Articles: postoperative-complications.
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Med. Clin. North Am. · Nov 2024
ReviewThe Geriatric Patient: Frailty, Prehabilitation, and Postoperative Delirium.
Historically and for ease of classification, the geriatric patient has received a chronologic definition of a person 65 years and older. Chronologic age remains an independent risk of postoperative complications and adverse surgical outcomes. ⋯ The concept of prehabilitation has shown promise as a proactive approach to optimize a patient's functional, cognitive, nutritional, and emotional in preparation for surgical interventions. Postoperative delirium is the most common neuropsychological complication after surgery.
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Perioperative risks associated with acute hepatitis, cirrhosis, and chronic kidney disease are substantial and prevalence of underlying chronic kidney or liver disease is rising; surgeries in these populations have accordingly become more common. Optimal perioperative management in both cases is paramount; this article focuses on understanding disease pathophysiology, a targeted preoperative evaluation, accurate estimation of perioperative risk, and anticipation and management of common postoperative complications.
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Minerva anestesiologica · Nov 2024
Randomized Controlled TrialIndividualized positive end-expiratory pressure in laparoscopic surgery: a randomized controlled trial.
The reduction in functional residual capacity (FRC) is a significant pathological factor in the development of postoperative pulmonary complications. Appropriate positive end-expiratory pressure (PEEP) is critical to preserve FRC during mechanical ventilation. Our previous study suggests that using driving pressure-guided PEEP can reduce postoperative pulmonary complications. In this study, we hypothesize that individualized PEEP can increase immediate postoperative FRC and improve lung ventilation. ⋯ Driving pressure-guided PEEP can preserve postoperative FRC and provide better ventilation and oxygenation for patients undergoing laparoscopic colorectal surgery.
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To provide improved guidance for the consistent application of the Clavien-Dindo classification (CDC) and Comprehensive Complication Index (CCI ® ) in challenging clinical scenarios. ⋯ The increasing use of the CDC and CCI ® in RCTs highlights the importance of their standardized application. The current consensus on various difficult scenarios may offer novel guidance for the consistent use of the CDC and CCI ® , aiming to improve complication reporting and better quality control, ultimately benefiting all health care stakeholders and, first and foremost, all patients.
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Comparative Study
Robotic Versus Navigation Assisted Posterior Lumbar Fusion: A National Database Study.
Retrospective cohort study. ⋯ Level III.