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Current Opinion in Anaesthesiology

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https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#1
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323669/quality-maternal-care-a-call-for-anesthesia-leadership-and-collaboration
#2
Jeanette R Bauchat
No abstract text is available yet for this article.
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#3
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323672/safety-interventions-on-the-labor-and-delivery-unit
#4
Rachel M Kacmar
PURPOSE OF REVIEW: The present review highlights recent advances in efforts to improve patient safety on labor and delivery units and well tolerated care for pregnant patients in general. RECENT FINDINGS: Recent studies in obstetric patient safety have a broad focus but repetitive themes for interdisciplinary training include: simulating critical events, having open multidisciplinary communication, frequent reviews of cases of maternal morbidity, and implementing maternal early warning systems...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#5
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319476/anesthesia-in-patients-with-infectious-disease-caused-by-multi-drug-resistant-bacteria
#6
Sharon Einav, Yonit Wiener-Well
PURPOSE OF REVIEW: Up to 50% of specific bacterial strains in healthcare admission facilities are multidrug-resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). RECENT FINDINGS: Anesthesiologists, their work area and tools have all been implicated in MDRO outbreaks. Causes include contamination of external ventilation circuits and noncontribution of filters to prevention, inappropriate decontamination procedures for nondisposable equipment (e...
March 17, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306683/update-in-pediatric-anesthesiology
#7
Lynne R Ferrari
No abstract text is available yet for this article.
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#8
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#9
Torsten Baehner, Richard K Ellerkmann
PURPOSE OF REVIEW: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. RECENT FINDINGS: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306680/anaesthesia-in-patients-with-liver-disease
#10
Malgorzata H Starczewska, Wint Mon, Peter Shirley
PURPOSE OF REVIEW: The purpose of this review is to summarize the most recent up to date research data and recommendations regarding anaesthetic management of patients with liver disease undergoing surgery. The incidence of chronic liver disease (CLD) continues to rise and perioperative mortality and morbidity remains unacceptably high in this group. Meticulous preoperative assessment and carefully planned anaesthetic management are vital in improving outcomes in patients with liver disease undergoing surgery...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#11
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291130/making-the-pediatric-perioperative-surgical-home-come-to-life-by-leveraging-existing-health-information-technology
#12
Izabela C Leahy, Rachel Borczuk, Lynne R Ferrari
PURPOSE OF REVIEW: To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. RECENT FINDINGS: By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291129/frailty-and-anesthesia
#13
Lior Shem Tov, Idit Matot
PURPOSE OF REVIEW: This review will deliberate on contemporary concepts regarding the frailty syndrome and its association with the perioperative period. Frailty syndrome and its relevance to organ systems, scoring tools and intervention measures will be discussed in detail. RECENT FINDINGS: Frail patients have a reduced ability to respond to physical stress, similar to a decreased physiological reserve in the perioperative period. Frailty assessment is gaining popularity as a tool to guide medical interventions in the elderly population...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#14
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291127/an-update-on-the-perioperative-management-of-children-with-upper-respiratory-tract-infections
#15
Adrian Regli, Karin Becke, Britta S von Ungern-Sternberg
PURPOSE OF REVIEW: This review summarizes the current evidence for the management of children with recent upper respiratory tract infections (URTIs). Furthermore, the review includes management guidelines for children with URTIs. RECENT FINDINGS: Good history and clinical examination is sufficient in most children presenting with URTI. Testing for immune markers or preoperative nitric oxide measurement does not add any additional value. Preoperative bronchodilator administration, intravenous induction with propofol, and noninvasive airway management all reduce the occurrence of respiratory adverse events...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291126/strategies-to-reduce-blood-product-utilization-in-obstetric-practice
#16
Holger Neb, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. RECENT FINDINGS: PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#17
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277382/current-applications-of-big-data-in-obstetric-anesthesiology
#18
Thomas T Klumpner, Melissa E Bauer, Sachin Kheterpal
PURPOSE OF REVIEW: The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. RECENT FINDINGS: Big data has been used to study rare outcomes, to identify trends within the healthcare system, to identify variations in practice patterns, and to highlight potential inequalities in obstetric anesthesia care. Big data studies have helped define the risk of rare complications of obstetric anesthesia, such as the risk of neuraxial hematoma in thrombocytopenic parturients...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277381/working-toward-quality-in-obstetric-anesthesia-a-business-approach
#19
Grant C Lynde
PURPOSE OF REVIEW: Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. RECENT FINDINGS: The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277380/update-on-developmental-anesthesia-neurotoxicity
#20
Laszlo Vutskits, Andrew Davidson
PURPOSE OF REVIEW: Adverse long-term impact of general anesthesia on the developing brain is a widely discussed and controversial issue with potential public health relevance. The goal of this article is to give insights into the most recent experimental and clinical observations aimed to advance our understanding in this field. RECENT FINDINGS: Recent investigations demonstrate long-term behavioral consequences of early-life anesthesia exposure in nonhuman primates under experimental conditions that are translationally relevant to human clinical practice...
March 8, 2017: Current Opinion in Anaesthesiology
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