Current opinion in critical care
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Postoperative pulmonary complications (PPC) are a prominent determinant of postoperative morbidity, mortality, and increased use of healthcare resources. Several scores have been developed to identify patients at higher risk of PPC and have been proposed or validated as tools to predict postoperative respiratory disorders, stratify risk among patients requiring surgery, and to plan clinical studies. The aim of this review is to provide an update on the recent progresses in perioperative medicine concerning the risk assessment, prevention, and treatment of PPCs. ⋯ Several strategies can improve patients' outcome, including risk assessment, intraoperative protective ventilation and postoperative noninvasive ventilation.
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New data have been made available in the field of haemostasis and thrombosis. Some long-awaited answers to important questions have been published, and some debates have benefited from an updated perspective. ⋯ These new data should help anaesthesiologists and intensivists to better understand and manage massively bleeding patients or direct oral anticoagulants treated patients.
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Nutritional status and nutrient delivery during critical illness impact clinical outcomes. We have reviewed recent studies that may guide best practices regarding nutrition therapy in critically ill children. ⋯ Systematic research and consensus-based practices are expected to promote optimal nutritional practices in critically ill children with the potential to improve clinical outcomes.
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In this review, we discuss the latest updates on perioperative acute kidney injury (AKI) and the specific considerations that are relevant to different surgeries and patient populations. ⋯ Perioperative AKI is prevalent and associated with significant morbidity and mortality. Considering the lack of effective preventive or therapeutic interventions, this review focuses on perioperative AKI: measures for early diagnosis, defining risks and possible mechanisms, and summarizing current knowledge for intraoperative fluid and hemodynamic management to reduce risk of AKI.