Current opinion in anaesthesiology
-
The role of fluid balance as an important contributor to patient morbidity and mortality in the peri-operative period is only now being understood. Numerous studies in disparate populations undergoing different surgeries suggest that. ⋯ In the absence of level 1 evidence it is difficult to make firm recommendations about practice, though observational and single-centre data suggest a significant survival advantage may be conferred by the peri-operative administration of fluids to monitored physiological targets only. The Australian approach to peri-operative fluid management is to create level 1 evidence. To this end, the development of a large multicentre randomized controlled trial of peri-operative fluid administration is underway.
-
The aim of this review is to underline the need for an adequate clinical and functional evaluation of respiratory function and asthma control in patients undergoing surgical procedures requiring general anesthesia to obtain useful information for an adequate preoperative pharmacological approach. ⋯ A better control of asthma must be considered the 'gold standard' for a patient at 'a reasonable low risk' to develop perioperative/postoperative bronchospasm. International consensus promoted by pulmonologists, anesthesiologists, and allergists might be useful to define a better diagnostic and therapeutic approach.
-
Curr Opin Anaesthesiol · Feb 2012
ReviewStrategies to reduce the use of blood products: a US perspective.
To describe the recent developments in the strategies to reduce allogeneic blood transfusions with emphasis on the impact on clinical outcomes. ⋯ Patient blood management is the timely use of safe and effective medical and surgical techniques designed to prevent anemia and decrease bleeding in an effort to improve patient outcome.
-
Curr Opin Anaesthesiol · Feb 2012
ReviewAtelectasis and perioperative pulmonary complications in high-risk patients.
This review evaluates the link between perioperative lung atelectasis and postoperative pulmonary complications (PPCs) and how appropriate ventilatory strategies could mitigate this problem. ⋯ A goal-directed ventilatory approach keeping an 'open lung' condition during the perioperative period may reduce the incidence of PPCs.