Current opinion in anaesthesiology
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Patient decision aids are educational tools used to assist patients and clinicians in healthcare decisions. As healthcare moves toward patient-centered care, these tools can provide support to anesthesiologists by facilitating shared decision-making. ⋯ Patient decision aids can support patient-centered care delivery and shared decision-making, especially in the field of anesthesia. Current research involves implementing the use of patient decision aids in the discussion for monitored anesthesia care. Further development of quality metrics is needed to improve the decision aids and maximize decision quality.
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Curr Opin Anaesthesiol · Apr 2020
ReviewInsights into basic science: what basic science can teach us about iron homeostasis in trauma patients.
This review summarizes recent basic science studies on homeostasis of iron, an essential dietary nutrient and potentially toxic metal, and explores the relevance of these studies to our understanding of trauma and related severe, acute events. ⋯ Perturbations in iron homeostasis can contribute significantly to an individual's predisposition to trauma and their ability to recover posttrauma, whereas pharmacologic targeting of ferroptosis may attenuate severity of trauma-induced organ dysfunction.
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Red cell transfusions are commonly used in management of hemorrhage in trauma patients. The appropriate indications and criteria for transfusion are still debated. Here, we summarize the recent findings on the use of red cell transfusion in trauma setting. ⋯ Although the debate on hemoglobin thresholds for transfusion continues, clinicians should not overlook proper management of the underlying issue (anemia).
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Predatory publishing poses a serious educational end ethical threat to the credibility of science. The aim of this review is to discuss the main features of this deceptive open-access model, its potential consequences and relevance for the whole scientific community. ⋯ Predatory journals and conferences are two sides of the same coin. As here reviewed, their deceptive practices have negative implications for scientists and clinicians, both educational and ethical. These range from publication of experimental data that are unreliable and poorly verified to inflated curricula and 'doped' academic careers. Because clinical practice is heavily based on research data, a solution is needed to ultimately ensure patients' safety.
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The alteration of circadian rhythms in the postoperative period has been demonstrated to influence the outcomes. With this narrative review we would revise how anesthesia, surgery and intensive care can interfere with the circadian clock, how this could impact on the postsurgical period and how to limit the disruption of the internal clock. ⋯ The synergic effect of anesthesia, surgery and postoperative intensive care on circadian rhythms require a careful approach to the patient considering a role for therapies and interventions aimed to re-establish the normal circadian rhythms. Over time, approach like the Awakening and Breathing Coordination, Delirium Monitoring and Management, Early Mobility and Family engagement and empowerment bundle can implement the clinical practice.