Anesthesia and analgesia
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Anesthesia and analgesia · May 2014
Implementation of a total joint replacement-focused perioperative surgical home: a management case report.
The perioperative setting in the United States is noted for variable and fragmented care that increases the chance for errors and adverse outcomes as well as the overall cost of perioperative care. Recently, the American Society of Anesthesiologists put forward the Perioperative Surgical Home (PSH) concept as a potential solution to this problem. Although the PSH concept has been described previously, "real-life" implementation of this new model has not been reported. ⋯ We believe that our experience with the Total Joint Replacement PSH program provides solid evidence of the feasibility of this practice model to improve patient outcomes and achieve high patient satisfaction. In the future, the impact of LOS on cost will have to be better quantified. Specifically, future studies comparing PSH to traditional care will have to include consideration of postdischarge care, which are drivers of the perioperative costs.
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Anesthesia and analgesia · May 2014
TEG® Functional Fibrinogen Analysis May Overestimate Fibrinogen Levels.
Fibrinogen is of crucial importance in patients with ongoing bleeding. In this study, we compared fibrinogen concentration measured by thrombelastography (TEG®) with fibrinogen plasma concentration determined by Clauss. ⋯ Similar patterns were observed when patients and healthy controls were analysed separately. The fibrinogen level may be overestimated when assessed using TEG® compared with the fibrinogen plasma concentration measured by the conventional method.