Current opinion in critical care
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Curr Opin Crit Care · Aug 2016
ReviewPostoperative complications of patients undergoing cardiac surgery.
Cardiac surgery is at high risk for the development of postoperative complications involving cardiovascular and respiratory system, as well as kidneys and central nervous system. The aim of this review is to provide an overview on the most recent findings concerning the type and incidence of different complications after cardiac surgery and to summarize the current recommendations. ⋯ Cardiac surgery is still at high risk for postoperative complications. The optimal type of anaesthesia, protective mechanical ventilation during and after surgery as well as haemodynamic management with vasoactive and inotropic drugs is still to be determined.
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Nutritional status and nutrient delivery during critical illness impact clinical outcomes. We have reviewed recent studies that may guide best practices regarding nutrition therapy in critically ill children. ⋯ Systematic research and consensus-based practices are expected to promote optimal nutritional practices in critically ill children with the potential to improve clinical outcomes.
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New data have been made available in the field of haemostasis and thrombosis. Some long-awaited answers to important questions have been published, and some debates have benefited from an updated perspective. ⋯ These new data should help anaesthesiologists and intensivists to better understand and manage massively bleeding patients or direct oral anticoagulants treated patients.
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Curr Opin Crit Care · Aug 2016
Postoperative complications in cardiac patients undergoing noncardiac surgery.
In this article we review the current knowledge on the underlying mechanisms of perioperative myocardial injury, the preoperative methods of predicting these complications, the diagnostic tools for detecting perioperative myocardial injuries, and the available protective strategies to prevent or attenuate the extent of myocardial injury. ⋯ These new insights will help to better tailor individual strategies to prevent or minimize perioperative cardiac complications. Especially, early diagnosis and intensification of treatment will get specific interest in the coming years.