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Anesthesiology Clinics

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https://www.readbyqxmd.com/read/28784227/organ-transplantation-a-systematic-review
#1
EDITORIAL
Aman Mahajan, Christopher Wray
No abstract text is available yet for this article.
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784226/transplantation-anesthesia-the-role-of-the-anesthesiologist
#2
EDITORIAL
Lee A Fleisher
No abstract text is available yet for this article.
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784225/anesthetic-considerations-in-transplant-recipients-for-nontransplant-surgery
#3
REVIEW
Joshua Herborn, Suraj Parulkar
As solid organ transplantation increases and patient survival improves, it will become more common for these patients to present for nontransplant surgery. Recipients may present with medical problems unique to the transplant, and important considerations are necessary to keep the transplanted organ functioning. A comprehensive preoperative examination with specific focus on graft functioning is required, and the anesthesiologist needs pay close attention to considerations of immunosuppressive regimens, blood product administration, and the risk benefits of invasive monitoring in these immunosuppressed patients...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784224/anesthesia-and-perioperative-care-in-reconstructive-transplantation
#4
REVIEW
Raymond M Planinsic, Jay S Raval, Vijay S Gorantla
Reconstructive transplantation of vascularized composite allografts (VCAs), such as upper extremity, craniofacial, abdominal, lower extremity, or genitourinary transplants, has emerged as a cutting-edge specialty, with more than 50 programs in the United States and 30 programs across the world performing these procedures. Most VCAs involve complicated technical planning and preparation, protracted surgery, and complex immunosuppressive or immunomodulatory protocols, each associated with unique anesthesiology challenges...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784223/anesthesia-for-intestinal-transplantation
#5
REVIEW
Christine Nguyen-Buckley, Melissa Wong
The diagnosis of irreversible intestinal failure confers significant morbidity, mortality, and decreased quality of life. Patients with irreversible intestinal failure may be treated with intestinal transplantation. Intestinal transplantation may include intestine only, liver-intestine, or other visceral elements. Intestinal transplantation candidates present with systemic manifestations of intestinal failure requiring multidisciplinary evaluation at an intestinal transplantation center. Central access may be difficult in intestinal transplantation candidates...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784222/anesthesia-for-liver-transplantation
#6
REVIEW
Dieter Adelmann, Kate Kronish, Michael A Ramsay
The provision of anesthesia for a liver transplant program requires a dedicated team of anesthesiologists. Liver transplant anesthesiologists must have an understanding of liver physiology and anatomy; the spectrum of clinical disease associated with liver dysfunction; the impact of warm and cold ischemia times, surgical techniques in liver transplantation, and the impact of ischemia-reperfusion syndrome; and optimal practices to protect the liver. The team must provide a 24-hour service, be actively involved in the selection committee process, and stay current with advances in the subspecialty...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784221/anesthesia-for-lung-transplantation
#7
REVIEW
Alina Nicoara, John Anderson-Dam
Perioperative management of patients undergoing lung transplantation is challenging and requires constant communication among the surgical, anesthesia, perfusion, and nursing teams. Although all aspects of anesthetic management are important, certain intraoperative strategies (mechanical ventilation, fluid management, extracorporeal mechanical support deployment) have tremendous impact on the subsequent evolution of the lung transplant recipient, especially with respect to allograft function, and should be carefully considered...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784220/anesthesia-for-heart-transplantation
#8
REVIEW
Davinder Ramsingh, Reed Harvey, Alec Runyon, Michael Benggon
This article seeks to evaluate current practices in heart transplantation. The goals of this article were to review current practices for heart transplantation and its anesthesia management. The article reviews current demographics and discusses the current criteria for candidacy for heart transplantation. The process for donor and receipt selection is reviewed. This is followed by a review of mechanical circulatory support devices as they pertain to heart transplantation. The preanesthesia and intraoperative considerations are also discussed...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784219/anesthesia-for-kidney-and-pancreas-transplantation
#9
REVIEW
Aaron M Mittel, Gebhard Wagener
Kidney transplants are the most common solid organ abdominal transplant and are occasionally performed simultaneously with pancreas transplants in diabetic patients. Preoperative evaluation of potential transplant recipients should focus on the potential for occult cardiovascular disease while also screening for other signs of end-organ dysfunction. Intraoperatively, it is of utmost importance to ensure adequate graft perfusion to limit the risk of postoperative graft dysfunction or rejection. Postoperative care of the kidney or pancreas transplant patient should focus on ensuring normalization of volume status, electrolyte concentrations, and glycemic control...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784218/anesthetic-management-of-pediatric-liver-and-kidney-transplantation
#10
REVIEW
Nicholas R Wasson, Jeremy D Deer, Santhanam Suresh
Pediatric patients with liver dysfunction and renal failure may exhibit many comorbidities. There are often associated congenital syndromes to be taken into account. Liver and renal transplantation offer a solution and substantial improvement in quality of life. Anesthetic management of pediatric liver and renal transplantation has not been well described. There are key differences between adults and children undergoing these procedures, and acknowledgment of some key principles provide a solid foundation to optimize perioperative outcomes...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784217/transfusion-medicine-and-coagulation-management-in-organ-transplantation
#11
REVIEW
Jaswanth Madisetty, Cynthia Wang
Organ transplantation recipients present unusual challenges with regard to blood transfusion. Although this patient population requires a larger proportion of blood product resources, liberal transfusion of allogeneic blood products can lead to a plethora of complications. Recent trends suggest that efforts to minimize bleeding, conserve products, and target transfusion to specific deficits and needs are increasingly becoming the standard practice; these must all occur with optimization of graft function and preservation in mind...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784216/anesthesia-management-of-organ-donors
#12
REVIEW
Victor W Xia, Michelle Braunfeld
The shortage of suitable organs is the biggest obstacle for transplants. At present, most organs for transplant in the United States are from donation after neurologic determination of death (brain death). Potential organs for transplant need to maintain their viability during a series of insults, including the original disease, physiologic derangements during the dying process, ischemia, and reperfusion. Proper donor management before, during, and after procurement has potential to increase the number and quality of organs from donors...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784215/infectious-complications-and-malignancies-arising-after-liver-transplantation
#13
REVIEW
Dame W Idossa, Douglas Alano Simonetto
Since the first liver transplant was performed in 1963, great advancements have been made in hepatic transplantation. Surgical techniques have been revised and improved, diagnostic methods for identifying and preventing infections have been developed, and a more conservative use of immunosuppressive agents has resulted in better long-term posttransplant outcomes. A total of 7841 liver transplantations were performed in the United States in 2016, resulting in greater than 85% survival at 1 year posttransplant...
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28784214/overview-of-immunosuppressive-therapy-in-solid-organ-transplantation
#14
REVIEW
Curtis D Holt
Mechanisms of rejection, new pharmacologic approaches, and genomic medicine are major foci for current research in transplantation. It is hoped that these new agents and personalized immunosuppression will provide for less toxic regimens that are effective in preventing both acute and chronic allograft rejection. Until new agents are available, practitioners must use various combinations of currently approved agents to find the best regimens for improved long-term outcomes.
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526165/pharmacology
#15
EDITORIAL
Lee A Fleisher
No abstract text is available yet for this article.
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526164/the-future-of-pharmacology-in-anesthesia-practice
#16
EDITORIAL
Alan D Kaye
No abstract text is available yet for this article.
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526163/new-hypnotic-drug-development-and-pharmacologic-considerations-for-clinical-anesthesia
#17
REVIEW
Mariah Kincaid Tanious, Sascha S Beutler, Alan D Kaye, Richard D Urman
Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic-rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526162/pharmacologic-considerations-of-anesthetic-agents-in-pediatric-patients-a-comprehensive-review
#18
REVIEW
Alan D Kaye, Charles J Fox, Ira W Padnos, Ken P Ehrhardt, James H Diaz, Elyse M Cornett, Debbie Chandler, Sudipta Sen, Shilpadevi Patil
Acute pain in the pediatric population has important differences in terms of biology, intrapopulation variation, and epidemiology. Discussion as to the pharmacologic considerations of anesthetic agents, such as induction agents, neuromuscular blockers, opioids, local anesthetics, and adjuvant agents, is presented in this article. Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. Anesthesiologists managing pediatric patients need to have a firm understanding of physiologic and pharmacologic differences compared with the adult population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526161/an-update-on-nonopioids-intravenous-or-oral-analgesics-for-perioperative-pain-management
#19
REVIEW
Alan D Kaye, Elyse M Cornett, Erik Helander, Bethany Menard, Eric Hsu, Brendon Hart, Andrew Brunk
Despite an appreciation for many unwanted physiologic effects from inadequate postoperative pain relief, moderate to severe postoperative pain remains commonplace. Although treatment options have evolved in recent years, the use of nonopioid analgesics agents can reduce acute pain-associated morbidity and mortality. This review focuses on the importance of effective postoperative nonopioid analgesic agents, such as acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoid agents, NMDA antagonists, alpha 2 agonists, and steroids, in opioid sparing and enhancing recovery...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526160/pharmacology-of-antiemetics-update-and-current-considerations-in-anesthesia-practice
#20
REVIEW
Alan D Kaye, Elyse M Cornett, John Chalabi, Natale Z Naim, Matthew B Novitch, Justin B Creel, Preya Jhita, Thomas N Trang, Jacquelyn R Paetzold, Nicholas Darensburg, Burton D Beakley, Richard D Urman
Postoperative nausea and vomiting (PONV) is associated with delayed recovery and dissatisfaction after surgical procedures. A key component to management is identifying risk factors and high-risk populations. Advances in pharmacologic therapeutics have resulted in agents targeting different pathways associated with the mediation of nausea and vomiting. This review focuses on these agents and the clinical aspects of their use in patients postoperatively. Combination therapies are reviewed, and studies demonstrate that when 2 or more antiemetic agents acting on different receptors are used, an overall improved efficacy is demonstrated when compared with a single agent alone in patients...
June 2017: Anesthesiology Clinics
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