Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2015
ReviewTo use or not to use hydroxyethyl starch in intraoperative care: are we ready to answer the 'Gretchen question'?
The decision of the European Medicines Agency (EMA) against the use of hydroxyethyl starch (HES)-based volume replacement solutions in critically ill patients has led to a general uncertainty when dealing with HES-based solutions, even though HES-containing solutions can still be used for the treatment of hypovolaemia caused by acute (sudden) blood loss. This review discusses current evidence of the intraoperative use of HES-based solutions. ⋯ The use of 6% HES 130/0.4 in elective surgery patients is associated with reduced fluid accumulation and no clinically relevant difference in bleeding or the rate of acute kidney injury as compared with crystalloid use alone. Current data do not allow a conclusion on mortality. As they provide no benefit, older starch preparations should not be used.
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Curr Opin Anaesthesiol · Jun 2015
ReviewBlood conservation strategies and the management of perioperative anaemia.
Anaemia is a global health problem with particularly high prevalence in the perioperative setting and it can significantly affect the patient outcomes. This review addresses new findings on the significance of anaemia and patient blood management (PBM) strategies to prevent and manage anaemia. ⋯ Despite the high prevalence of anaemia and the significant toll it takes on patients, simple and effective strategies are available to detect, diagnose and treat it.
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Curr Opin Anaesthesiol · Jun 2015
ReviewAspirin in the perioperative period: a review of the recent literature.
The indications for aspirin (ASA) for both primary and secondary prevention of thrombotic events continue to evolve. We review some of these indications and the recent literature regarding the perioperative administration of ASA. ⋯ The continuation or discontinuation of ASA perioperatively remains a complicated issue. Further, well designed trials are needed for additional clarification.
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Curr Opin Anaesthesiol · Jun 2015
Editorial Historical ArticleImproving perioperative outcomes and the giants of evidence-based medicine.