Current opinion in anaesthesiology
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The primary purpose of this article is to highlight the latest airway research in multitrauma. ⋯ Risks and benefits of ultimate prehospital airway control is a controversial topic. Utilization of videolaryngoscopes in multitrauma remains open for research. Standardization of training requirements, equipment, and development of prehospital and in-hospital airway algorithms are needed to improve outcomes. Rational utilization of available airway devices, development of new devices, or both may help to promote this goal.
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Curr Opin Anaesthesiol · Apr 2010
Review Case ReportsTherapeutic hypothermia and traumatic brain injury.
Therapeutic hypothermia after traumatic brain injury (TBI)? For the last 10 years, no topic has been more popular and more controversial among neurointensivists. This article reviews the most current findings (experimental, clinical, adult and pediatric TBI), as well as the clinical management of therapeutic hypothermia. ⋯ Taking into consideration all results from clinical hypothermia TBI studies discussion has to be focused around the possibility that a better outcome could be achieved if protocols for therapeutic hypothermia are reviewed. It is possible that the negative effects of the cooling and the rewarming procedure currently overshadow the neuroprotective effects.
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Curr Opin Anaesthesiol · Apr 2010
ReviewPerioperative considerations in patients with cirrhotic cardiomyopathy.
This review aims to identify specific criteria for cirrhotic cardiomyopathy, examine the correlation with perioperative adverse outcomes and explore options for hemodynamic monitoring. ⋯ To detect cirrhotic cardiomyopathy, physicians must conduct a systematic examination of the patient. Overt manifestations of cirrhotic cardiomyopathy often only become evident after a patient is exposed to physiological or drug-induced stress. Appropriate hemodynamic monitoring is a cornerstone in the perioperative management of cirrhotic patients.
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The ever-increasing demand for productivity has forced anesthesiology departments to implement a safe, efficient, and structured approach to the preoperative evaluation of surgical patients. The goal of the present article is to discuss the evolution, benefits, and the future of preoperative clinics including a telephone-based system. ⋯ It is difficult to compare the efficacy of different preoperative evaluation systems with regard to properly educating the patient, minimizing complications, and maximizing surgical suite functioning. Several authors have pointed out that quality improvement of the preoperative clinic should be guided by obtaining patient feedback.
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To update readers on recent literature regarding treatment of coagulopathy for patients with life-threatening bleeding, highlighting emerging therapeutic options, controversial topics, and ongoing clinical trials. ⋯ Massive transfusion protocols standardize treatment of the coagulopathy of massive bleeding, leading to rapid restoration of hemostasis and decrease in early mortality.