Current opinion in anaesthesiology
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In this review, we discuss recent developments and trends in the perioperative management of thrombocytopenia. ⋯ Given the lack of good quality evidence, much research remains to be done. However, with a multidisciplinary multimodal perioperative strategy, the risk of bleeding can be decreased effectively.
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The purpose of this review is to provide the latest evidence for delivering safe and effective anesthesia care for pediatric patients with coronavirus disease 2019 (COVID-19) and to highlight continuing gaps in the literature. ⋯ Pediatric anesthesia care can be safely delivered to children with COVID-19 and after COVID-19 infection. More attention needs to be focused on the perioperative management of COVID-19 children in recovery requiring anesthesia.
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Curr Opin Anaesthesiol · Jun 2021
ReviewPatients with psychiatric disease: implications for anesthesiologists.
Psychiatric illness is common in patients presenting for surgery. Overall health and surgical outcomes are adversely affected by the presence of psychiatric comorbidities. ⋯ From our review of the recent literature we continue to support the continuation of psychoactive agents in the perioperative period, taking into consideration the effects these agents have on concomitant drug use in the perioperative period; and the risks of withholding them at a high-stress time.
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Curr Opin Anaesthesiol · Jun 2021
ReviewPerioperative frailty: lessons learned and future directions.
As the surgical population ages, preoperative diagnosis and optimization of frailty becomes increasingly important. Various concepts are used to define frailty, and several tools have been validated for use in the perioperative period. This article reviews current conceptual frameworks of frailty, references current literature and provides a practical approach to the preoperative frailty assessment with a focus on potential interventions. ⋯ Emerging evidence suggests that frailty may be mitigated with patient-specific, multidimensional preoperative interventions, thus potentially improving postoperative outcomes in this vulnerable patient population.
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Curr Opin Anaesthesiol · Jun 2021
ReviewThe disruptive physician and impact on the culture of safety.
The disruptive physician is a growing problem in medicine. All too often, physician behavior negatively impacts the delivery of quality patient care. The hostile environment that certain behaviors create makes it difficult for team members advocate for their patients. It is imperative that physician practices develop and an understanding of how to identify the disruptive physician to maintain patient safety. ⋯ The practice of medicine is multifaceted. It is imperative that the assurance of psychological safety is met to meet the standards of high quality and safe care for patients.