Articles: post-operative.
-
Delirium is an organic mental syndrome significantly associated with long-term cognitive decline, increased hospital stays and higher mortality. This systematic review of randomised controlled trials (RCTs) with meta-analysis assesses the association of remimazolam with postoperative cognitive function and delirium compared with non-benzodiazepine hypnotics. ⋯ PROSPERO CRD42024532751.
-
The win ratio analysis method might provide new insight on the impact of positive end-expiratory pressure (PEEP) on clinical outcomes. ⋯ Clinicaltrials.gov (study identifier NCT03937375).
-
The integration of enhanced recovery after surgery (ERAS) protocols into the peri-operative management of video-assisted thoracic surgery (VATS) has facilitated rapid patient recovery, enabling discharge within 48 h. However, postoperative pulmonary complications (PPCs) postdischarge pose significant concerns for patient welfare. Despite the established utility of lung ultrasound (LUS) in diagnosing the causes of dyspnoea, the effectiveness of quantitative LUS in predicting PPCs after VATS remains uncertain. ⋯ LUSS on POD 1 emerged as an independent risk factor for PPCs in fast-track VATS patients and reliably predicted the occurrence of PPCs within 30 days of hospital discharge.
-
Perioperative strokes may promote postoperative neurocognitive dysfunction. We thus evaluated the incidence of postoperative strokes and the association between strokes and postoperative neurocognitive outcomes in older patients recovering from non-cardiac surgery. ⋯ One in 9 patients aged 60 years and older who had major non-cardiac surgery, mainly intracranial, experienced a perioperative covert stroke. Covert strokes more than doubled the risk of postoperative delirium and long-term neurocognitive decline. Covert perioperative strokes are common and clinically meaningful.
-
Anesthesia and analgesia · Dec 2024
The Association Between Fluid Management and Intraoperative Blood Pressure and Patients' Outcome After Complex Spine Surgeries.
Both intraoperative hypotension and excessive fluid administration can lead to detrimental perioperative complications. However, how much fluid is considered excessive and how is intraoperative hypotension related to major postoperative complications? ⋯ We discovered a change point in net fluid administration of 1,865mL. Above this change point, higher net fluid administration is associated with increased odds of developing postoperative complications. Intraoperative hypotension in complex spine surgeries was associated with increased postoperative complications.