Articles: postoperative.
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Pediatr Crit Care Me · Dec 2023
ReviewVascular Reconstruction After Cannulation for Support With Extracorporeal Membrane Oxygenation: Literature Review of Data in the Pediatric Population.
Extracorporeal membrane oxygenation (ECMO) is an invaluable life-support resource in the treatment of critically ill children. Traditionally, neck vascular cannulation requires ligation of the carotid artery and jugular vein. In this literature review, we identify rates of postoperative vessel patency, complications, and neurologic outcomes after vascular reconstruction following decannulation. ⋯ Vascular reconstruction after ECMO decannulation has been reported since 1990. Although reconstruction does not appear to carry significant short-term morbidity, there are no large prospective studies or randomized controlled trials demonstrating its efficacy in improving neurologic outcomes in ECMO patients. There is also a paucity of data regarding outcomes in older children or long-term ramifications of vascular reconstruction.
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Quality indicators are used to monitor the quality and safety of care in ambulatory surgery, a specialty in which major morbidity and mortality remain low. As the demand for safe and cost-effective ambulatory surgical care continues to increase, quality indicators and metrics are becoming critical tools used to provide optimal care for these patients. ⋯ Quality indicators will continue to play a growing role in the monitoring of quality and safety in ambulatory surgery, especially with the trend towards value-based reimbursement models and efficient, cost-effective surgical care. Additionally, quality indicators are useful tools to monitor postoperative patient outcomes and recovery pathways and the efficiency of operating room utilization and scheduling.
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Anesthesia and analgesia · Dec 2023
Randomized Controlled TrialPreoperative Ultrasound-Guided Internal Branch Block of Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Double Lumen Endotracheal Intubation: A Randomized Trial.
Postoperative sore throat (POST) is one of the more common side effects of tracheal intubation patients under general anesthesia (GA) after extubation using double-lumen endobronchial tubes (DLTs). The internal branches of the superior laryngeal nerve (SLN) block (iSLNB) have been reported to anesthetize the larynx for airway manipulation (such as awake tracheal intubation) and pain treatment efficiently. We hypothesized that ultrasound-guided iSLNB (US-guided iSLNB) combined with GA would ameliorate the incidence and severity of POST and hoarseness. ⋯ Preoperative US-guided iSLNB could significantly ameliorate the incidence and severity of POST induced by double-lumen bronchial catheter intubation.
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Curr Opin Anaesthesiol · Dec 2023
ReviewThe future of postoperative vital sign monitoring in general wards: improving patient safety through continuous artificial intelligence-enabled alert formation and reduction.
Monitoring of vital signs at the general ward with continuous assessments aided by artificial intelligence (AI) is increasingly being explored in the clinical setting. This review aims to describe current evidence for continuous vital sign monitoring (CVSM) with AI-based alerts - from sensor technology, through alert reduction, impact on complications, and to user-experience during implementation. ⋯ The current evidence for AI-aided CSVM suggest a significant role for the technology in reducing the constant 10-30% in-hospital risk of severe postoperative complications. However, large, randomized trials documenting the benefit for patient improvements are still sparse. And the clinical uptake of explainable AI to improve implementation needs investigation.