Current opinion in anaesthesiology
-
Curr Opin Anaesthesiol · Apr 2020
ReviewFrom the ICU to the operating room: how to manage the patient?
To outline key points for perioperative ICU optimization of nutrition, airway management, blood product preparation and transfusion, antibiotic prophylaxis and transport. ⋯ ICU patients who require surgery may benefit from appropriate perioperative management.
-
Antimicrobial resistance (AMR) is increasing in ICUs around the world, but the prevalence is variable. We will review recent literature and try to answer the question whether this is a myth or a new reality, as well as discuss challenges and potential solutions. ⋯ AMR is a reality in most ICUs around the world, but the extent of the problem is clearly highly variable. Infection prevention and control as well as appropriate antimicrobial use are the cornerstones to turn the tide.
-
Curr Opin Anaesthesiol · Apr 2020
ReviewPoint-of-Care diagnostics of coagulation in the management of bleeding and transfusion in trauma patients.
Trauma-associated bleeding and coagulopathy require timely identification, prevention, and effective treatment. The present review summarizes the recent literature around point-of-care (POC) coagulation tests, their usefulness in the management of trauma-induced coagulopathy (TIC), their impact on trauma patient outcomes, and the requirement of quality assurance. ⋯ In contrast to an abundance of reviews and practical approaches to POC coagulation management in trauma patients, there is a scarcity of research in the field and large-scale clinical trials are urgently needed. The paneuropean multicenter trial Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy (iTACTIC) will inform on the potential of viscoelastic tests to augment transfusion protocols for better patient outcomes.
-
Curr Opin Anaesthesiol · Apr 2020
ReviewMedical science faces the post-truth era: a plea for the grassroot values of science.
Science and its public perception are compromised by scientific fraud and predatory journals, and also by the general erosion of the meaning of truth in the so-called post-truth era. These developments have significant influence on scientific medicine and their impact on the public discourse. The purpose of this article is to show how fake science, and also the uncritical dissemination of compromised results in public and social media, threatens scientific medicine. ⋯ In the post-truth era, publication of false results in predatory journals and by fraudulent authors become even more dangerous for the health and life of patients, as their dissemination via new social media is nearly unstoppable and in the public perception truth is losing its meaning. The scientific community has implemented specific counter-measures to minimize the chances of false results being published. However, it is even more important that every participant in the scientific process assumes the responsibility according to his or her role. An orientation towards the values that have constituted and formed science is helpful in fulfilling this responsibility.
-
Patient decision aids are educational tools used to assist patients and clinicians in healthcare decisions. As healthcare moves toward patient-centered care, these tools can provide support to anesthesiologists by facilitating shared decision-making. ⋯ Patient decision aids can support patient-centered care delivery and shared decision-making, especially in the field of anesthesia. Current research involves implementing the use of patient decision aids in the discussion for monitored anesthesia care. Further development of quality metrics is needed to improve the decision aids and maximize decision quality.