Articles: postoperative-complications.
-
Med. Clin. North Am. · Nov 2024
ReviewThe Geriatric Patient: Frailty, Prehabilitation, and Postoperative Delirium.
Historically and for ease of classification, the geriatric patient has received a chronologic definition of a person 65 years and older. Chronologic age remains an independent risk of postoperative complications and adverse surgical outcomes. ⋯ The concept of prehabilitation has shown promise as a proactive approach to optimize a patient's functional, cognitive, nutritional, and emotional in preparation for surgical interventions. Postoperative delirium is the most common neuropsychological complication after surgery.
-
Perioperative risks associated with acute hepatitis, cirrhosis, and chronic kidney disease are substantial and prevalence of underlying chronic kidney or liver disease is rising; surgeries in these populations have accordingly become more common. Optimal perioperative management in both cases is paramount; this article focuses on understanding disease pathophysiology, a targeted preoperative evaluation, accurate estimation of perioperative risk, and anticipation and management of common postoperative complications.
-
To explore the patterns of sagittal imbalance in patients with lumbar or thoracolumbar degenerative kyphosis (DK) and determine its implication for the risk of mechanical complication (MC) after corrective surgery. ⋯ The findings decipher the distinct patterns of sagittal imbalance in severe DK patients with kyphotic apex at thoracolumbar or lumbar spine. Patients with kyphotic apex apex at L2 or below, low SS, and global imbalance showed the highest risk of postoperative mechanical failure.
-
Initially introduced as a safer alternative to smoking, electronic cigarettes (e-cigarettes) and vaping have since been associated with lung injury. Nevertheless, there is limited perioperative data on their potential contribution to the harmful effects of mechanical ventilation on the lungs. We hypothesized that, in adults undergoing noncardiothoracic surgeries, preoperative vaping/e-cigarette use is associated with hypoxemia during the first postoperative hour, and with an increased incidence of intraoperative and postoperative pulmonary complications. ⋯ Vaping/e-cigarette use was neither associated with clinically significant hypoxemia during the first hour in the postanesthesia care unit nor with an increase in pulmonary complications. Nevertheless, our findings cannot definitively exclude the deleterious effects of vaping and e-cigarette use on the lungs, and anesthesiologists should consider potential perioperative complications.