scholarly journals Treatment of Surgical Patients is Evidence-based

2001 ◽  
Vol 167 (5) ◽  
pp. 324-330 ◽  
Author(s):  
Ross Kingston, Mary Barry, Sean Tierney,
Keyword(s):  
Surgical Patients ◽  
Evidence Based

Perioperative risk prediction

2021 ◽  
pp. 1-2
Author(s):  
Edward Davis
Keyword(s):  
Decision Making ◽  
Risk Prediction ◽  
Scoring Systems ◽  
Perioperative Risk ◽  
Surgical Patients ◽  
Evidence Based

Predicting outcomes for surgical patients accurately can be challenging preoperatively. Fortunately, there is an array of evidence-based scoring systems which can guide perioperative decision making and discussions of risk with patients.

scholarly journals The Effect of a Multifaceted Postoperative Nausea and Vomiting Reduction Strategy on Prophylaxis Administration Amongst Higher-Risk Adult Surgical Patients

2018 ◽  
Vol 46 (2) ◽  
pp. 185-189 ◽  
Author(s):  
A. Pym ◽  
E. Ben-Menachem
Keyword(s):  
High Risk ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Outcome Data ◽  
Nausea And Vomiting ◽  
Surgical Patients ◽  
Evidence Based ◽  
Post Intervention ◽  
Reduction Strategy ◽  
Risk Patients

Postoperative nausea and vomiting (PONV) is a common and distressing problem for patients and increases the burden of care in post-anaesthesia care units (PACU). As such it has been a recent focus for quality improvement. Evidence-based guidelines have demonstrated the benefit of PONV risk stratification and prophylaxis, but may be underutilised in clinical practice. This prospective pre-/post-intervention study was conducted at an adult tertiary hospital in non-cardiac adult surgical patients at higher risk of PONV. The intervention included promotion of an evidence-based PONV guideline, and provision of individualised prescribing and patient outcome data to anaesthetists. Six hundred and twenty-eight patients with ≥2 risk factors for PONV following general anaesthesia for non-cardiac surgery were included (333 pre-intervention and 295 post-intervention). Prior to the intervention, 9.0% (30/333) of moderate- and high-risk patients received antiemetic prophylaxis consistent with our guideline. Post-intervention, the rate of guideline adherence was 19.3% (57/295). In the high-risk PONV group, the time in PACU was significantly reduced post-intervention, 66 minutes versus 83 minutes (P=0.032). This institution-specific PONV reduction strategy had a modest but significant effect on improving prophylaxis administration. However, our findings indicate that further efforts would be required to ensure fuller compliance with the current extensive evidence base for PONV management in higher-risk patients.

Article Commentary: Optimizing Surgical Care: A Contemporary Assessment of Temperature, Oxygen, and Glucose

2010 ◽  
Vol 76 (6) ◽  
pp. 571-577 ◽  
Author(s):  
Ashley Dickinson ◽  
Motaz Qadan ◽  
Hiram C. Polk
Keyword(s):  
Immune Response ◽  
Quality Of Care ◽  
Innate Immune Response ◽  
Surgical Care ◽  
Innate Immune ◽  
Surgical Patients ◽  
Evidence Based

Factors such as temperature, oxygen, and glucose have recently been implicated in the development of surgical sepsis by either promoting or attenuating protective components of the innate immune response. Reducing infective sequelae and the improvement of the quality of care of surgical patients is a top practice priority today. These factors and their associated effects are discussed through the examination of recent clinical and scientific studies to provide an up-to-date evidence-based review.

scholarly journals Infusion and transfusion therapy: main aspects

2021 ◽  
Vol 17 (3) ◽  
pp. 25-29
Author(s):  
V.V. Nikonov ◽  
K.I. Lyzohub ◽  
M.V. Lyzohub
Keyword(s):  
Perioperative Period ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Evidence Based ◽  
Consensus Guidelines ◽  
Successful Management ◽  
Transfusion Therapy ◽  
Vital Functions ◽  
Crystalloid Solutions ◽  
Based Medicine

The adequate choice of strategy for infusion therapy is an essential component of successful management of critically ill patients. Infusion therapy is one of the main methods of maintai-ning vital functions of patients in the perioperative period. In the practice of a doctor, there are reasonable doubts about the feasibility and safety of various solutions for infusion therapy. Both are fundamental principles of infusion therapy, and the changes that have taken place, of course, need to be understood from the standpoint of evidence-based medicine. Balanced crystalloid solutions were safe and clinically effective, their use is provided by the Bri-tish Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients.

Treatment of trauma-associated hypothermia in children: evidence-based practice

2000 ◽  
Vol 9 (4) ◽  
pp. 227-234 ◽  
Author(s):  
LM Bernardo ◽  
R Henker ◽  
J O'Connor
Keyword(s):  
Clinical Trials ◽  
Emergency Care ◽  
Single Case ◽  
Case Reports ◽  
Traumatic Injury ◽  
Operative Management ◽  
Research Literature ◽  
Surgical Patients ◽  
Published Data ◽  
Evidence Based

BACKGROUND: Hypothermia is a serious immediate consequence of traumatic injury in children. Although numerous studies have addressed the treatment of hypothermia in adults after trauma or surgery, few have examined this issue in injured children. OBJECTIVES: To evaluate the research literature on when and how to treat hypothermia during emergency care of children with trauma and to apply these findings to clinical nursing practice. METHODS: Electronic literature searches conducted periodically for 3 years yielded more than 50 publications on hypothermia and its treatment in trauma and surgical patients. Publications were grouped by cause of hypothermia and by warming methods. Single case reports and publications related to submersion injuries were excluded. RESULTS: Three clinical trials of patients with head injuries included adolescents aged 15 years and older. One study compared peripheral and core warming methods used during operative management of infants and young children. Only one study evaluated core warming in children with trauma. DISCUSSION: The treatments examined in the few research-based studies on the treatment of hypothermia during emergency care of children with trauma were given low recommendations. Although the warming methods were successful in selected surgical and adult patients, the methods cannot be recommended for treating children with trauma because of the lack of evidence-based findings. CONCLUSIONS: Caution should be used when extrapolating published data on the treatment of hypothermia in injured adults to injured children. Ongoing clinical trials should evaluate in children with trauma those warming methods that have been used successfully in surgical patients.

Postoperative and Ventilator-Associated Pneumonia

2019 ◽  
Author(s):  
Caitlin A. Fitzgerald ◽  
Craig M. Coopersmith
Keyword(s):  
Hospital Costs ◽  
Surgical Patients ◽  
Postoperative Pneumonia ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Common Complication ◽  
The Third ◽  
Patient Morbidity ◽  
Surgical Critical Care ◽  
Surgical Icu

Postoperative pneumonia is currently the third most common complication seen in surgical patients and is associated with an increase in both patient morbidity and hospital costs. The incidence of postoperative pneumonia varies among the different surgical subspecialties. A number of evidence-based strategies exist regarding the prevention and management of pneumonia. However, the majority of studies on ventilator-associated pneumonia (VAP) do not specifically focus on surgical patients but rather are based on mixed medical-surgical ICU patients. The aim of this review is to define the incidence, pathogenesis, and risk factors of both postoperative and VAP; determine what pathogens are commonly encountered; discuss treatment methods; and introduce measures that can be implemented in both the surgical wards and the ICU aimed at preventing this complication. This review contains 5 figures, 7 tables, and 64 references.  Key Words: antimicrobial therapy, disease prevention, postoperative pneumonia, surgical critical care; ventilator associated pneumonia, culture, prevention, management, bundles, diagnosis

Pathophysiological Basis of CNS Injury in Cardiac Surgical Patients: Detection and Prevention

Perfusion ◽  
2006 ◽  
Vol 21 (4) ◽  
pp. 203-208 ◽  
Author(s):  
John M Murkin
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cardiac Surgery ◽  
Management Strategy ◽  
Surgical Patients ◽  
Evidence Based ◽  
Cns Injury ◽  
Comprehensive Management ◽  
Inflammatory Processes ◽  
Potential Interactions

The current understanding of adverse central nervous system (CNS) events following cardiac surgery involves several identifiable, evidence-based mechanisms: athero-sclerotic emboli, microgaseous and microparticulate emboli, and hypoperfusion.1 Secondary factors, including patient co-morbidities and inherent genetic susceptibilities, as well as systemic inflammatory processes and a suboptimal metabolic milieu may interact to potentiate the extent of injury.2 In this review a number of these factors and their potential interactions will be explored with a view towards developing a comprehensive management strategy to minimize CNS injury.

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