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Intensive care medicine · Sep 2017
ReviewCurrent research priorities in perioperative intensive care medicine.
- Michael A Gillies, Michael Sander, Andrew Shaw, Duminda N Wijeysundera, John Myburgh, Cesar Aldecoa, Ib Jammer, Suzana M Lobo, Naomi Pritchard, GrocottMichael P WMPWRespiratory and Critical Care Theme, Southampton NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, SO16 6YD, UK., Marcus J Schultz, and Rupert M Pearse.
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. michael.gillies@ed.ac.uk.
- Intensive Care Med. 2017 Sep 1; 43 (9): 1173-1186.
IntroductionSurgical treatments are offered to more patients than ever before, and increasingly to older patients with chronic disease. High-risk patients frequently require critical care either in the immediate postoperative period or after developing complications. The purpose of this review was to identify and prioritise themes for future research in perioperative intensive care medicine.MethodsWe undertook a priority setting process (PSP). A panel was convened, drawn from experts representing a wide geographical area, plus a patient representative. The panel was asked to suggest and prioritise key uncertainties and future research questions in the field of perioperative intensive care through a modified Delphi process. Clinical trial registries were searched for on-going research. A proposed "Population, Intervention, Comparator, Outcome" (PICO) structure for each question was provided.ResultsTen key uncertainties and future areas of research were identified as priorities and ranked. Appropriate intravenous fluid and blood component therapy, use of critical care resources, prevention of delirium and respiratory management featured prominently.ConclusionAdmissions following surgery contribute a substantial proportion of critical care workload. Studies aimed at improving care in this group could have a large impact on patient-centred outcomes and optimum use of healthcare resources. In particular, the optimum use of critical care resources in this group is an area that requires urgent research.
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