INTERNATIONAL ANESTHESIOLOGY CLINICS最新文献

{"title":"Trauma","authors":"L. Maerz, K. Davis, S. Rosenbaum","doi":"10.1097/AIA.0b013e3181950030","DOIUrl":"https://doi.org/10.1097/AIA.0b013e3181950030","url":null,"abstract":"The June 2023 Trauma Roundup360 looks at: Aspirin or low-molecular-weight heparin for thromboprophylaxis?; Lateral plating or retrograde nailing for distal femur fractures?; Sciatic nerve palsy after acetabular fixation: what about patient position?; How reliable is the new OTA/AO classification for trochanteric hip fractures?; Young hip fractures: is a medial buttress the answer?; When is the best time to ‘flap’ an open fracture?; The mortality burden of nonoperatively managed hip fractures.","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"47 1","pages":"25-36"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/AIA.0b013e3181950030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42364647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric surgery centers: the way forward.","authors":"Angela M Bader","doi":"10.1097/AIA.0000000000000390","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000390","url":null,"abstract":"","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"55-61"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Index.","authors":"","doi":"10.1097/01.aia.0000923792.31426.1b","DOIUrl":"https://doi.org/10.1097/01.aia.0000923792.31426.1b","url":null,"abstract":"","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"70-71"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9076014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy in older surgical patients: practical steps for managing perioperative medications.","authors":"Rebecca M Gerlach, Christina C Kim","doi":"10.1097/AIA.0000000000000395","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000395","url":null,"abstract":"The likelihood of developing a medical condition requiring pharmacologic therapy increases with age. Older patients frequently take multiple medications, including prescription, over-the-counter (OTC) or complementary medicines, often termed polypharmacy. The average age of surgical patients is older than that of the general population, 1 so encountering polypharmacy perioperatively is common. In a South Korean review of 7.36 million patients in the National Health Insurance claims database, 36.9% of patients over the age of 65 used ≥ 5 prescription medications, while 7.1% used 10 or more medications. 2 In the United States, examination of the National Ambulatory Medical Care Survey revealed a point prevalence of polypharmacy ( ≥ 5 medications) of 44% in community-dwelling patients 65 years or older who did not have dementia, and 72% in those who did have dementia. 3 In a Danish population, the broader issues of potentially inappropriate medication (PIM) use was examined through a population-based register. 4 PIM can include inappropriate drug choice, polypharmacy, or potential drug-drug interactions, but generally refers to medications that should be avoided in older people due to the potential risks outweighing the bene fi ts. Although the use of PIM decreased from 2000 to 2015 (from 54.7% to 43.5% in people with dementia and from 39.5% to 28.8% in people without dementia), there remained a high prevalence of potentially inappropriate prescribing practices, including in patients with dementia. 4 While the term polypharmacy indicates the administration of multiple medications in a patient, there is no consensus de fi nition. A systematic review of polypharmacy de fi nitions categorized them as “ (1) numerical only (using the number of medications to de fi ne polypharmacy), (2) numerical with an associated duration of therapy or health care setting (such as during hospital stay), or (3) descriptive (using a brief description to de fi ne polypharmacy).","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"16-22"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9120497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive impairment and its adverse outcomes in older surgical patients: an under-recognized problem!","authors":"Ellene Yan, David He, Tarek K Rajji, Frances Chung","doi":"10.1097/AIA.0000000000000392","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000392","url":null,"abstract":"The older population, aged 65 years or older, is projected to nearly triple from 524 million in 2010 to 1.5 billion by 2050, representing 8.5% to 16.7% of the global population, respectively. 1 This increase is particularly pronounced in comparison to the trend of the younger population aged 20 years or below, which is estimated to remain relatively static from 2.5 billion in 2015 to 2.6 billion in 2050. With the increase in life expectancy, the number of individuals with cognitive impairment (CI) has increased by 117% in the last 25 years. 2 It will continue to increase with the aging forecast. The susceptibility of older individuals to develop CI partly derives from the complexity of the aging process. Aging involves in fl ammatory and physiological changes across multiple organ systems including the brain, ren-dering the older population more vulnerable and less resilient to future in fl ammatory insults. 3 Globally, 313 million surgeries are performed with 4 million postoperative deaths and","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"23-28"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10077396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disruption in older surgical patients and its important implications.","authors":"Nina Butris, Evan Tang, David He, Dong-Xin Wang, Frances Chung","doi":"10.1097/AIA.0000000000000391","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000391","url":null,"abstract":"Sleep is an essential physiological function characterized by a temporary state of unawareness. Adequate sleep is essential for rest, recovery, survival, andenergy conservation. 1 Perioperatively, patients are at an increased risk of experiencing poor sleep quality, which has been linked to adverse postoperative outcomes. 2 – 6 As a result, quality of sleep is important to perioperative care.","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"47-54"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition screening and therapy in the older surgical patient: an area that is ignored.","authors":"David G A Williams, Timothy E Miller","doi":"10.1097/AIA.0000000000000397","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000397","url":null,"abstract":"% of the","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"29-33"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10429510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary assessment and optimization for older surgical patients.","authors":"Evan M Henricks, Kurt J Pfeifer","doi":"10.1097/AIA.0000000000000398","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000398","url":null,"abstract":"Advances in surgical and anesthetic techniques coupled with increased life expectancy have led to an increasing proportion of older adults receiving surgical care. Commonly, these patients are medically complex, conferring increased risk for postsurgical complications. Postoperative pulmonary complications (PPCs), including respiratory failure, pneumonia, and exacerbation of chronic lung disease, are common in older surgical patients, occurring in ~6% of major abdominal procedures. Although older adults are at a significantly increased risk for cardiovascular disease, PPCs may account for a larger proportion of surgical complications than cardiac events and be associated with greater morbidity and mortality than cardiovascular complications. The older adult population is especially prone to these complications, as evidenced by the correlation between PPCs and advanced age, cognitive impairment, and functional dependence. Appropriately assessing and managing the risk of PPCs in older adults can help encourage age-friendly health system practices in the perioperative setting.","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"8-15"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10449865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative medicine for Older People undergoing Surgery (POPS): Comprehensive Geriatric Assessment (CGA) and optimization in the perioperative setting.","authors":"Jennifer J Stewart, Judith S L Partridge, Jugdeep K Dhesi","doi":"10.1097/AIA.0000000000000396","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000396","url":null,"abstract":"In the developed world, the majority of surgery is now undertaken on older patients. This is not surprising given the association between aging and pathologies that require surgery, including degenerative disease (eg, osteoarthritis), neoplastic disease (eg, solid organ tumors), and vascular disease (eg, coronary or peripheral arterial disease). Older people have much to gain from surgery undertaken in terms of increasing longevity and/or symptom control. However, this older population presents to surgical services, not only with the index surgical pathology, but also with age-associated decline in physiological status, and often with other coexisting health issues including multimorbidity and geriatric syndromes such as frailty and/or cognitive impairment. There is now evidence across surgical subspecialties that these factors, poor physiological reserve, multimorbidity, frailty and cognitive impairment, are important, independent predictors of adverse postoperative outcomes. This is true across clinician-reported (morbidity, mortality), patientreported (experience, satisfaction), and process-related (late cancellations of surgery, length of hospital stay, readmissions) outcomes. Furthermore, these same factors are also associated with high financial costs to health and social care systems. With the observed changes in the age and pathophysiological profile of the surgical population, the need for geriatric medicine services to support surgical and anesthetic teams in delivering perioperative care for older people has been recognized. This need was first addressed as orthogeriatric services for patients with hip fractures were developed. Over the past 20 years geriatric medicine delivered perioperative services has expanded with innovative models of care now in existence for those presenting for planned and unplanned surgery across surgical subspecialties. These new perioperative services for older people are usually delivered using Comprehensive Geriatric Assessment (CGA) and optimization methodology. The first service to utilize and describe this CGA-based approach was established at Guy’s and St Thomas’ NHS Foundation Trust in the United Kingdom and has informed the development of other models of care nationally and internationally. In this article, we describe the Guy’s and St Thomas’ Perioperative medicine for Older People undergoing Surgery (POPS) service and discuss the workforce required to deliver it. The evidence supporting such an approach will be summarized and the translation of the service across hospitals in the United Kingdom and internationally will be described.","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"62-69"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9120504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical prehabilitation in older and frail individuals: a scoping review.","authors":"Monika Sadlonova, Nicole B Katz, Jane S Jurayj, Laura Flores, Christopher M Celano, Christine A F von Arnim, Julie K Silver","doi":"10.1097/AIA.0000000000000394","DOIUrl":"10.1097/AIA.0000000000000394","url":null,"abstract":"","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"34-46"},"PeriodicalIF":0.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10429509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}