Search results for "Perioperative care"
showing 10 items of 35 documents
Clinical pathways for urology patients during the COVID-19 pandemic
2020
The public health emergency caused by the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant reallocation of health resources with a consequent reorganization of the clinical activities also in several urological centers. A panel of Italian urologists has agreed on a set of recommendations on pathways of pre-, intra- and post-operative care for urological patients undergoing urgent procedures or non-deferrable oncological interventions during the COVID-19 pandemic. Simplification of the diagnostic and staging pathway has to be prioritized in order to reduce hospital visits and consequently the risk of contagion. In absence of strict uniform regulations that impose th…
Machine learning risk prediction of mortality for patients undergoing surgery with perioperative SARS-CoV-2: the COVIDSurg mortality score
2021
The British journal of surgery 108(11), 1274-1292 (2021). doi:10.1093/bjs/znab183
The heart in the elderly critically ill patient
2002
Cardiac complications such as myocardial infarction and congestive heart failure are the primary source of perioperative morbidity and mortality in elderly surgical patients. This is the result of structural and functional age-related changes in the heart and the vasculature and an increasing incidence of cardiovascular disorders. Appropriate perioperative management of the elderly patient should be based on the extent of functional compromise, the type and severity of pre-existing disease, and the invasiveness of the surgical procedure. Current studies suggest that appropriately administered medical therapy, particularly beta-adrenergic blockade, may reduce perioperative cardiovascular mor…
Internet-based perioperative exercise program in patients with Barrett’s carcinoma scheduled for esophagectomy [iPEP - study] a prospective randomize…
2017
Abstract Background Patients undergoing surgery for esophageal cancer have a high risk for postoperative deterioration of lung function and pulmonary complications. This is partly due to one-lung ventilation during thoracotomy. This often accounts for prolonged stay on intensive care units, delayed postoperative reconvalescence and reduced quality of life. Socioeconomic disadvantages can result from these problems. Physical preconditioning has become a crucial leverage to optimize fitness and lung function in patients scheduled for esophagectomy, in particular during the time period of neoadjuvant therapy. Methods/Study design We designed a prospective multicenter randomized-controlled tria…
Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces posto…
2013
Introduction Several single-center studies and meta-analyses have shown that perioperative goal-directed therapy may significantly improve outcomes in general surgical patients. We hypothesized that using a treatment algorithm based on pulse pressure variation, cardiac index trending by radial artery pulse contour analysis, and mean arterial pressure in a study group (SG), would result in reduced complications, reduced length of hospital stay and quicker return of bowel movement postoperatively in abdominal surgical patients, when compared to a control group (CG). Methods 160 patients undergoing elective major abdominal surgery were randomized to the SG (79 patients) or to the CG (81 patien…
Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial
2018
Background The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. Methods We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a bod…
Incidence and predictors of portal and splenic vein thrombosis after pure laparoscopic splenectomy.
2017
Background. Optimal modalities for diagnosis, treatment, and surveillance of portal or splenic vein thrombosis have not yet been defined. The present retrospective study aimed to investigate the role of computed tomography performed systematically before and after laparoscopic splenectomy to assess the incidence of portal or splenic vein thrombosis, predictors, and outcomes. Methods. Computed tomography scans were obtained from 170 patients undergoing elective laparoscopic splenectomy between 2005 and 2015. Pre- and postoperative splenic vein diameter was measured at the splenoportal junction and at a distance of 2, 4, 6 cm from it. Univariate and multivariate analyses were used to identify…
High flow nasal therapy in perioperative medicine: from operating room to general ward
2018
Abstract Background High flow nasal therapy (HFNT) is a technique in which humidified and heated gas is delivered to the airways through the nose via small nasal prongs at flows that are higher than the rates generally applied during conventional oxygen therapy. The delivered high flow rates combine mixtures of air and oxygen and enable different inspired oxygen fractions ranging from 0.21 to 1. HFNT is increasingly used in critically ill adult patients, especially hypoxemic patients in different clinical settings. Main body Noninvasive ventilation delivers positive pressure (end-expiratory and inspiratory pressures or continuous positive airway pressure) via different external interfaces. …
The perioperative management of small animals with previously implanted pacemakers undergoing anaesthesia.
2020
Abstract Objective There is little information in the veterinary literature about the perioperative management of small animal patients with previously implanted pacemakers undergoing elective or emergency non-cardiac procedures. The purpose of this article is to review the current literature with regard to human patients, with previously implanted pacemakers, undergoing general anaesthesia. Using this and the current information on pacemakers and anaesthesia in dogs and cats, we provide recommendations for small animal patients in this situation. Databases used Google Scholar, PubMed and CAB Abstracts using and interlinking and narrowing the search terms: “dog”, “cat”, “small animals”, “an…
Manejo perioperatorio de pacientes con sospecha o infección grave por coronavirus SARS-CoV-2 programados para implante de dispositivos electrónicos p…
2020
Resumen La infeccion por SARS-CoV-2 ha evolucionado hasta convertirse progresivamente en una pandemia declarada por la Organizacion Mundial de la Salud (OMS) que ha obligado a las organizaciones de salud a nivel mundial, regional y local a adoptar una serie de medidas para hacer frente al COVID-19 e intentar disminuir su impacto, no solo en el ambito social sino tambien en el ambito sanitario, modificandose las pautas de actuacion en los servicios de salud. Dentro de estas recomendaciones que incluyen las Unidades de Tratamiento del Dolor, los pacientes con sospecha o infeccion confirmada por SARS-CoV-2 pueden encontrase en situacion de espera para intervencion no demorable para implante o …