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Current Opinion in Anaesthesiology

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https://www.readbyqxmd.com/read/28092271/trauma-and-transfusion
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#7
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28030449/hemodynamic-monitoring-in-thoracic-surgical-patients
#8
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
#9
(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
#10
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
#11
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
https://www.readbyqxmd.com/read/27922848/lung-regeneration-steps-toward-clinical-implementation-and-use
#12
Elizabeth A Calle, Katherine L Leiby, MichaSam B Raredon, Laura E Niklason
PURPOSE OF REVIEW: Whole lung tissue engineering is a relatively new area of investigation. In a short time, however, the field has advanced quickly beyond proof of concept studies in rodents and now stands on the cusp of wide-spread scale up to large animal studies. Therefore, this technology is ever closer to being directly clinically relevant. RECENT FINDINGS: The main themes in the literature include refinement of the fundamental components of whole lung engineering and increasing effort to direct induced pluripotent stem cells and lung progenitor cells toward use in lung regeneration...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#13
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906719/diagnosis-of-cardiac-surgery-associated-acute-kidney-injury-from-functional-to-damage-biomarkers
#14
Wim Vandenberghe, Jorien De Loor, Eric A J Hoste
PURPOSE OF REVIEW: Acute kidney injury (AKI) occurs in up to 30% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906718/anesthesia-for-nonintubated-video-assisted-thoracic-surgery
#15
Hiroshi Sunaga, Justin D Blasberg, Paul M Heerdt
PURPOSE OF REVIEW: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. RECENT FINDINGS: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#16
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27898430/an-update-on-the-various-practical-applications-of-the-stop-bang-questionnaire-in-anesthesia-surgery-and-perioperative-medicine
#17
Mahesh Nagappa, Jean Wong, Mandeep Singh, David T Wong, Frances Chung
PURPOSE OF REVIEW: The present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. RECENT FINDINGS: The STOP-Bang questionnaire was originally validated as a screening tool to identify surgical patients who are at high-risk of obstructive sleep apnea (OSA). A recent meta-analysis confirmed that STOP-Bang is validated for use in the sleep clinic, surgical, and general population...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27875367/cardiac-surgery-associated-acute-kidney-injury-much-improved-but-still-long-ways-to-go
#18
Alexander Zarbock
No abstract text is available yet for this article.
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27841788/mortality-and-cost-of-acute-and-chronic-kidney-disease-after-cardiac-surgery
#19
Nicholas Lysak, Azra Bihorac, Charles Hobson
PURPOSE OF REVIEW: Acute and chronic kidney diseases (AKI and CKD) have far-reaching implications for surgical patients in regards to postoperative outcomes and hospital cost. We review the recent literature on the effects of AKI and CKD on morbidity, mortality, and resource utilization among cardiac surgery patients. RECENT FINDINGS: Both AKI and CKD increase the risk for short-term and long-term mortalities, morbidity, length of stay, and hospital cost among postoperative patients, with increasing disease stage correlating with worse outcomes...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27841787/therapy-of-acute-kidney-injury-in-the-perioperative-setting
#20
Stefano Romagnoli, Zaccaria Ricci, Claudio Ronco
PURPOSE OF REVIEW: The current review analyzes the current pharmacologic approaches in cardiac surgery-associated acute kidney injury and renal replacement/support therapies. RECENT FINDINGS: Hemodynamic management and promising therapies, including atrial natriuretic peptide, calcium sensitizer inodilators, and mesenchymal stem cells have been discussed. Encouraging results from pre-emptive renal replacement therapies have been also addressed. SUMMARY: Cardiac surgery is responsible for the highest risk of renal dysfunction with respect to other surgical settings...
February 2017: Current Opinion in Anaesthesiology
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