Articles: cations.
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Curr Opin Anaesthesiol · Jun 2022
ReviewOpioid abuse and perioperative care: a new medical disease.
This review article aims to describe the perioperative clinical implications of opioid use or opioid use disorder (OUD) and to provide recommendations related to analgesia, anesthesia, and postoperative care for patients with this 'new medical disease'. ⋯ A coordinated, evidence-based, multidisciplinary team approach is critical when caring for patients with OUD to ensure safety, provide adequate analgesia, and reduce the risk of relapse. Enhanced postoperative monitoring, multimodal analgesia, and a plan for preoperative opioid management may help to modify the risks of adverse postoperative outcomes.
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To identify and synthesize the scientific literature on virtual reality (VR)-based mindfulness applications for the management of chronic pain in adults. ⋯ While studies suggested VR could improve chronic pain management by enhancing the practice of mindfulness, weak study designs and small sample sizes limited the utility of the review results. Future research should rigorously co-design and test VR-based mindfulness applications with people with chronic pain to assess if they improve health and other outcomes.
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Curr Opin Crit Care · Jun 2022
ReviewElectrical impedance tomography in the adult intensive care unit: clinical applications and future directions.
Electrical impedance tomography (EIT) is a novel, noninvasive, radiation-free, bedside imaging and monitoring tool to assess and visualize regional distribution of lung ventilation and perfusion. Although primarily a research tool, rapidly emerging data are beginning to define its clinical role, and it is poised to become a ubiquitous addition to the arsenal of the intensive care unit (ICU). In this review, we summarize the data supporting clinical use of EIT in adult ICUs, with an emphasis on appropriate application while highlighting future directions. ⋯ As EIT becomes more common and its clinical role more defined, intensivists will benefit from a clear understanding of its applications and limitations.
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Anesthesia and analgesia · Jun 2022
ReviewThe Changing Face of Cystic Fibrosis: An Update for Anesthesiologists.
Cystic fibrosis (CF) is the most common fatal genetic disease in North America. While CF is more common among Whites, it is increasingly being recognized in other races and ethnicities. Although there is no cure, life expectancy has steadily improved, with the median survival exceeding 46 years in the United States. ⋯ CF is a multisystem disease that affects primarily the lungs, pancreas, hepatobiliary system, and reproductive organs. Anesthesiologists routinely encounter CF patients for various surgical and medical procedures, depending on the age group. This review article focuses on the changing epidemiology of CF, advances in the classification of CFTR mutations, the latest innovations in CFTR modulator therapies, the impact of the coronavirus disease pandemic, and perioperative considerations that anesthesiologists must know while caring for patients with CF.
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Curr Opin Crit Care · Jun 2022
ReviewThe weaning from mechanical ventilation: a comprehensive ultrasound approach.
Due to heart, lung and diaphragm interactions during weaning from mechanical ventilation, an ultrasound integrated approach may be useful in the detection of dysfunctions potentially leading to weaning failure. In this review, we will summarize the most recent advances concerning the ultrasound applications relevant to the weaning from mechanical ventilation. ⋯ The present review summarizes the potential role of ultrasonography in the weaning process. A multimodal integrated approach allows the clinician to comprehend the pathophysiological processes of weaning failure.