BACKGROUND Guidelines support the use of a restrictive strategy in blood transfusion management in a variety of clinical settings. However, recent randomized controlled trials (RCTs) performed in the perioperative setting suggest a beneficial effect on survival of a liberal strategy. We aimed to assess the effect of liberal and restrictive blood transfusion strategies on mortality in perioperat...

This review considers the changing nature of surgical risk assessment and the definition of risk; discusses the pathophysiology of perioperative myocardial infarction in relation to tests of coronary flow reserve; surveys the extensive literature on preoperative myocardial perfusion imaging (MPI) and outlines key trends; presents practical points on image interpretation; addresses the needs of ...

BACKGROUND The purpose of this study was to determine the predictive value of dobutamine stress echocardiography for perioperative cardiac events in patients scheduled for elective major noncardiac vascular surgery. METHODS AND RESULTS Patients (n = 136; mean age, 68 years) unable to exercise underwent a dobutamine stress test before surgery (incremental dobutamine infusion [10-40 micrograms....

SUMMARY Preoperative frailty predicts adverse postoperative outcomes. Recommendations for preoperative assessment of elderly patients include performing a frailty assessment. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical health care professionals' perception and use of frailty assessment for perioperative care. We survey...

BACKGROUND The aim of this study was to survey the relative importance of postoperative recovery targets and perioperative care items, as perceived by a large group of international dedicated professionals. METHODS A questionnaire with eight postoperative recovery targets and 13 perioperative care items was mailed to participants of the first international Enhanced Recovery After Surgery (ERA...

Objectives This study examined the effect of flipped learning in comparison to traditional learning in a surgical nursing practicum. Methods The subjects of this study were 102 nursing students in their third year of university who were scheduled to complete a clinical nursing practicum in an operating room or surgical unit. Participants were randomly assigned to either a flipped learning gro...

OBJECTIVE Open prostatectomy (OP) is a valid option for the surgical treatment of large prostates in the absence of holmium laser enucleation. The most frequent complication of OP is intra- and perioperative bleeding. Preoperative use of dutasteride has been shown to reduce vascularity and perioperative bleeding in transurethral resection of the prostate (TUR-P). However, there has been no stud...

BACKGROUND Lung-protective ventilation in patients with acute respiratory distress syndrome improves mortality. Adopting this strategy in the perioperative period has been shown to reduce lung inflammation and postoperative pulmonary and non-pulmonary sepsis complications in patients undergoing major abdominal surgery. We conducted a prospective observational study into the intra-operative vent...

BACKGROUND There is only limited empirical evidence about the effectiveness of opinion leaders as health care change agents. AIM To test the feasibility of identifying, and the characteristics of, opinion leaders using a sociometric instrument and a self-designating instrument in different professional groups within the UK National Health Service. DESIGN Postal questionnaire survey. SETTI...

OBJECTIVE To test a causal model of the impact of (a) nursing unit context on professional nursing practice; (b) professional practice on selected organizational (nurses' work satisfaction, nursing turnover, average length of patient stay) and patient outcomes (patient satisfaction, rate of reported medication errors, and falls); and (c) nursing unit context on these same organizational and pat...