journal
https://read.qxmd.com/read/38278598/the-evolving-landscape-of-perioperative-medicine
#1
EDITORIAL
Zdravka Zafirova, Richard D Urman
No abstract text is available yet for this article.
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278597/preoperative-patient-evaluation-obtaining-the-information-we-need-to-inform-the-care-we-provide
#2
EDITORIAL
Lee A Fleisher
No abstract text is available yet for this article.
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278596/what-s-new-in-preoperative-cardiac-testing
#3
REVIEW
Murad Elias, Vahé S Tateosian, Deborah C Richman
More than 300 million surgeries are performed annually worldwide. Patients are progressively aging and often have multiple comorbidities that put them at increased cardiovascular risk in the perioperative period. The United States published latest guidelines regarding preoperative cardiac evaluation and risk stratification for patients undergoing non-cardiac surgery in 2014. There are multiple risk stratification tools available that can help guide management. Furthermore, newer laboratory tests, such as preoperative NT-proBNP and high-sensitivity troponin assays, may aid in preventing and diagnosing perioperative myocardial injury...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278595/social-determinants-of-health-and-preoperative-care
#4
REVIEW
Mofya S Diallo, Romana Hasnain-Wynia, Thomas R Vetter
Preoperative care exists as part of perioperative continuum during which anesthesiologists and surgeons optimize patients for surgery. These multispecialty efforts are important, particularly for patients with complex medical histories and those requiring major surgery. Preoperative care improves planning and determines the clinical pathway and discharge disposition. The role of nonmedical social factors in the preoperative planning is not well described in anesthesiology. Research to improve outcomes based on social factors is not well described for anesthesiologists but could be instrumental in decreasing disparities and advancing health equity in surgical patients...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278594/value-based-health-care-in-perioperative-medicine-process-maps-and-costing-to-determine-best-practices
#5
REVIEW
David Newton, Angela M Bader
Perioperative care in the United States is largely based on current fee-for-service models. Fee-for-service models are not based on the true cost of services provided, charges do not equal costs, and reimbursement varies based on insurer. Value-based health care is defined as patient-centered outcomes over cost of providing these services. Process mapping and time-driven activity-based costing can be used to define actual cost of services provided. Outcomes after discharge can be measured, so that the overall value of care provided can be assessed and improved based on the outcomes and costs identified...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278593/management-of-preoperative-anemia
#6
REVIEW
Laura Mendez-Pino, Andrés Zorrilla-Vaca, David L Hepner
Anemia is the most common modifiable risk factor for postoperative morbidity and mortality. Early identification and optimal management are key to restore iron stores and ensure its resolution before surgery. Several therapies have been proposed to treat anemia in the perioperative period, such as iron supplementation and erythropoiesis-stimulating agents, though it remains unclear which is the most optimal to improve clinical outcomes. This article summarizes the most updated evidence on perioperative management of anemia and denotes differences among the international guidelines to reflect the conflicting evidence in this field and the need for further research in specific areas...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278592/marijuana-use-vaping-and-preoperative-anesthetic-and-surgical-considerations-in-clinical-practice
#7
REVIEW
Anusha Kallurkar, Alan D Kaye, Sahar Shekoohi
In recent years, marijuana and vaping have acquired widespread popularity, with millions of people using them for a variety of reasons, including recreational purposes. However, these practices have often overlooked the implications on surgery and the preoperative anesthesia considerations. Marijuana can influence a patient's response to anesthesia, alter postoperative pain management, and increase the risk of complications, whereas vaping can have negative effects on the respiratory system and hinder the body's ability to recover after surgery...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278591/preoperative-patient-evaluation-newer-hypoglycemic-agents
#8
REVIEW
Mario Villasenor, Angela Roberts Selzer
New medications in the treatment of diabetes are an active area of research and drug development. Although many hypoglycemic therapies have been in use for decades, new evidence continues to emerge highlighting benefits of these medications for other indications. In this article, the authors review the classes of newer hypoglycemic agents and summarize medications currently in phase 2 and 3 clinical trials. The literature to support specific recommendations for perioperative management is scant, however, where it exists, we have included it...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278590/anesthesia-liability-related-to-pre-existing-conditions
#9
REVIEW
Alan D Kaye, Sonnah Barrie, Rucha A Kelkar, Sahar Shekoohi
In 1985, the American Society of Anesthesiologists initiated a quality improvement closed claims analysis project for anesthetic injury to elevate patient safety. To date, there have been a total of 8954 documented claims, describing injuries contracted under sedation, regional anesthesia, or failure to attend to a patient's post-operative needs. The Closed Claims database reveals that the most highly documented health care complications were a loss of life at 2%, nerve injuries at 2%, and damage to the brain at 9%...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278589/beyond-the-consulting-room-and-telemedicine-unveiling-the-future-of-anesthesiology-with-virtual-preoperative-assessment
#10
REVIEW
Carolina S Romero, Mark G Filipovic, Markus M Luedi
Telemedicine has rapidly evolved, offering expanded applications including virtual consultations, remote patient education, and therapeutic options. It provides advantages such as increased accessibility, reduced travel time, and convenience. Challenges include privacy concerns, the digital divide, and the need for regulatory frameworks. Virtual preoperative assessment shows promise in safely identifying patients who do not require in-person consultations. Legal considerations and liability issues need to be addressed...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278588/preoperative-assessment-of-a-patient-undergoing-bariatric-surgery
#11
REVIEW
Jennifer J Yuan, Raksha Bangalore, Dana Darwish, Tiffany S Moon, Anupama Wadhwa
Over the past few decades, obesity rates in the United States have risen drastically, and with this, there has been a rising demand for bariatric surgery. As such, anesthesiologists need to be familiar with the challenges presented by patients seeking bariatric surgery. Obesity causes pathophysiologic changes which may affect decision-making during the management of these patients. Patients seeking bariatric surgery also have a long, prescribed preoperative course that offers anesthesiologists the opportunity to be involved earlier during the pre-surgical evaluation and optimization process...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278587/preoperative-evaluation-of-patients-undergoing-eye-surgery
#12
REVIEW
Alvaro Andres Macias, Jeremy Goldfarb
Ophthalmic surgery encompasses a wide range of procedures addressing various ocular conditions. Although generally considered low risk, a thorough preoperative evaluation is still crucial in optimizing patient outcomes and ensuring safe surgical interventions. This review provides a comprehensive overview of the preoperative assessment and management of patients presenting for ophthalmic surgery, specifically focusing on cataract surgery. We discuss the role of routine preoperative testing, the assessment of intraocular factors, and the evaluation of systemic comorbidities and medications...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278586/preoperative-management-of-the-adult-oncology-patient
#13
REVIEW
Shannon M Popovich, Thomas R Vetter
Anesthesiologists are experiencing first-hand the aging population, given older patients more frequently presenting for surgery, often with geriatric syndromes influencing their anesthetic management. The overall incidence and health burden of cancer morbidity and mortality are also rapidly increasing worldwide. This growth in the cancer population, along with the associated risk factors and comorbidities often accompanying a cancer diagnosis, underscores the need for anesthesiologists to become well versed in the preoperative evaluation and management of the adult patient with cancer...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278585/newer-immunosuppressants-for-rheumatologic-disease-preoperative-considerations
#14
REVIEW
Ye Rin Koh, Kenneth C Cummings
With the advent of small-molecule immune modulators, recombinant fusion proteins, and monoclonal antibodies, treatment options for patients with rheumatic diseases are now broad. These agents carry significant risks and an individualized approach to each patient, balancing known risks and benefits, remains the most prudent course. This review summarizes the available immunosuppressant treatments, discusses their perioperative implications, and provides recommendations for their perioperative management.
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278584/perioperative-management-of-novel-pharmacotherapies-for-heart-failure-and-pulmonary-hypertension
#15
REVIEW
Caroline R Gross, Robin Varghese, Zdravka Zafirova
Heart failure (HF) and pulmonary hypertension (PH) are increasingly prevalent comorbidities in patients presenting for noncardiac surgery. The unique pathophysiology and pharmacotherapies associated with these syndromes have important perioperative implications. As new medications for HF and PH emerge, it is imperative that anesthesiologists and other perioperative providers understand their mechanisms of action, pharmacokinetics, and potential adverse effects. We present an overview of the novel HF and PH pharmacotherapies and strategies for their perioperative management...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278583/stimulant-drugs-and-stimulant-use-disorder
#16
REVIEW
Wenyu Song, Aurélien Simona, Ping Zhang, David W Bates, Richard D Urman
The authors aim to summarize several key points of stimulant drugs and stimulant use disorder, including their indications, short-term and long-term adverse effects, current treatment strategies, and association with opioid medications. The global prevalence of stimulant use has seen annual increase in the last decade. Multiple studies have shown that stimulant use and stimulant use disorder are associated with a range of individual and public health issues. Stimulant misuse has led to a significant increase of overdose deaths in the United States...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/38278582/perioperative-evaluation-of-brain-health
#17
REVIEW
Carolina S Romero, Richard D Urman, Markus M Luedi
As the global population is aging and surgical needs rise, the occurrence of perioperative neurocognitive disorders (PND) is becoming a significant concern. PND refers to cognitive changes that occur before or after surgery, including neurocognitive disorders, postoperative delirium, and delayed neurocognitive recovery. To address this issue, a brain health assessment initiative within a multidisciplinary team is an emerging concept. Assessing cognitive function, comorbidities, severity of neurocognitive disorders, medications, nutritional status, sleep quality, and other factors can help mitigate the risk of PND and improve patient outcomes...
March 2024: Anesthesiology Clinics
https://read.qxmd.com/read/37838392/perioperative-safety-culture-principles-practices-and-pragmatic-approaches
#18
EDITORIAL
Matthew D McEvoy, James H Abernathy
No abstract text is available yet for this article.
December 2023: Anesthesiology Clinics
https://read.qxmd.com/read/37838391/patient-safety-in-2023-developing-a-new-science-in-a-postpandemic-world
#19
EDITORIAL
Lee A Fleisher
No abstract text is available yet for this article.
December 2023: Anesthesiology Clinics
https://read.qxmd.com/read/37838390/systems-of-care-delivery-and-optimization-in-the-postoperative-care-wards
#20
REVIEW
Connor Snarskis, Arna Banerjee, Andrew Franklin, Liza Weavind
A third of all patients are at risk for a serious adverse event, including death, in the first month after undergoing a major surgery. Most of these events will occur within 24 hours of the operation but are unlikely to occur in the operating room or postanesthesia care unit. Most opioid-induced respiratory depression events in the postoperative period resulted in death (55%) or anoxic brain injury (22%). A future state of mature artificial intelligence and machine learning will improve situational awareness of acute clinical deterioration, minimize alert fatigue, and facilitate early intervention to minimize poor outcomes...
December 2023: Anesthesiology Clinics
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