We have located links that may give you full text access.
JOURNAL ARTICLE
REVIEW
ICU admission after surgery: who benefits?
Current Opinion in Critical Care 2017 October
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance.
RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation. Recent health services research has failed to find association between ICU admission and improved outcome in many types of elective major noncardiac surgery. Use of alternatives to ICU such as post anaesthesia care units (PACUs), high dependency units (HDUs) or specialist wards with enhanced nursing care are able to perform some elements of ICU monitoring in a less intensive environment, and may provide a better alternative to the traditional model of ICU admission for many patients having major surgery. ICU admission should still be considered for very high-risk patients and those having complex or emergency surgery. Improved triage tools are required to identify those at the highest risk of death or complications.
SUMMARY: Identifying those most at risk of death and complications following surgery and preventing them is the major challenge of perioperative care in the coming decades. Future research should focus on how postoperative care can best be structured to provide optimum care to patients within available resources. Incidence of complications or failure to rescue (FtR) may provide useful metrics in future research.
RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation. Recent health services research has failed to find association between ICU admission and improved outcome in many types of elective major noncardiac surgery. Use of alternatives to ICU such as post anaesthesia care units (PACUs), high dependency units (HDUs) or specialist wards with enhanced nursing care are able to perform some elements of ICU monitoring in a less intensive environment, and may provide a better alternative to the traditional model of ICU admission for many patients having major surgery. ICU admission should still be considered for very high-risk patients and those having complex or emergency surgery. Improved triage tools are required to identify those at the highest risk of death or complications.
SUMMARY: Identifying those most at risk of death and complications following surgery and preventing them is the major challenge of perioperative care in the coming decades. Future research should focus on how postoperative care can best be structured to provide optimum care to patients within available resources. Incidence of complications or failure to rescue (FtR) may provide useful metrics in future research.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app