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Magic in a bottle? A Focused review of factor concentrates for the intraoperative treatment of acquired coagulopathy – Fibrinogen concentrate, prothrombin complex concentrate, and recombinant activated factor VII 瓶子里的魔法？术中治疗获得性凝血病的浓缩因子——纤维蛋白原浓缩物、凝血酶原复合浓缩物和重组活化因子VII的重点综述
IF 4.7 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-12-01 DOI: 10.1016/j.bpa.2023.11.003
Amir Zabida , Justyna Bartoszko , Keyvan Karkouti
{"title":"Magic in a bottle? A Focused review of factor concentrates for the intraoperative treatment of acquired coagulopathy – Fibrinogen concentrate, prothrombin complex concentrate, and recombinant activated factor VII","authors":"Amir Zabida ,&nbsp;Justyna Bartoszko ,&nbsp;Keyvan Karkouti","doi":"10.1016/j.bpa.2023.11.003","DOIUrl":"10.1016/j.bpa.2023.11.003","url":null,"abstract":"<div><div>Goal-directed administration of blood components including red cells, platelets, plasma, and factor concentrates plays a critical role in the management of intraoperative coagulopathy<span>. Increasingly commonly used, purified and recombinant factor concentrates are being recognized for their logistical advantages and potentially superior efficacy. Three- and four-factor prothrombin<span> concentrates, fibrinogen concentrates<span> and activated factor VII have an evolving evidence base relative to frozen plasma and cryoprecipitate. This review discusses these compounds, compares them to conventional blood products, discusses the trial data supporting their use, and reviews indications for intraoperative transfusion based on point-of-care testing and conventional laboratory results. While factor concentrates have become an increasingly popular option for treating acquired factor deficiency in surgical patients, evidence is evolving and clinical trial data in one surgical patient population may not be transferable to another. High quality clinical studies will help optimize management of coagulopathy and improve patient outcomes while decreasing any associated risks.</span></span></span></div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 4","pages":"Pages 527-536"},"PeriodicalIF":4.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135716959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient blood management 患者血液管理
IF 4.7 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-12-01 DOI: 10.1016/j.bpa.2024.01.001
Lachlan F. Miles
{"title":"Patient blood management","authors":"Lachlan F. Miles","doi":"10.1016/j.bpa.2024.01.001","DOIUrl":"10.1016/j.bpa.2024.01.001","url":null,"abstract":"","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 4","pages":"Pages 437-438"},"PeriodicalIF":4.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143234789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative anaemia: Hiding in plain sight 术后贫血：隐藏在视线之中
IF 4.7 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-12-01 DOI: 10.1016/j.bpa.2023.11.002
Ethan H. Crispell , Jessica Trinh , Matthew A. Warner
{"title":"Postoperative anaemia: Hiding in plain sight","authors":"Ethan H. Crispell ,&nbsp;Jessica Trinh ,&nbsp;Matthew A. Warner","doi":"10.1016/j.bpa.2023.11.002","DOIUrl":"10.1016/j.bpa.2023.11.002","url":null,"abstract":"<div><div><span>Postoperative anaemia is common among surgical patients. While often viewed as a benign condition, postoperative anaemia is neither inevitable nor harmless, being intricately linked with adverse outcomes. In this review, we summarize the prevalence, aetiology, and outcomes of postoperative anaemia and highlight prevention and management strategies. Further, we propose a novel framework to characterize postoperative anaemia as an acute organ injury (i.e., acute blood injury, anaemic subtype), thereby drawing attention to a condition that is frequently overlooked. Additionally, we discuss areas warranting further research, including </span>risk stratification for patients at heightened risk for the development of postoperative anaemia and associated complications and determination of appropriate treatment strategies.</div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 4","pages":"Pages 486-494"},"PeriodicalIF":4.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135615521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does patient blood management represent good value for money? 患者血液管理是否物有所值？
IF 4.7 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-12-01 DOI: 10.1016/j.bpa.2023.11.004
Adam Irving , Zoe K. McQuilten
{"title":"Does patient blood management represent good value for money?","authors":"Adam Irving ,&nbsp;Zoe K. McQuilten","doi":"10.1016/j.bpa.2023.11.004","DOIUrl":"10.1016/j.bpa.2023.11.004","url":null,"abstract":"<div><div>Patient blood management is the umbrella term for a suite of initiatives designed to optimise blood product usage, minimise transfusion needs, and ensure appropriate and evidence-based transfusion practices. In this review we summarise published economic evaluations of patient blood management to determine whether they represent good value for money. We identified 54 economic evaluations of patient blood management, the majority of which had positive cost-effectiveness conclusions. In particular, anaemia management with ferric carboxymaltose, adopting a restrictive transfusion strategy, and the administration of tranexamic acid appear likely to be highly cost effective. Intraoperative cell salvage may be cost effective if used in patients at high risk of bleeding. Overall, patient blood management programmes are likely to reduce costs and improve patient outcomes in a wide range of patient populations. No identified evaluations included an assessment of the impact of patient blood management on preserving the blood supply.</div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 4","pages":"Pages 511-518"},"PeriodicalIF":4.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135670225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The patient with congenital heart disease in ambulatory surgery 门诊手术中的先天性心脏病患者
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI: 10.1016/j.bpa.2022.11.006
Gert-Jan Eerdekens (MD, Anesthesia Consultant) , Dieter Van Beersel (MD, PhD-Student, Anesthesia Consultant) , Steffen Rex (MD, PhD, Associate Professor, Head of the Anesthesia Department) , Marc Gewillig (MD, PhD, Professor, Pediatric Cardiologist) , An Schrijvers (MD, Anesthesia Consultant) , Layth AL tmimi (MD, PhD, Associate Professor, Anesthesia Consultant)
{"title":"The patient with congenital heart disease in ambulatory surgery","authors":"Gert-Jan Eerdekens (MD, Anesthesia Consultant) ,&nbsp;Dieter Van Beersel (MD, PhD-Student, Anesthesia Consultant) ,&nbsp;Steffen Rex (MD, PhD, Associate Professor, Head of the Anesthesia Department) ,&nbsp;Marc Gewillig (MD, PhD, Professor, Pediatric Cardiologist) ,&nbsp;An Schrijvers (MD, Anesthesia Consultant) ,&nbsp;Layth AL tmimi (MD, PhD, Associate Professor, Anesthesia Consultant)","doi":"10.1016/j.bpa.2022.11.006","DOIUrl":"https://doi.org/10.1016/j.bpa.2022.11.006","url":null,"abstract":"<div><p><span>The number of patients with congenital heart disease (CHD) undergoing </span>ambulatory surgery<span> is increasing. Deciding whether a CHD patient is suitable for an ambulatory procedure is still challenging. Several factors must be considered, including the type of planned procedure, the complexity of the underlying pathology, the American Society of Anesthesiologists’ Physical Status classification of the patient, and other patient-specific factors, including comorbidity, chronic complications of CHD, medication, coagulation disorders, and issues related to the presence of a pacemaker (PM) or cardioverter-defibrillator.</span></p><p>Numerous studies reported higher perioperative mortality and morbidity rates in surgical patients with CHD than non-CHD patients. However, most of these studies were conducted in a cohort of hospitalized patients and may not reflect the ambulatory setting. The current review aims to provide the anesthesiologist with an overview and practical recommendations on selecting and managing a CHD patient scheduled for an ambulatory procedure.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 3","pages":"Pages 421-436"},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50198451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Total joint replacement in ambulatory surgery 全关节置换术在门诊手术中的应用
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI: 10.1016/j.bpa.2023.03.005
Jaime L. Baratta (Associate Professor of Anesthesiology and Perioperative Medicine) , Brittany Deiling (Assistant Professor of Anesthesiology) , Yasser R. Hassan (Instructor of Anesthesiology and Perioperative Medicine) , Eric S. Schwenk (Professor of Anesthesiology and Perioperative Medicine)
{"title":"Total joint replacement in ambulatory surgery","authors":"Jaime L. Baratta (Associate Professor of Anesthesiology and Perioperative Medicine) ,&nbsp;Brittany Deiling (Assistant Professor of Anesthesiology) ,&nbsp;Yasser R. Hassan (Instructor of Anesthesiology and Perioperative Medicine) ,&nbsp;Eric S. Schwenk (Professor of Anesthesiology and Perioperative Medicine)","doi":"10.1016/j.bpa.2023.03.005","DOIUrl":"https://doi.org/10.1016/j.bpa.2023.03.005","url":null,"abstract":"<div><p>Total joint arthroplasty<span> is one of the most commonly performed surgical procedures in the United States, and projected numbers are expected to double in the next ten years. From 2018 to 2020, total hip and knee arthroplasty were removed from the United States’ Center for Medicare and Medicaid Services “inpatient-only” list, accelerating this migration to the ambulatory setting. Appropriate patient selection, including age, body mass index<span><span>, comorbidities, and adequate social support, is critical for successful ambulatory total joint arthroplasty. General anesthesia<span> and neuraxial anesthesia are both safe and effective anesthetic choices, and recent studies in this population have found no difference in outcomes. Multimodal analgesia, including </span></span>acetaminophen<span>, nonsteroidal anti-inflammatory drugs, local infiltration analgesia, and peripheral nerve blocks<span>, is the foundation for adequate pain control. Common reasons for “failure to launch” include postoperative urinary retention<span>, postoperative nausea and vomiting, inadequate analgesia, and hypotension.</span></span></span></span></span></p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 3","pages":"Pages 269-284"},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50198416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regional anaesthesia for ambulatory surgery 门诊手术的区域麻醉
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI: 10.1016/j.bpa.2022.12.001
Kristof Nijs MD , Joke Ruette MD , Marc Van de Velde MD, PhD, EDRA, FESAIC (Professor) , Björn Stessel MD, PhD (Professor)
{"title":"Regional anaesthesia for ambulatory surgery","authors":"Kristof Nijs MD ,&nbsp;Joke Ruette MD ,&nbsp;Marc Van de Velde MD, PhD, EDRA, FESAIC (Professor) ,&nbsp;Björn Stessel MD, PhD (Professor)","doi":"10.1016/j.bpa.2022.12.001","DOIUrl":"https://doi.org/10.1016/j.bpa.2022.12.001","url":null,"abstract":"<div><p><span>Regional anaesthesia (RA) has an important and ever-expanding role in </span>ambulatory surgery<span><span><span>. Specific practices vary depending on the preferences and resources of the anaesthesia team and hospital setting. It is used for various purposes, including as primary anaesthetic technique for surgery but also as postoperative analgesic modality. The limited duration of action of currently available </span>local anaesthetics<span> limits their application in postoperative pain control and enhanced recovery. The search for the holy grail of </span></span>regional anaesthetics<span><span> continues. Current evidence suggests that a peripheral nerve block performed with long-acting local anaesthetics in combination with intravenous or perineural </span>dexamethasone gives the longest and most optimal sensory block.</span></span></p><p><span>In this review, we outline some possible blocks for ambulatory surgery and additives to perform RA. Moreover, we give an update on local anaesthesia </span>drugs<span><span> and adjuvants, paediatric RA in </span>ambulatory care and discuss the impact of RA by COVID-19.</span></p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 3","pages":"Pages 397-408"},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50198424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthesia for ambulatory surgery 门诊手术的麻醉
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI: 10.1016/j.bpa.2023.05.001
An Teunkens (Kliniekhoofd Anesthesie), A. Valedon (Consultant Anaesthesist)
{"title":"Anesthesia for ambulatory surgery","authors":"An Teunkens (Kliniekhoofd Anesthesie),&nbsp;A. Valedon (Consultant Anaesthesist)","doi":"10.1016/j.bpa.2023.05.001","DOIUrl":"https://doi.org/10.1016/j.bpa.2023.05.001","url":null,"abstract":"","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 3","pages":"Pages 267-268"},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50198418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The future of ambulatory surgery for geriatric patients 老年患者门诊手术的未来
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI: 10.1016/j.bpa.2022.12.004
Mary Ann Vann MD, FASA (Assistant Professor)
{"title":"The future of ambulatory surgery for geriatric patients","authors":"Mary Ann Vann MD, FASA (Assistant Professor)","doi":"10.1016/j.bpa.2022.12.004","DOIUrl":"https://doi.org/10.1016/j.bpa.2022.12.004","url":null,"abstract":"<div><p>The elderly segment of the population is growing rapidly worldwide. Older patients comprise a disproportionate percentage of the surgical caseload. Physiological changes are inevitable with aging; some may impact a patient’s response to anesthesia and surgery. Careful evaluation of an elderly patient preoperatively is vital to proper patient selection for ambulatory surgeries<span>, particularly for complex and lengthy procedures. Cognitive issues, frailty<span>, and geriatric syndromes make a patient vulnerable and sometimes unsuitable for certain ambulatory procedures. Preoperative planning and interventions may improve outcomes for the elderly patient undergoing ambulatory surgery.</span></span></p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 3","pages":"Pages 343-355"},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50198422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The diabetes patient for ambulatory surgery 门诊手术的糖尿病患者
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI: 10.1016/j.bpa.2023.03.002
Mary Ann Vann MD FASA (Assistant Professor)
{"title":"The diabetes patient for ambulatory surgery","authors":"Mary Ann Vann MD FASA (Assistant Professor)","doi":"10.1016/j.bpa.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.bpa.2023.03.002","url":null,"abstract":"<div><p>Perioperative management of blood glucose is vital to the recovery and return to normal life for patients with diabetes undergoing ambulatory surgery<span><span>. Important aspects of the preoperative assessment include the evaluation of the patient's usual level of control and self-management skills and the occurrence of hypoglycemia. There are disputes on the perioperative administration of diabetes medications, insulin, and certain other </span>drugs<span>. This article will provide information on current recommendations for ambulatory surgery and anesthesia for diabetic patients. It will address controversies and reemphasize important points of optimal care. New drugs and technologies for diabetes patients that may impact the perioperative period will be described.</span></span></p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"37 3","pages":"Pages 373-385"},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50198420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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