Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Feb 2016
ReviewFast track in thoracic surgery and anaesthesia: update of concepts.
Update of key elements on enhanced recovery after thoracic anaesthesia and surgery. ⋯ The concept of enhanced recovery ('fast-track') after thoracic surgery and anaesthesia was developed in recent years making allowance to the increased number of video-assisted parenchymal lung resections in managing primary lung cancer. Current studies promote the benefit in thoracic surgical patients, if an established departmental protocol-based algorithm is implemented.
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Curr Opin Anaesthesiol · Feb 2016
ReviewBest anaesthetic drug strategy for morbidly obese patients.
The purpose of this review is to describe an evidence-based drug strategy applicable to any obese patient, rather than to present one standard 'ideal' anaesthetic drug combination. The ultimate choice of specific drugs in any given situation will depend upon clinician experience, patient specifics, and drug availability. The fundamental principle in anaesthesia for the obese patient is to use the shortest acting, least fat soluble agents to ensure rapid recovery to safe levels of alertness and mobility. ⋯ This review introduces newer findings to help us use anaesthetic and analgesic drugs more safely in the morbidly obese. However, there remain many areas of uncertainty with a lack of consensus on many issues.
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Curr Opin Anaesthesiol · Feb 2016
ReviewLung transplantation: from the procedure to managing patients with lung transplantation.
The perioperative management of lung transplantation patients remains a challenge. The most important goal is the prevention or attenuation of primary graft failure due to ischemia and reperfusion, operative trauma, and activation of systemic inflammation; it significantly influences short-long and long-term outcome. This review focuses on different aspects regarding the management of these high-risk patients. ⋯ There is evidence that important key strategies improve outcome after lung transplantation. An update on the substantial challenges in anesthesia comprises ventilator strategy and the use of extracorporeal circulation to minimize inflammation associated with primary graft failure.