Articles

Using bispectral index and cerebral oximetry to guide hemodynamic therapy in high-risk surgical patients

High-risk surgery represents 12.5% of cases but contributes 80% of deaths in the elderly population. Reduction in morbidity and mortality by the use of intervention strategies could result in thousands of live...

Authors: Heena Bidd, Audrey Tan and David Green

The maintenance and monitoring of perioperative blood volume

The assessment and maintenance of perioperative blood volume is important because fluid therapy is a routine part of intraoperative care. In the past, patients undergoing major surgery were given large amounts...

Authors: Takehiko Iijima, Birgitte Brandstrup, Peter Rodhe, Audrius Andrijauskas and Christer H Svensen

Choice of anesthetic technique on plasma concentrations of interleukins and cell adhesion molecules

Whether inflammatory responses to surgery are comparably activated during total intravenous anesthesia (TIVA) and during volatile anesthesia remains unclear. We thus compared the perioperative effects of TIVA ...

Authors: Daniela C Ionescu, Simona Claudia D Margarit, Adina Norica I Hadade, Teodora N Mocan, Nicolae A Miron and Daniel I Sessler

Observational study of the effects of age, diabetes mellitus, cirrhosis and chronic kidney disease on sublingual microvascular flow

Sidestream dark field (SDF) imaging has been used to demonstrate microcirculatory abnormalities in a variety of critical illnesses. The microcirculation is also affected by advancing age and chronic comorbidit...

Authors: Toby Reynolds, Amanda Vivian-Smith, Shaman Jhanji and Rupert M Pearse

Peri-operative care of elderly patients – an urgent need for change: a consensus statement to provide guidance for specialist and non-specialist anaesthetists

Authors: Chris Dodds, Irwin Foo, Kerri Jones, Shiv Kumar Singh and Carl Waldmann

Introduction to the postanaesthetic care unit

High-risk, noncardiac surgery represents only 12.5% of surgical procedures, but 83.3% of deaths. The postanaesthetic care unit (PACU) addresses the need for an improved level of care for these patients by prov...

Authors: Joanna C Simpson and S Ramani Moonesinghe

Preoperative cardiopulmonary exercise testing in England – a national survey

Cardiopulmonary exercise testing (CPET) has become well established in the preoperative assessment of patients presenting for major surgery in the United Kingdom. There is evidence supporting its use in risk-s...

Authors: Sam Huddart, Emily L Young, Rebecca-Lea Smith, Peter JE Holt and Pradeep K Prabhu

Neither dynamic, static, nor volumetric variables can accurately predict fluid responsiveness early after abdominothoracic esophagectomy

Hypotension is common in the early postoperative stages after abdominothoracic esophagectomy for esophageal cancer. We examined the ability of stroke volume variation (SVV), pulse pressure variation (PPV), cen...

Authors: Hironori Ishihara, Eiji Hashiba, Hirobumi Okawa, Junichi Saito, Toshinori Kasai and Toshihito Tsubo

Anaerobic threshold, is it a magic number to determine fitness for surgery?

The use of cardiopulmonary exercise testing (CPET) to evaluate cardiac and respiratory function was pioneered as part of preoperative assessment in the mid 1990s. Surgical procedures have changed since then. T...

Authors: Paul Older

Measuring outcomes after major abdominal surgery during hospitalization: reliability and validity of the Postoperative Morbidity Survey

Measurement of outcomes after major abdominal surgery has traditionally focused on mortality, however the low incidence in elective surgery makes this measure a poor comparator. The Postoperative Morbidity Sur...

Authors: Simon J Davies, James Francis, Jonathan Dilley, R Jonathan T Wilson, Simon J Howell and Victoria Allgar

Protocol-directed insulin infusion sliding scales improve perioperative hyperglycaemia in critical care

Perioperative hyperglycaemia is associated with poor outcomes in patients undergoing cardiac surgery. Frequent postoperative hyperglycaemia in cardiac surgery patients has led to the initiation of an insulin i...

Authors: Man Lin Hui, Arun Kumar and Gary G Adams

Perioperative acute kidney injury

Acute kidney injury (AKI) is a serious complication in the perioperative period, and is consistently associated with increased rates of mortality and morbidity. Two major consensus definitions have been develo...

Authors: Stacey Calvert and Andrew Shaw

Strategies to promote reporting of Surgical Care Improvement Project (SCIP) measures: a pilot survey of anesthesia department leaders

The Surgical Care Improvement Project (SCIP) is a quality improvement initiative focused on reducing surgical complications. Reporting SCIP performance measures helps determine whether hospitals receive the fu...

Authors: Rebecca M Speck, Mark D Neuman, Andrew R Bond and Lee A Fleisher

Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur

Peripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective ana...

Authors: Szilard Szucs, Gabriella Iohom, Brian O’Donnell, Pavol Sajgalik, Ishtiaq Ahmad, Nazar Salah and George Shorten

The cost-effectiveness of an outpatient anesthesia consultation clinic before surgery: a matched Hong Kong cohort study

Outpatient anesthesia clinics are well established in North America, Europe and Australia, but few economic evaluations have been published. The Perioperative Systems in Hong Kong are best described as a hybri...

Authors: Anna Lee, Po Tong Chui, Chun Hung Chiu, Tony Gin and Anthony MH Ho

Perioperative fluid management: Consensus statement from the enhanced recovery partnership

Authors: Monty G Mythen, Michael Swart, Nigel Acheson, Robin Crawford, Kerri Jones, Martin Kuper, John S McGrath and Alan Horgan

Welcome to Perioperative Medicine

Authors: Mark Hamilton and Monty G Mythen