Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Apr 2020
ReviewFrom the ICU to the operating room: how to manage the patient?
To outline key points for perioperative ICU optimization of nutrition, airway management, blood product preparation and transfusion, antibiotic prophylaxis and transport. ⋯ ICU patients who require surgery may benefit from appropriate perioperative management.
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Curr Opin Anaesthesiol · Apr 2020
ReviewOld, older, the oldest: red blood cell storage and the potential harm of using older red blood cell concentrates.
Over the last decades, clinical studies have suggested that transfusion of red blood cells (RBCs) might negatively impact patient outcomes. Even though large randomized clinical trials did not show differences in mortality when transfusing fresh versus standard-issue RBC units, data imply that RBCs at the very end of storage could elicit negative effects. ⋯ Further research to improve the quality of RBC units and to study populations potentially at risk is warranted. Until the question whether transfusion of old blood is detrimental for specific patient populations has been answered, a deliberate use of RBC transfusion should be implemented.
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Curr Opin Anaesthesiol · Apr 2020
ReviewInflammatory response in trauma patients: are there ways to decrease the inflammatory reaction?
Trauma patients are considered a complex population of patients in emergency medicine and need extensive, specialized therapy. One major part is the prevention and treatment of the inflammatory response, which occurs in patients after severe injury resulting in complications like endotheliopathy. Likely as a consequence, coagulopathy occurs. Sterile inflammation is hard to address, especially because of the lack of a single activator. Moreover, it is a complex composition of factors that lead to a pathologic immune response. Our understanding of these patterns is increasing, but the complete pathophysiologic changes have yet to be investigated. Therefore, there is no specific target to treat inflammatory response in trauma patients at the moment. ⋯ Our increasing understanding of the immune system have led to new potential therapeutic perspectives. All of these approaches need further research to be validated. As the current therapies are based on empirical strategies and have not changed much over the years, new treatment options would be an important progress.
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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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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.