Significant variability in transfusion practice persists despite guidelines. Although the lysine analogues are effective antifibrinolytics, safety concerns exist with high doses tranexamic acid. Despite recombinant activated factor VII promising results in massive bleeding after cardiac surgery, it significantly increases arterial thromboembolic risk. Aortic valve repair may evolve to standard ...

Objective Retrospective studies and a meta-analysis were performed to evaluate the safety and effectiveness of the perioperative administration of recombinant human brain natriuretic peptide (rhBNP) during cardiac surgery under extracorporeal circulation. Methods Computerized literature searches were performed in Medline, Embase, The Cochrane Library, CNKI, CBM, and WANFANG to find randomized...

BACKGROUND Laparoscopic cholecystectomy (LC), a gold standard procedure for cholelithiasis, is associated with higher incidence of bile duct injuries and perioperative bleeding. These complications are of further concern when LC is carried out on patients with liver cirrhosis. Although LC is now increasingly being performed for cholelithiasis in cirrhotic patients, the safety of the procedure i...

Case reports indicate that diabetes patients receiving outpatient insulin pump therapy have been allowed to continue treatment during surgical procedures. Although allowed during surgery, there is actually little information in the medical literature on how to manage patients receiving insulin pump therapy during a planned surgical procedure. A multidisciplinary work group reviewed current info...

Objectives. To investigate the efficacy and safety of perioperative endocrine therapy (PET) for patients with Cushing's syndrome (CS) undergoing retroperitoneal laparoscopic adrenalectomy (RLA). Methods. The novel, simplified PET modality of 82 patients who underwent RLA procedures for CS were studied. Clinical manifestations were observed for all patients on days 1 and 5 postoperatively, and c...

Anesthesiology, V 127 • No 2 215 August 2017 J OHN Snow was one of the founding fathers of anesthesia in the late nineteenth century and a pioneering epidemiologist. He recorded the details of more than 5,000 anesthetics during more than 12 yr of practice and stressed the importance of accurate drug administration and patient monitoring.1 In 1949, Mackintosh2...

PRACTICE Alerts are consensus-based reports that address specific aspects of patient management, patient care, and patient safety. This Practice Alert reviews published recommendations that address the perioperative management of surgical patients with recently implanted coronary artery stents. The intent of the Alert is to provide the anesthesiologist with information about (1) the increased r...

Within traditional clinical care, the postoperative recovery after pelvic/rectal surgery has been slow with high morbidity and long hospital stay. The enhanced recovery after surgery program is a multimodal approach to perioperative care designed to accelerate recovery and safely reduce hospital stay. This review will briefly summarize optimal perioperative care, before, during and after surger...

BACKGROUND Enhanced recovery after surgery (ERAS) protocols consist of a set of perioperative measures aimed at improving patient recovery and decreasing length of stay and postoperative complications. We assess the implementation and outcomes of an ERAS program for colorectal surgery. METHODS Single center observational study. Data were collected from consecutive patients undergoing open or ...