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Current Opinion in Anaesthesiology

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https://www.readbyqxmd.com/read/28207566/the-new-sepsis-definition-limitations-and-contribution-to-research-and-diagnosis-of-sepsis
#1
Franck Verdonk, Alice Blet, Alexandre Mebazaa
PURPOSE OF REVIEW: Based on recent clinical, epidemiological, and pathophysiological data, a third international consensus conference was carried out to define new criteria of sepsis in February 2016. This review presents the different items of this new definition, their limitations and their contribution to research and diagnosis of sepsis, in comparison with the previous definitions. RECENT FINDINGS: Incidence, management, and pathophysiological knowledge of sepsis have improved over the past 20 years...
February 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28207565/intensive-care-medicine-in-2017-urgent-need-and-existing-chances-to-improve-outcome
#2
Gernot Marx
No abstract text is available yet for this article.
February 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28151829/haemotherapy-algorithm-for-the-management-of-trauma-induced-coagulopathy-an-australian-perspective
#3
James Winearls, Biswadev Mitra, Michael C Reade
PURPOSE OF REVIEW: Recent advances in the understanding of the pathophysiological processes associated with traumatic haemorrhage and trauma-induced coagulopathy have resulted in improved outcomes for seriously injured trauma patients. However, a significant number of trauma patients still die from haemorrhage. This article reviews the various transfusion strategies utilized in the management of traumatic haemorrhage and describes the major haemorrhage protocol (MHP) strategy employed by an Australian trauma centre...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28151828/nutrition-in-the-critically-ill-patient
#4
Kristine W A C Koekkoek, Arthur R H van Zanten
PURPOSE OF REVIEW: To summarize recent relevant studies regarding nutrition during critical illness and provide recommendations for clinical practice. RECENT FINDINGS: Recently acquired knowledge regarding nutritional status and risk assessment, body composition, gastric residual volume, prokinetics, tube positioning, enteral vs parenteral nutrition, nutritional dose and timing of initiation, pharmaconutrition, dysbiosis and probiotics are discussed. SUMMARY: Body composition especially lean body mass is associated with clinical outcomes...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28151827/ethics-of-research-for-patients-in-pain
#5
David B Waisel
PURPOSE OF REVIEW: This review describes advances in rising and continuing ethical issues in research in patients in pain. Although some of the issues focus directly on pain research, such as research in neonatal pain management, others focus on widespread ethical issues that are relevant to pain research, such as scientific misconduct, deception, placebo use and genomics. RECENT FINDINGS: Scientific misconduct is more widespread than realized and requires greater awareness of the markers of misconduct like irreproducibility...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28151826/continuous-electroencephalographic-monitoring-in-the-icu-an-overview-of-current-strengths-and-future-challenges
#6
Danny M W Hilkman, Walther N K A van Mook, Vivianne H J M van Kranen-Mastenbroek
PURPOSE OF REVIEW: In ICUs, numerous physiological parameters are continuously monitored and displayed. Yet, functional monitoring of the organ of primary concern, the brain, is not routinely performed. Despite the benefits of ICU use of continuous electroencephalographic (EEG)-monitoring (cEEG) is increasingly recognized, several issues nevertheless seem to hamper its widespread clinical implementation. RECENT FINDINGS: Utilization of ICU cEEG has significantly improved detection and characterization of cerebral pathology, prognostication and clinical management in specific patient groups...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28118166/update-on-low-dose-corticosteroids
#7
Josef Briegel, Thomas Bein, Patrick Möhnle
PURPOSE OF REVIEW: Low-dose hydrocortisone is recommended in patients with septic shock unresponsive to fluid and vasopressor therapy. Recent research added new data for patients with septic shock and other target groups such as patients with severe sepsis, acute respiratory distress syndrome (ARDS), community-acquired pneumonia, and burns. The objective of this review is to summarize and comment recent findings on low-dose corticosteroids (LDC) in critically ill patients. RECENT FINDINGS: In the last 2 years, a series of clinical trials and retrospective analyses investigated LDC therapy in critically ill patients with severe systemic inflammation of various origins...
January 23, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28118165/assessment-of-competence-developing-trends-and-ethical-considerations
#8
Melissa Chin, Robert S Lagasse
PURPOSE OF REVIEW: This review explores new concepts in competency assessment in anesthesiology, the associated ethical challenges, and directions for new research. RECENT FINDINGS: Many new tools for the assessment of competence are currently in development to address changes in medical education curricula. The assessment of competence currently focuses on technical skills, nontechnical skills, and the interaction of both through the use of simulation, with increasing emphasis on validity and reliability testing...
January 23, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28118164/quality-organization-and-risk-in-anaesthesia-the-french-perspective
#9
Jean Marty, Emmanuel Samain
PURPOSE OF REVIEW: Ensuring the quality and safety of anaesthesia in the face of budgetary restrictions and changing demographics is challenging. In France, the environment is regulated by the legislation, and it is often necessary to find solutions that seize opportunities to break with the traditional organization. RECENT FINDINGS: Postoperative mortality remains excessively high. The move towards ambulatory care is being adequately integrated into all the stages of patient management in the context of a single therapeutic plan that is mutually agreed upon by all caregivers...
January 23, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28118163/evolving-healthcare-delivery-paradigms-and-the-optimization-of-value-in-anesthesiology
#10
Navid Alem, Zeev Kain
PURPOSE OF REVIEW: Healthcare worldwide is evolving to yield enhanced care provided at a lowered cost. Patient-centric paradigms that hasten surgical recovery and strengthen collaboration amongst medical professionals are gaining impetus. This review will discuss the changing healthcare landscape and outline its implications on anesthesiology practice. RECENT FINDINGS: Anesthesiologists must be nimble and versatile as they adapt to healthcare redesign. An increased responsibility for patient outcomes should be embraced by extending the breadth and depth of clinical practice throughout the surgical care continuum...
January 23, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28092271/trauma-and-transfusion
#11
Kai Zacharowski
No abstract text is available yet for this article.
January 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28092270/multimodal-individualized-concept-of-hemodynamic-monitoring
#12
Zsolt Molnar, Zsolt Szabo, Marton Nemeth
PURPOSE OF REVIEW: To discuss the pathophysiological rationale of advanced hemodynamic monitoring in the critically ill and also to highlight the importance of a multimodal, individualized approach. RECENT FINDINGS: There are several clinical studies and animal experiments evaluating, which hemodynamic endpoint should be the best target during fluid management. Recent systematic reviews and meta-analyses also investigated the effects of advanced hemodynamic endpoints targeted hemodynamic management on outcome mainly in high-risk surgical patients...
January 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28085709/hemotherapy-algorithm-for-the-management-of-trauma-induced-coagulopathy-the-german-and-european-perspective
#13
Marc Maegele, Giuseppe Nardi, Herbert Schöchl
PURPOSE OF REVIEW: This review presents a synopsis of best current knowledge with reference to the updated German and European guidelines and recommendations on the management of severe trauma hemorrhage and trauma-induced coagulopathy as well as a viscoelastic-based treatment algorithm based upon international expert consensus to trigger the administration of hemostatic agents and blood products. RECENT FINDINGS: Uncontrolled hemorrhage and trauma-induced coagulopathy are the major causes for preventable death after trauma and early detection and aggressive management have been associated with improved outcomes...
January 12, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28059848/hemodynamic-monitoring-in-thoracic-surgical-patients
#14
Jacob Raphael, Lindsay A Regali, Robert H Thiele
PURPOSE OF REVIEW: This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population. RECENT FINDINGS: Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics...
January 3, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28005618/the-impaired-and-or-disabled-anesthesiologist
#15
Jonathan D Katz
PURPOSE OF REVIEW: Impairment and/or disability resulting from any of a number of etiologies will afflict a significant number of anesthesiologists at some point during their career. The impaired anesthesiologist can be difficult to identify and challenging to manage. Questions will arise as to if, how, and when colleagues, family members, or friends should intercede if significant impairment is suspected.This review will examine the common sources of impairment among anesthesiologists and the professional implications of these conditions...
December 21, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906720/decisions-regarding-forgoing-life-sustaining-treatments
#16
Gail A Van Norman
PURPOSE OF REVIEW: Decisions to forego life-sustaining treatments are complex, and disagreements between physicians and patients occur. This review discusses recent findings regarding what factors influence physicians and patients or their surrogates in these decisions and considers whether futility arguments regarding life-sustaining treatments should be abandoned. RECENT FINDINGS: Cardiopulmonary resuscitation is one paradigm in the literature for studying end-of-life decision-making...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28030449/hemodynamic-monitoring-in-thoracic-surgical-patients
#17
Jacob Raphael, Lindsay A Regali, Robert H Thiele
PURPOSE OF REVIEW: This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population. RECENT FINDINGS: Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28030448/editorial-introductions
#18
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27977430/long-term-consequences-of-acute-kidney-injury-in-the-perioperative-setting
#19
Carlos E Palant, Richard L Amdur, Lakhmir S Chawla
PURPOSE OF REVIEW: Recent studies indicate that acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected syndromes. Although the majority of patients who suffer an episode of AKI will recover laboratory indices suggesting complete or near complete recovery of renal function, a significant portion of post-AKI survivors will develop major kidney events, including development of late-stage CKD, need for renal replacement therapies, and death. RECENT FINDINGS: Our review highlights epidemiology of adverse post-AKI events, association of AKI with late development of nonrenal adverse outcomes, use of bedside equations that facilitate prognostication of adverse renal outcomes of AKI, and how variability in serum creatinine values in individual patients, even among those with normal baseline renal function may indicate risk for the development of CKD...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27941354/the-endothelial-glycocalyx-and-perioperative-lung-injury
#20
Florian Brettner, Vera von Dossow, Daniel Chappell
PURPOSE OF REVIEW: Ventilator-induced lung injury is a major contributor to perioperative lung injury. The end-expiratory lung volume, regional lung overdistension, and tidal recruitment are known to be the main factors causing subsequent alveolar damage and inflammation. The alveolar-capillary membrane including the endothelial glycocalyx as an integral part of the vascular endothelium seems to play a major role in different kinds of lung injury. RECENT FINDINGS: Recent studies underline the pivotal importance of the endothelial glycocalyx in lung injury...
February 2017: Current Opinion in Anaesthesiology
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