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Perioperative Medicine

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https://www.readbyqxmd.com/read/29757298/correction-to-cardiopulmonary-exercise-testing-cpet-in-the-united-kingdom-a-national-survey-of-the-structure-conduct-interpretation-and-funding
#1
T Reeves, S Bates, T Sharp, K Richardson, S Bali, J Plumb, H Anderson, J Prentis, M Swart, D Z H Levett
[This corrects the article DOI: 10.1186/s13741-017-0082-3.].
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29755736/surgical-specialty-and-preoperative-medical-consultation-based-on-commercial-health-insurance-claims
#2
Stephan R Thilen, Alex L Woersching, Anda M Cornea, Elliott Lowy, Edward M Weaver, Miriam M Treggiari
Background: Surgical patients are sometimes referred for preoperative evaluations by consultants in other medical specialties, although consultations are unnecessary for many patients, particularly for healthy patients undergoing low-risk surgeries. Surgical specialty has been shown to predict usage of preoperative consultations. However, evidence is generally limited regarding factors associated with preoperative consultations. This study evaluates surgical specialty and other predictors of preoperative consultations...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29692886/what-are-the-optimum-components-in-a-care-bundle-aimed-at-reducing-post-operative-pulmonary-complications-in-high-risk-patients
#3
Sophie V Griffiths, Daniel H Conway, Michael Sander, Ib Jammer, Michael P W Grocott, Ben C Creagh-Brown
Background: Post-operative pulmonary complications (POPC) are common, predictable and associated with increased morbidity and mortality, independent of pre-operative risk. Interventions to reduce the incidence of POPC have been studied individually, but the use of a care bundle has not been widely investigated. The purpose of our work was to use Delphi consensus methodology and an independently chosen expert panel to formulate a care bundle for patients identified as being at high of POPC, as preparation towards an evaluation of its effectiveness at reducing POPC...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29651334/the-evaluation-of-risk-prediction-models-in-predicting-outcomes-after-bariatric-surgery-a-prospective-observational-cohort-pilot-study
#4
David Andrew Gilhooly, Michelle Cole, Suneetha Ramani Moonesinghe
Background: As the prevalence of obesity is increasing, the number of patients requiring surgical intervention for obesity-related illness is also rising. The aim of this pilot study was to explore predictors of short-term morbidity and longer-term poor weight loss after bariatric surgery. Methods: This was a single-centre prospective observational cohort pilot study in patients undergoing bariatric surgery. We assessed the accuracy (discrimination and calibration) of two previously validated risk prediction models (the Physiological and Operative Severity Score for the enumeration of Morbidity and Mortality, POSSUM score, and the Obesity Surgical Mortality Risk Score, OS-MS) for postoperative outcome (postoperative morbidity defined using the Post Operative Morbidity Survey)...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29644051/correction-to-american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-perioperative-fluid-management-within-an-enhanced-recovery-pathway-for-colorectal-surgery
#5
Robert H Thiele, Karthik Raghunathan, C S Brudney, Dileep N Lobo, Daniel Martin, Anthony Senagore, Maxime Cannesson, Tong Joo Gan, Michael Monty G Mythen, Andrew D Shaw, Timothy E Miller
[This corrects the article DOI: 10.1186/s13741-016-0049-9.].
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29644050/correction-to-american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#6
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
[This corrects the article DOI: 10.1186/s13741-017-0063-6.].
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29484172/apnoeic-oxygenation-by-nasal-cannula-during-airway-management-in-children-undergoing-general-anaesthesia-a-pilot-randomised-controlled-trial
#7
Lafi Olayan, Abdulaleem Alatassi, Jaimin Patel, Sherran Milton
Background: Airway management is a core clinical skill in anaesthesia. Pre-oxygenation prior to induction of anaesthesia is a standard practice to prevent desaturation. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. The effectiveness of apnoeic oxygenation in the adult is well documented; however, evidence in the paediatric is lacking. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in children...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29423173/cardiopulmonary-exercise-testing-cpet-in-the-united-kingdom-a-national-survey-of-the-structure-conduct-interpretation-and-funding
#8
T Reeves, S Bates, T Sharp, K Richardson, S Bali, J Plumb, H Anderson, J Prentis, M Swart, D Z H Levett
Background: Cardiopulmonary exercise testing (CPET) is an exercise stress test with concomitant expired gas analysis that provides an objective, non-invasive measure of functional capacity under stress. CPET-derived variables predict postoperative morbidity and mortality after major abdominal and thoracic surgery. Two previous surveys have reported increasing utilisation of CPET preoperatively in England. We aimed to evaluate current CPET practice in the UK, to identify who performs CPET, how it is performed, how the data generated are used and the funding models...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29344350/the-sensitivity-of-the-human-thirst-response-to-changes-in-plasma-osmolality-a-systematic-review
#9
REVIEW
Fintan Hughes, Monty Mythen, Hugh Montgomery
Background: Dehydration is highly prevalent and is associated with adverse cardiovascular and renal events. Clinical assessment of dehydration lacks sensitivity. Perhaps a patient's thirst can provide an accurate guide to fluid therapy. This systematic review examines the sensitivity of thirst in responding to changes in plasma osmolality in participants of any age with no condition directly effecting their sense of thirst. Methods: Medline and EMBASE were searched up to June 2017...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29238571/immunonutrition-within-enhanced-recovery-after-surgery-eras-an-unresolved-matter
#10
EDITORIAL
Ruchir Gupta, Anthony Senagore
Preoperative malnutrition because of poor oral intake significantly increases the risk of adverse events after surgery and leads to increased length of stay. While immunonutrition has been utilized in the non-ERAS setting, its utility in both minimally invasive surgery and ERAS pathway procedures remain poorly defined. There are at least ten meta-analyses regarding the assessment of immunonutrition, but virtually, all of these were performed in an era prior to minimally invasive surgery, adoption of enhanced recovery protocols, and an understanding of the assessment and physiology of sarcopenia...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29238570/impact-of-asa-score-misclassification-on-nsqip-predicted-mortality-a-retrospective-analysis
#11
Alex Helkin, Sumeet V Jain, Angelika Gruessner, Maureen Fleming, Leslie Kohman, Michael Costanza, Robert N Cooney
Background: The ASA physical classification score has a major impact on the observed/expected (O/E) mortality ratio in the NSQIP General Vascular Mortality Model. The difference in predicted mortality is greatest between ASAs 3 and 4. We hypothesized under-classified ASA scores significantly affect the O/E mortality. Methods: We conducted a retrospective review of NSQIP essential surgery cases from January 2014 to December 2014 ( n  = 1264) with mortality sub-analysis ( n  = 33) at our institution...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29204270/comparison-of-risk-scoring-systems-in-the-prediction-of-outcome-after-liver-resection
#12
S Ulyett, G Shahtahmassebi, S Aroori, M J Bowles, C D Briggs, M G Wiggans, G Minto, D A Stell
Background: Risk prediction techniques commonly used in liver surgery include the American Society of Anesthesiologists (ASA) grading, Charlson Comorbidity Index (CCI) and cardiopulmonary exercise tests (CPET). This study compares the utility of these techniques along with the number of segments resected as predictive tools in liver surgery. Methods: A review of a unit database of patients undergoing liver resection between February 2008 and January 2015 was undertaken...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29204269/a-systematic-review-and-overview-of-health-economic-evaluations-of-emergency-laparotomy
#13
Sohail Bampoe, Peter M Odor, S Ramani Moonesinghe, Matthew Dickinson
Background: Little is known about the economic impact of emergency laparotomy (EL) surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. Methods: MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29201360/are-physician-assistant-and-patient-airway-assessments-reliable-compared-to-anesthesiologist-assessments-in-detecting-difficult-airways-in-general-surgical-patients
#14
Erin Payne, Jacqueline Ragheb, Elizabeth S Jewell, Betsy P Huang, Angela M Bailey, Laura M Fritsch, Milo Engoren
Background: Airway management remains one of the most important responsibilities of anesthesiologists. Prediction of difficult airway allows time for proper selection of equipment, technique, and personnel experienced in managing patients with difficult airway. Face to face preoperative anesthesia interviews are difficult to conduct as they necessitate patients traveling to the clinics, and, in practice, are usually conducted in the morning of the procedure by the anesthesiologist, when identification of predictors of difficult intubation may lead to schedule delays or case cancelations...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29201359/rationale-for-and-approach-to-preoperative-opioid-weaning-a-preoperative-optimization-protocol
#15
REVIEW
Heath McAnally
The practice of chronic opioid prescription for chronic non-cancer pain has come under considerable scrutiny within the past several years as mounting evidence reveals a generally unfavorable risk to benefit ratio and the nation reels from the grim mortality statistics associated with the opioid epidemic. Patients struggling with chronic pain tend to use opioids and also seek out operative intervention for their complaints, which combination may be leading to increased postoperative "acute-on-chronic" pain and fueling worsened chronic pain and opioid dependence...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29201358/association-of-postoperative-nausea-vomiting-and-pain-with-breastfeeding-success
#16
Ramon Abola, Jamie Romeiser, Suman Grewal, Sabeen Rizwan, Rishimani Adsumelli, Ellen Steinberg, Elliott Bennett-Guerrero
Background: Successful breastfeeding is a goal set forth by the World Health Organization to improve neonatal care. Increasingly, patients express the desire to breastfeed, and clinicians should facilitate successful breastfeeding. The primary aim of this study is to determine if postoperative nausea and vomiting (PONV) or postoperative pain are associated with decreased breastfeeding success after cesarean delivery. Methods: This is a historical cohort study using the Stony Brook Elective Cesarean Delivery Database...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29167742/the-effect-of-natural-sounds-on-the-anxiety-of-patients-undergoing-coronary-artery-bypass-graft-surgery
#17
Mohammad Javad Amiri, Tabandeh Sadeghi, Tayebeh Negahban Bonabi
Background: This study aims to investigate the effect of natural sounds on the anxiety of patients undergoing coronary artery bypass graft surgery (CABG). Methods: In this clinical trial, 90 patients, who were candidates for CABG in an urban area of Iran, were selected and randomly assigned to intervention and control groups by the minimization method. In the intervention group, natural sounds were broadcast through headphones for 30 min. In the control group, headphones connected to a silent device were used...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29090090/surgeons-views-on-preoperative-medical-evaluation-a-qualitative-study
#18
Kevin R Riggs, Zackary D Berger, Martin A Makary, Eric B Bass, Geetanjali Chander
BACKGROUND: There is substantial variation in the practice of preoperative medical evaluation (PME) and limited evidence for its benefit, which raises concerns about overuse. Surgeons have a unique role in this multidisciplinary practice. The objective of this qualitative study was to explore surgeons' practices and their beliefs about PME. METHODS: We conducted of semi-structured interviews with 18 surgeons in Baltimore, Maryland. Surgeons were purposively sampled to maximize diversity in terms of practice type (academic vs...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29075482/fluid-resuscitation-practices-in-cardiac-surgery-patients-in-the-usa-a-survey-of-health-care-providers
#19
Solomon Aronson, Paul Nisbet, Martin Bunke
BACKGROUND: Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. METHODS: We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR)...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29034090/pre-to-postoperative-coagulation-profile-of-307-patients-undergoing-oesophageal-resection-with-epidural-blockade-over-a-10-year-period-in-a-single-hospital-implications-for-the-risk-of-spinal-haematoma
#20
Owain Thomas, Emanuel Lybeck, Per Flisberg, Ulf Schött
BACKGROUND: Epidural anaesthesia and analgesia are indicated for oesophageal surgery. A rare but serious complication is spinal haematoma, which can occur on insertion, manipulation or withdrawal of catheters. Evidence and guidelines are vague regarding which tests are appropriate and how to interpret their results. We aimed to describe how routine coagulation test results change during oesophagectomy's perioperative course. METHODS: Following ethical approval, we retrospectively identified patients who had undergone oesophagectomy between 2002 and 2012...
2017: Perioperative Medicine
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