar, Ian Maconochie, Myra H Wyckoff, Theresa M Olasveengen, Eunice M Singletary, Robert Greif, Richard Aickin, Farhan Bhanji, Michael W Donnino, Mary E Mancini, Jonathan P Wyllie, David Zideman, Lars W Andersen, Dianne L Atkins, Khalid Aziz, Jason Bendall, Katherine M Berg, David C Berry, Blair L Bigham, Robert Bingham, Thomaz Bittencourt Couto, Bernd W Böttiger, Vere Borra, Janet E Bray, Jan Breckwoldt, Steven C Brooks, Jason Buick, Clifton W Callaway, Jestin N Carlson, Pascal Cassan, Maaret Castrén, Wei-Tien Chang, Nathan P Charlton, Adam Cheng, Sung Phil Chung, Julie Considine, Keith Couper, Katie N Dainty, Jennifer Anne Dawson, Maria Fernanda de Almeida, Allan R de Caen, Charles D Deakin, Ian R Drennan, Jonathan P Duff, Jonathan L Epstein, Raffo Escalante, Raúl J Gazmuri, Elaine Gilfoyle, Asger Granfeldt, Anne-Marie Guerguerian, Ruth Guinsburg, Tetsuo Hatanaka, Mathias J Holmberg, Natalie Hood, Shigeharu Hosono, Ming-Ju Hsieh, Tetsuya Isayama, Taku Iwami, Jan L Jensen, Vishal Kapadia, Han-Suk Kim, Monica E Kleinman, Peter J Kudenchuk, Eddy Lang, Eric Lavonas, Helen Liley, Swee Han Lim, Andrew Lockey, Bo Lofgren, Matthew Huei-Ming Ma, David Markenson, Peter A Meaney, Daniel Meyran, Lindsay Mildenhall, Koenraad G Monsieurs, William Montgomery, Peter T Morley, Laurie J Morrison, Vinay M Nadkarni, Kevin Nation, Robert W Neumar, Kee-Chong Ng, Tonia Nicholson, Nikolaos Nikolaou, Chika Nishiyama, Gabrielle Nuthall, Shinichiro Ohshimo, Deems Okamoto, Brian O'Neil, Gene Yong-Kwang Ong, Edison F Paiva, Michael Parr, Jeffrey L Pellegrino, Gavin D Perkins, Jeffrey Perlman, Yacov Rabi, Amelia Reis, Joshua C Reynolds, Giuseppe Ristagno, Charles C Roehr, Tetsuya Sakamoto, Claudio Sandroni, Stephen M Schexnayder, Barnaby R Scholefield, Naoki Shimizu, Markus B Skrifvars, Michael A Smyth, David Stanton, Janel Swain, Edgardo Szyld, Janice Tijssen, Andrew Travers, Daniele Trevisanuto, Christian Vaillancourt, Patrick Van de Voorde, Sithembiso Velaphi, Tzong-Luen Wang, Gary Weiner, Michelle Welsford, Jeff A Woodin, Joyce Yeung, Jerry P Nolan, Mary Fran Hazinski
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts...
December 2019: Resuscitation
#8
JOURNAL ARTICLE
Michiko Sugita, Mai Matsumoto, Yuri Tsukano, Chikako Fukunaga, Tatsuo Yamamoto
There is little evidence of gastric excretion after ingestion of solids. We examined gastric emptying times after ingesting normal breakfast in healthy adult volunteer using ultrasonography. Eight adult volunteers fasted for 8 h, and we examined the gastric antral area in the right lateral decubitus position using ultrasonography. Sixteen adult volunteers ingested normal breakfast. We evaluated the gastric antral area in the same manner at two consecutive time points before lunch. Gastric volume was calculated by using an approximation formula based on the antral area...
December 2019: Journal of Anesthesia
#9
JOURNAL ARTICLE
I Ahmad, K El-Boghdadly, R Bhagrath, I Hodzovic, A F McNarry, F Mir, E P O'Sullivan, A Patel, M Stacey, D Vaughan
Awake tracheal intubation has a high success rate and a favourable safety profile but is underused in cases of anticipated difficult airway management. These guidelines are a comprehensive document to support decision making, preparation and practical performance of awake tracheal intubation. We performed a systematic review of the literature seeking all of the available evidence for each element of awake tracheal intubation in order to make recommendations. In the absence of high-quality evidence, expert consensus and a Delphi study were used to formulate recommendations...
April 2020: Anaesthesia
#10
REVIEW
Christopher C Young, Erica M Harris, Charles Vacchiano, Stephan Bodnar, Brooks Bukowy, R Ryland D Elliott, Jaclyn Migliarese, Chad Ragains, Brittany Trethewey, Amanda Woodward, Marcelo Gama de Abreu, Martin Girard, Emmanuel Futier, Jan P Mulier, Paolo Pelosi, Juraj Sprung
Postoperative pulmonary complications (PPCs) occur frequently and are associated with substantial morbidity and mortality. Evidence suggests that reduction of PPCs can be accomplished by using lung-protective ventilation strategies intraoperatively, but a consensus on perioperative management has not been established. We sought to determine recommendations for lung protection for the surgical patient at an international consensus development conference. Seven experts produced 24 questions concerning preoperative assessment and intraoperative mechanical ventilation for patients at risk of developing PPCs...
December 2019: British Journal of Anaesthesia
#11
JOURNAL ARTICLE
J Mark Riddell, John M Trummel, Igho J Onakpoya
BACKGROUND: Ketamine is a phencyclidine intravenous anaesthetic that blocks N-methyl-d-aspartate receptors and HCN channels in the CNS. Lately it has gained acceptance in a low-dose form, with studies showing an analgesic benefit in orthopaedic surgery. Our goal was to critically appraise and synthesise current evidence regarding use of low-dose ketamine in major, painful orthopaedic surgeries. METHODS: We conducted searches in Medline, Embase, Cochrane, and specialty journals for randomised controlled trials (RCTs) that compared low-dose ketamine to placebo...
September 2019: British Journal of Anaesthesia
#12
REVIEW
Abdulrahman Alboog, Sandy Bae, Jason Chui
PURPOSE OF REVIEW: The aim of this article is to review the evidence regarding the anesthetic management of blood loss, pain control, and position-related complications of adult patients undergoing complex spine procedures. RECENT FINDINGS: The most recent evidence of the anesthetic management of complex spine surgery was identified with a systematic search and graded. In our review, prophylactic tranexamic acid and optimal prone positioning were shown to be effective blood conservation strategies with minimal risks to the patients...
October 2019: Current Opinion in Anaesthesiology
#13
REVIEW
M J Scott, G Baldini, K C H Fearon, A Feldheiser, L S Feldman, T J Gan, O Ljungqvist, D N Lobo, T A Rockall, T Schricker, F Carli
BACKGROUND: The present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery. METHODS: The physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care...
November 2015: Acta Anaesthesiologica Scandinavica
#14
REVIEW
Anahi Perlas, Cristian Arzola, Peter Van de Putte
This narrative review summarizes the current knowledge on point-of-care ultrasound (POCUS) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic management at the bedside. An I-AIM framework (Indication, Acquisition, Interpretation, and Medical decision-making) is used to summarize and organize the content areas. This narrative review spans the breadth of the literature on pediatric and adult subjects as well as on special patient populations such as obstetric and severely obese individuals...
April 2018: Canadian Journal of Anaesthesia
#15
REVIEW
Bhushan H Katira
Ventilator-induced lung injury (VILI) is a central confounder to improving outcomes from use of positive-pressure ventilation in critical illness. Therefore, with increasing use of positive-pressure ventilation, awareness to prevent VILI has grown. Because VILI cannot be diagnosed at the bedside, its prevention can only be attained by identifying the clinical mechanisms of harm, such as high tidal volume, high plateau pressure, and so forth, which, in turn, are derived from decades of laboratory work. The practice of positive-pressure ventilation has undergone a significant change; most important in the past decade is the preference to use noninvasive ventilation...
June 2019: Respiratory Care
#16
REVIEW
Adrian Regli, Paolo Pelosi, Manu L N G Malbrain
The incidence of intra-abdominal hypertension (IAH) is high and still underappreciated by critical care physicians throughout the world. One in four to one in three patients will have IAH on admission, while one out of two will develop IAH within the first week of Intensive Care Unit stay. IAH is associated with high morbidity and mortality. Although considerable progress has been made over the past decades, some important questions remain regarding the optimal ventilation management in patients with IAH. An important first step is to measure intra-abdominal pressure (IAP)...
April 25, 2019: Annals of Intensive Care
#17
REVIEW
Philip van der Zee, Diederik Gommers
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2019. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2019 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://www.springer.com/series/8901 .
March 9, 2019: Critical Care: the Official Journal of the Critical Care Forum
#18
JOURNAL ARTICLE
Hiromasa Kawakami, Daisuke Nakajima, Takahiro Mihara, Hitoshi Sato, Takahisa Goto
BACKGROUND: Clinical trials regarding the antishivering effect of perioperative magnesium have produced inconsistent results. We conducted a systematic review and meta-analysis with Trial Sequential Analysis to evaluate the effect of perioperative magnesium on prevention of shivering. METHODS: We searched PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and 2 registry sites for randomized clinical trials that compared the administration of magnesium to a placebo or no treatment in patients undergoing surgeries...
February 5, 2019: Anesthesia and Analgesia
#19
EDITORIAL
Michael Joannidis, Sebastian J Klein, Marlies Ostermann
No abstract text is available yet for this article.
April 2019: Intensive Care Medicine
#20
JOURNAL ARTICLE
Elina Cv Brinck, Elina Tiippana, Michael Heesen, Rae Frances Bell, Sebastian Straube, R Andrew Moore, Vesa Kontinen
BACKGROUND: Inadequate pain management after surgery increases the risk of postoperative complications and may predispose for chronic postsurgical pain. Perioperative ketamine may enhance conventional analgesics in the acute postoperative setting. OBJECTIVES: To evaluate the efficacy and safety of perioperative intravenous ketamine in adult patients when used for the treatment or prevention of acute pain following general anaesthesia. SEARCH METHODS: We searched CENTRAL, MEDLINE and Embase to July 2018 and three trials registers (metaRegister of controlled trials, ClinicalTrials...
December 20, 2018: Cochrane Database of Systematic Reviews
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