Articles: postoperative.
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Randomized Controlled Trial Multicenter Study Comparative Study
Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery.
Closed-loop goal-directed fluid therapy with colloids is associated with lower volume infused and fewer postoperative complications than with crystalloids.
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To evaluate to what extent delirium experts agree on the diagnosis of delirium when independently assessing exactly the same information and to evaluate the sensitivity of delirium screening tools in routine daily practice of clinical nurses. ⋯ There was considerable disagreement in classification of delirium by experts who independently assessed exactly the same information, showing the difficulty of delirium diagnosis. Furthermore, the sensitivity of daily delirium screening by clinical nurses was poor. Future research should focus on development of objective instruments to diagnose delirium.
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Multicenter Study
The postoperative handover: a focus group interview study with nurse anaesthetists, anaesthesiologists and PACU nurses.
To investigate different professionals' (nurse anaesthetists', anaesthesiologists', and postanaesthesia care unit nurses') descriptions of and reflections on the postoperative handover. ⋯ The present findings revealed variations in different professionals' views on the postoperative handover. Healthcare interventions are needed to minimise the gap between professionals' perceptions and practices and to achieve a shared understanding of postoperative handover. Furthermore, to ensure high-quality and safe care, stakeholders/decision makers need to pay attention to the environment and infrastructure in postanaesthesia care.
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Anesthesia and analgesia · Nov 2016
Multicenter Study Observational StudyMetabolic Acidosis Assessment in High-Risk Surgeries: Prognostic Importance.
Metabolic acidosis frequently is present in surgical patients; however, different types of metabolic acidosis (hyperlactatemia, hyperchloremia, and others) may have different relationships to perioperative outcomes. We hypothesized that in postoperative surgical patients, distinctive types of metabolic acidosis would correlate differently with the outcomes of high-risk surgeries. ⋯ We found that among patients with different types of acidosis, patients who developed hyperlactatemic metabolic acidosis postoperatively showed greater rates of renal dysfunction within 7 days and hyperlactatemic acidosis represented an independent factor on 30-day mortality in high-risk surgical patients.
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Anesthesia and analgesia · Jul 2016
Multicenter Study Observational StudyAnesthesia Practice and Perioperative Outcomes at 2 Tertiary Care Hospitals in Freetown, Sierra Leone.
Anesthesia in West Africa is associated with high mortality rates. Critical shortages of adequately trained personnel, unreliable electrical supply, and lack of basic monitoring equipment are a few of the unique challenges to surgical care in this region. This study aims to describe the anesthesia practice at 2 tertiary care hospitals in Sierra Leone. ⋯ We identified gaps in the application of internationally recommended anesthesia practices at both hospitals, likely caused by lack of available resources. Mortality rates were similar to those in other resource-limited countries.