JournalTOCs

Best Practice & Research Clinical Anaesthesiology
Number of Followers: 15

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1521-6896 - ISSN (Online) 1532-169X
Published by Elsevier

[3200 journals]

Erratum regarding previously published articles
- Abstract: Publication date: Available online 25 September 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s):
Failure to Rescue: A Quality Indicator for Post-operative Care
- Abstract: Publication date: Available online 25 September 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Eric B. Rosero, Bryan T. Romito, Girish P. Joshi
Mechanical ventilation in neurocritical caresetting: a clinical approach
- Abstract: Publication date: Available online 18 September 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Denise Battaglini, Dorota Siwicka Gieroba, Iole Brunetti, Nicolò Patroniti, Giulia Bonatti, Patricia Rieken Macedo Rocco, Paolo Pelosi, Chiara Robba
Cannabis and Cannabidiol (CBD) for the Treatment of Fibromyalgia
- Abstract: Publication date: Available online 15 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Amnon A. Berger, Joseph Keefe, Ariel Winnick, Elasaf Gilbert, Jonathan P. Eskander, Cyrus Yazdi, Alan D. Kaye, Omar Viswanath, Ivan Urits
General Anesthetic Techniques For Enhanced Recovery After Surgery: Current
Controversies
- Abstract: Publication date: Available online 14 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Girish P. Joshi
Navigating the complexities of treating COVID-19 during the Pandemic and a
Multimodal Approach to Chronic Pain
- Abstract: Publication date: Available online 9 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Omar Viswanath, Alan D. Kaye
Treatment and Management of Myofascial Pain Syndrome
- Abstract: Publication date: Available online 8 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Karina Charipova, Kyle Gress, Amanda L. Schaaf, Soham Gupta, Hayley C. Kiernan, Paula E. Choi, Jai Won Jung, Elyse Cornett, Alan D. Kaye, Omar Viswanath
The Role of Acupuncture in the treatment of chronic pain
- Abstract: Publication date: Available online 8 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Megha Patel, Ivan Urits, Alan D. Kaye, Omar Viswanath
The Use of Antineuropathic Medications for the Treatment of Chronic Pain
- Abstract: Publication date: Available online 8 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Nathan Li, Kevin Berardino, Kimberly Aleen Artounian, Prudhvi Bandi, Jai Won Jung, Rachel J. Kaye, Laxmaiah Manchikanti, Adam M. Kaye, Thomas Simopoulos, Alan D. Kaye, Monica Torres, Omar Viswanath
Pharmacologic Options for the Treatment of Chronic Migraine Pain
- Abstract: Publication date: Available online 8 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Kyle Gress, Karina Charipova, Alec M. Zamarripa, Parth M. Patel, Grace Lassiter, Jai Won Jung, Alan D. Kaye, Omar Viswanath
Minimally Invasive Treatment of Lateral Epicondylitis
- Abstract: Publication date: Available online 8 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Michael Markel, Paula Choi, Neeraj Vij, Aaron Tran, Daniel An, Amnon A. Berger, Elyse Cornett, Alan D. Kaye, Omar Viswanath
Cognitive Behavioral Therapy for the Treatment of Chronic Pelvic Pain
- Abstract: Publication date: Available online 8 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Jessica Callan, Warner C. Moore, Mitchell C. Fuller, Jordan S. Renschler, Paul Fisher, Jai Won Jung, Jamal Hasoon, Jonathan Eskander, Alan D. Kaye, Omar Viswanath
An evidence-based review of neuromodulation for the treatment and
management of refractory angina
- Abstract: Publication date: Available online 7 August 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Anjana Patel, Joseph Leider, Anthony Anya, Henry Franscioni, Jai Won Jung, Hisham Kassem, Alan D. Kaye, Omar Viswanath
Management of Postoperative Nausea and Vomiting in the Context of an
Enhanced Recovery After Surgery Program
- Abstract: Publication date: Available online 31 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jonathon Schwartz, Tong J. Gan
Use of Spinal Cord Stimulation for the Treatment of Post Total Knee
Arthroplasty Pain
- Abstract: Publication date: Available online 24 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Michael Markel, Neeraj Vij, Josh Ulanday, Megan Machek, Daniel An, Karina Charipova, Kyle Gress, Jared A. Herman, Alan D. Kaye, Omar Viswanath
Initiatives to broaden safety concerns in anaesthetic practice: The Green
Operating Room
- Abstract: Publication date: Available online 24 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): H. Beloeil, P. Albaladejo
Preoperative laboratory testing: Implications of “Choosing
Wisely” guidelines
- Abstract: Publication date: June 2020Source: Best Practice & Research Clinical Anaesthesiology, Volume 34, Issue 2Author(s): Harish Siddaiah, Shilpadevi Patil, Anitha Shelvan, Kenneth Philip Ehrhardt, Cain W. Stark, Kenneth Ulicny, Sasha Ridgell, Austin Howe, Elyse M. Cornett, Richard D. Urman, Alan D. Kaye
Point-of-care ultrasound in the preoperative setting
- Abstract: Publication date: June 2020Source: Best Practice & Research Clinical Anaesthesiology, Volume 34, Issue 2Author(s): Isabella Meier, Andreas P. Vogt, Massimiliano Meineri, Heiko A. Kaiser, Markus M. Luedi, Matthias Braun
Clinical management of the pregnant patient undergoing non-obstetric
surgery: Review of guidelines
- Abstract: Publication date: June 2020Source: Best Practice & Research Clinical Anaesthesiology, Volume 34, Issue 2Author(s): Chikezie N. Okeagu, Prathima Anandi, Sonja Gennuso, Farees Hyatali, Cain W. Stark, Amit Prabhakar, Elyse M. Cornett, Richard D. Urman, Alan David Kaye
Managing preoperative anemia: Evolving concepts and strategies for
improving patient outcomes
- Abstract: Publication date: June 2020Source: Best Practice & Research Clinical Anaesthesiology, Volume 34, Issue 2Author(s): Chizoba Mosieri, Debbie Chandler, Devin S. Reed, Madelyn K. Craig, Farees Hyatali, Anusha Kallurkar, Elyse M. Cornett, Richard D. Urman, Alan D. Kaye
Perioperative acute kidney injury: Stratification and risk reduction
strategies
- Abstract: Publication date: June 2020Source: Best Practice & Research Clinical Anaesthesiology, Volume 34, Issue 2Author(s): Alexander Gomelsky, Kenneth Abreo, Nazih Khater, Adrian Abreo, Bakhtiar Amin, Madelyn K. Craig, Amit Prabhakar, Elyse M. Cornett, Richard D. Urman, Alan D. Kaye
Metabolic syndrome – Evidence-based strategies for patient
optimization
- Abstract: Publication date: June 2020Source: Best Practice & Research Clinical Anaesthesiology, Volume 34, Issue 2Author(s): Shuhan J. Reyes, Taylor Pak, Tiffany Sun Moon
Pharmacogenomics, Concepts for the Future of Perioperative Medicine and
Pain Management, a Review
- Abstract: Publication date: Available online 22 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Alan D. Kaye, Cody M. Koress, Matthew B. Novitch, Jai Won Jung, Ivan Urits, Omar Viswanath, Jordan S. Renschler, Edward S. Alpaugh, Elyse M. Cornett
Utilization of B12 for the Treatment of Chronic Migraine
- Abstract: Publication date: Available online 20 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Melis Yilmaz, Ehab Bahrun, Caitlin Merley, Logan Scoon, Grace Lassiter, Daniel An, Vwaire Orhurhu, Alan D. Kaye, Omar Viswanath
Occupational burnout syndrome and posttraumatic stress among healthcare
professionals during the novel Coronavirus Disease 2019 (COVID-19)
pandemic
- Abstract: Publication date: Available online 18 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jaroslava Raudenská, Veronika Steinerová, Alena Javůrková, Ivan Urits, Alan D. Kaye, Omar Viswanath, Giustino Varrassi
The use of Positive End Expiratory Pressure in patients affected by
COVID-19: time to reconsider the relation between morphology and
physiology
- Abstract: Publication date: Available online 18 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Gaetano Perchiazzi, Mariangela Pellegrini, Elena Chiodaroli, Ivan Urits, Alan D. Kaye, Omar Viswanath, Giustino Varrassi, Filomena Puntillo
Elective Cardiac Surgery during the COVID-19 Pandemic: Proceed or
Postpone'
- Abstract: Publication date: Available online 18 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Islam M. Shehata, Amir Elhassan, Jai Won Jung, Ivan Urits, Omar Viswanath, Alan D. Kaye
Clinical and Economic Burden of Postoperative Nausea and Vomiting:
Analysis of Existing Cost Data
- Abstract: Publication date: Available online 18 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Kyle Gress, Ivan Urits, Omar Viswanath, Richard D. Urman
Healthcare at the Time of COVID-19: A Review of the Current Situation with
Emphasis on Anesthesia Providers
- Abstract: Publication date: Available online 17 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Martina Rekatsina, Antonella Paladini, Eleni Moka, Cheng Teng Yeam, Ivan Urits, Omar Viswanath, Alan D. Kaye, John A. Morgan, Giustino Varrassi
Impact of Covid-19 pandemic on chronic pain management: looking for the
best way to deliver care
- Abstract: Publication date: Available online 17 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Filomena Puntillo, Mariateresa Giglio, Nicola Brienza, Omar Viswanath, Ivan Urits, Alan D. Kaye, Joseph Pergolizzi, Antonella Paladini, Giustino Varrassi
Treatment Recommendations for Chronic Knee Osteoarthritis
- Abstract: Publication date: Available online 4 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Kyle Gress, Karina Charipova, Daniel An, Jamal Hasoon, Alan D. Kaye, Antonella Paladini, Giustino Varrassi, Omar Viswanath, Alaa Abd-Elsayed, Ivan Urits
Best Practice in Cardiac Anesthesia during the COVID-19 Pandemic:
Practical Recommendations
- Abstract: Publication date: Available online 3 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Eleni Moka, Antonella Paladini, Martina Rekatsina, Ivan Urits, Omar Viswanath, Alan D. Kaye, Cheng Teng Yeam, Giustino Varrassi
The Utilization of Buprenorphine in Chronic Pain
- Abstract: Publication date: Available online 3 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Cynthia Pham, Daniel Swanson, Kevin Berardino, Prudhvi Bandi, Ariunzaya Amgalan, Rachel J. Kaye, Jai Won Jung, Alan D. Kaye, Antonella Paladini, Giustino Varrassi, Adam M. Kaye, Laxmaiah Manchikanti, Omar Viswanath
An evidence-based review of CGRP Mechanisms in the propagation of Chronic
Visceral Pain
- Abstract: Publication date: Available online 3 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Nathan Li, Ehab Bahrun, Hayk Hakobyan, Lekha Anantuni, Daniel An, Amon A. Berger, Alan D. Kaye, Antonella Paladini, Giustino Varrassi, Kevin E. Vorenkamp, Omar Viswanath
Use of cannabidiol (CBD) for the treatment of chronic pain
- Abstract: Publication date: Available online 2 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Kyle Gress, Karina Charipova, Kelly Habib, David Lee, Christopher Lee, Jai Won Jung, Hisham Kassem, Elyse Cornett, Antonella Paladini, Giustino Varrassi, Alan D. Kaye, Omar Viswanath
A comprehensive review of partial opioid agonists for the treatment of
chronic pain
- Abstract: Publication date: Available online 2 July 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Kyle Gress, Karina Charipova, Jai Won Jung, Alan D. Kaye, Antonella Paladini, Giustino Varrassi, Omar Viswanath, Ivan Urits
Preoperative management of anticoagulation in the surgical patient:
highlights of the latest guidelines
- Abstract: Publication date: Available online 12 June 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Hany Elgamal, Markus M. Luedi, Joerg Karl Ender, Massimiliano Meineri
Genomics Testing and Personalized Medicine in the Preoperative Setting:
Can it Change Outcomes in Postoperative Pain Management'
- Abstract: Publication date: Available online 10 June 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Rahul Chaturvedi, Brenton Alexander, Alison M. A’Court, Ruth S. Waterman, Brittany N. Burton, Richard D. Urman, Rodney A. Gabriel
Shared Decision Making – Creating Pathways and Models of Care
- Abstract: Publication date: Available online 6 June 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Sarah K. Abbett, Angela M. Bader, Richard D. Urman
Cognitive Impairment Assessment and Interventions to Optimize Surgical
Patient Outcomes
- Abstract: Publication date: Available online 29 May 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Tasneem F. Hasan, Roger E. Kelley, Elyse M. Cornett, Richard D. Urman, Alan D. Kaye
Multiple Drug Allergies: Recommendations for Perioperative Management
- Abstract: Publication date: Available online 29 May 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Shilpadevi S. Patil, Lu Sun, Charles J. Fox, Kathryn E. Anthony, Fallon A. Anzalone, Paul M. Fisher, Brook Girma, Genkai J. Huang, Emily L. Barsley, Elyse M. Cornett, Richard D. Urman, Alan D. Kaye
Telemedicine for preoperative assessment during a COVID-19 pandemic:
Recommendations for clinical care
- Abstract: Publication date: Available online 14 May 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Maks Mihalj, Thierry Carrel, Igor D. Gregoric, Lukas Andereggen, Pascal O. Zinn, Dietrich Doll, Frank Stueber, Rodney A. Gabriel, Richard D. Urman, Markus M. Luedi
Perioperative glucose management: current status and future directions
- Abstract: Publication date: Available online 11 May 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andreas P. Vogt, Lia Bally
Chronic Pain and Substance Abuse Disorders: Preoperative Assessment and
Optimization Strategies
- Abstract: Publication date: Available online 7 May 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Alan D. Kaye, Sandeep Kandregula, Jennifer Kosty, Anthony Sin, Bharat Guthikonda, G.E. Ghali, Jack W. Gamble, Madelyn K. Craig, Alex D. Pham, Devin S. Reed, Sonja A. Gennuso, Rhett M. Reynolds, Ken "Kenny" Philip Ehrhardt, Elyse M. Cornett, Richard D. Urman
Preoperative Frailty Assessment Combined with Prehabilitation and
Nutrition Strategies: Emerging Concepts and Clinical Importance
- Abstract: Publication date: Available online 24 April 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Karina Gritsenko, Erik Helander, Michael P.K. Webb, Chikezie N. Okeagu, Farees Hyatali, Jordan S. Renschler, Fallon Anzalone, Elyse M. Cornett, Richard D. Urman, Alan D. Kaye
Perioperative Strategies for Reduction of Postoperative Pulmonary
Complications
- Abstract: Publication date: Available online 23 April 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Debbie Chandler, Chizoba Mosieri, Anusha Kallurkar, Alex D. Pham, Lindsey K. Okada, Rachel J. Kaye, Elyse M. Cornett, Charles J. Fox, Richard D. Urman, Alan D. Kaye
Preoperative Patient Evaluation: Challenges and Opportunities
- Abstract: Publication date: Available online 23 April 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Markus M. Luedi, Richard D. Urman
Coagulation, hemostasis and transfusion during liver transplantation
- Abstract: Publication date: Available online 16 March 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Carolyn Thai, Cynthia Oben, Gebhard Wagener
Transplant anesthesia and critical care: current research and possible
future developments
- Abstract: Publication date: Available online 12 March 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Claus U. Niemann, Gianni Biancofiore
Enhanced recovery after surgery and practical application to liver
transplanation
- Abstract: Publication date: Available online 18 February 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): M. Susan Mandell, Jiapeng Huang, Jing ZhaoAbstractThere is a growing support for the use of protocols that incorporate multiple steps aimed to reduce the time patients require to regain health. A recurring limitation is the variable outcomes of these protocols with more or less success at the sites they are instituted. This review examines the essential building blocks needed to launch a successful ERAS protocol. It address why there are differences in outcome measures between centers such as length of stay and the cost of care even if the protocols and patient populations are similar.To understand what factors can affect the success of an enhanced recovery program, we explore ERAS as a process rather than a summary of detailed care steps. The influence of integrated care delivery, leadership style and choice of goals of care are explained in the context of ERAS as a process of how medical care is delivered. ERAS is presented as a solution to fragmented health care delivery which increases the cost of care and often delays recovery. The importance of Integrated Delivery System and its relationship to high quality healthcare delivery and better outcomes is explored. The role of ERAS in liver transplant is examined and how the clinical goal of early extubation resulted in a progression of evidence-based care steps to that are consistent with ERAS protocols.
Preoperative cardiac assessment in liver transplant candidates
- Abstract: Publication date: Available online 18 February 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrea De Gasperi, Gregorio Spagnolin, Martina Ornaghi, Laura Petrò, Gianni BiancofioreAbstractNew and extended indications, older age, higher cardiovascular risk, and the long-standing cirrhosis - associated complications mandate specific skills for an appropriate preoperative assessment of the LT candidate. The incidence of cardiac diseases (dysrhythmias, cardiomyopathies, coronary artery disease, valvular heart disease) are increasing among LT recipients: however, no consensus exists among clinical practice guidelines for cardiovascular screening and risk stratification. In spite of different “transplant center-centered protocols”, basic “pillars” are common (electrocardiography, baseline echocardiography, functional assessment). Due to intrinsic limitations, yields and relevance of noninvasive stress tests, under constant scrutiny even if used, are discussed, focusing the definition of the “high risk” candidate and exploring noninvasive imaging and new forms of stress imaging. The aim is to find an appropriate and rational stepwise algorithm. The final commitment is to select the right candidate for a finite resource, the graft, able to save (and change) lives.
“Perioperative management of anti-thrombotic treatment”
- Abstract: Publication date: Available online 29 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Alberto Zanetto, Marco Senzolo, Annabel BlasiAbstractEnd stage liver disease is characterized by multiple and complex alterations of hemostasis that are associated with an increased risk of both bleeding and thrombosis. Liver transplantation further challenges the feeble hemostatic balance of patients with decompensated cirrhosis, and the management of anti-thrombotic treatment during and after transplant surgery is particularly difficult. Bleeding was traditionally considered the major concern during and early after surgery, but it is increasingly recognized that transplant recipients may also develop thrombotic complications. Pathophysiology of hemostatic complications during and after transplantation is multifactorial and include pre-, intra-, and post-operative risk factors. Risk stratification is important, as it helps the identification of high-risk recipients in whom anti-thrombotic prophylaxis should be considered. In recipients who develop thrombosis during or after surgery, prompt treatment is indicated to prevent graft failure, re-transplantation, and death.
Anesthesia for combined liver-thoracic transplantation
- Abstract: Publication date: Available online 25 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Miriam Zeillemaker - Hoekstra, Carlijn I. Buis, Vlado Cernak, Koen MEM. ReyntjensAbstractThe combined transplantation of a thoracic organ and the liver is performed in patients with dual-organ failure in whom survival is not expected with single-organ transplantation alone. Although uncommonly performed, the number of combined liver-lung and liver-heart transplants is increasing. Anesthetic management of this complex procedure is challenging. Major blood loss, prolonged operation time, difficult weaning of cardiopulmonary bypass and coagulation disturbances are common. Despite the complexity of surgery, outcome is comparable to single organ transplant.
Critical Care Management in Patients with Acute Liver Failure
- Abstract: Publication date: Available online 23 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Nadja Rifaie, Fuat H. SanerAbstractAcute liver failure is defined as severe hepatic dysfunction (marked transaminases elevation, detoxification disorder (jaundice and coagulopathy with INR> 1.5)Presence of hepatic encephalopathy and exclusion of underlying chronic liver disease and a secondary cause like sepsis or cardiogenic shock.Reasons for acute liver failure includes paracetamol -and warfarin toxicity, autoimmune – and viral (mainly hepatitis B and E) hepatitis, herbal and dietary supplements. Even in term of meticulous and careful review of the patient around 20-30% of the reasons remains unknown. In order of its rarity, randomized controlled trial could hardly be done. However, due to improved ICU treatment, the mortality, even in advanced stage of ALF decreased. However, in 5-10% of the cases an emergency transplantation is required. This justifies the treatment of this patient cohort in institutions who can provide this kind of treatment.
Perioperative considerations for kidney and pancreas-kidney
transplantation
- Abstract: Publication date: Available online 22 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Beatriz Tena, Marina VendrellSummaryKidney transplantation is the treatment of choice in patients with end-stage renal disease, as it improves survival and quality of life. Living donor kidney transplant prior to pancreas transplantation, or simultaneous pancreas and kidney transplantation are also discussed.Patients usually present comorbidities, and extensive preoperative workups are recommended, especially cardiac assessment, though type and frequency of surveillance is not established.Nefroprotective strategies include adequate fluid status and goal-directed therapy. The classical use of diuretics has not demonstrated a real nefroprotective effect at follow-up. Thromboprophylaxis regimes, especially for the pancreatic graft outcome, are of importance.Of note, transplantation in the obese population has increased in the last decades. Strict preoperative evaluation and pulmonary considerations must be kept in mind.Finally, robotic kidney transplant is a recent approach that presents anesthetic challenges, mainly related to steep Trendelemburg position and fluid restriction.
Economic considerations in abdominal transplantation
- Abstract: Publication date: Available online 22 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Evan E. Lebovitz, Anh Vinh T. Nguyen, Tetsuro SakaiAbstractCare for end-stage organ failure through transplant is one of the landmark accomplishments of the modern medicine. At the same time, organ transplant is a resource-intensive service that has been under increasing scrutiny in this era of cost containment. A detailed understanding of the economic implications of organ quality, recipient characteristics, and allocation policy is vital for the transplant professionals. Prior studies of kidney transplant economics demonstrate significant cost savings achieved by eliminating the need for long-term dialysis. However, transplant providers are experiencing higher financial costs because of changes in recipient characteristics. Liver transplantation economics are also more challenging because of the severity of illness-based organ allocation. Furthermore, the broader use of marginal organs has been demonstrated to increase costs. Novel strategies are vital to reduce the financial burden faced by the centers that perform transplantations on elevated risk patients and utilize lower quality organs.
Splanchnic and systemic circulation cross talks: Implication for
hemodynamic management of liver transplant recipient
- Abstract: Publication date: Available online 17 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ahmed Mukhtar, Ahmed Lotfy, Amr Hussein, Eman FouadAbstractThe interaction between splanchnic and systemic circulation has many hemodynamic and renal consequences during liver transplant. In patient with liver cirrhosis, splanchnic vasodilatation causes arterial steal from systemic circulation into splanchnic bed which decreases effective blood volume. Moreover, rapid volume loading in these patients has little impact on cardiac output because higher proportion of infused fluid is shifted to splanchnic area. Thus, in dissection phase the traditional approach of volume loading to maintain intraoperative hemodynamic stability seems not only ineffective but also may aggravate surgical bleeding. Two approaches of volume therapy have been mentioned to maintain hemodynamic stability during liver transplantation: splanchnic volume reduction by volume restriction with or without and splanchnic decongestion by using splanchnic vasoconstrictors. After reperfusion, increase in central blood volume was thought to have deleterious effect on the new graft function, however, the precise central venous pressure value that causes hepatic congestion after reperfusion is unknown.
Manuscript submission to Best Practice & Research: Clinical Anesthesiology
Acute Kidney Injury: A Critical Care Perspective for Orthotopic Liver
Transplantation
- Abstract: Publication date: Available online 17 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrew J. MacDonald, Constantine J. KarvellasAbstractAcute kidney injury is associated with high perioperative mortality in patients undergoing liver transplantation. In the era of Model of End-stage Liver Disease score-based allocation, more patients with impaired renal function are receiving liver transplantation. The majority of preoperative acute kidney injury is secondary to azotemia, including hepatorenal syndrome—a progressive form of renal impairment unique to liver failure. Prompt recognition and initiation of cause-directed therapies are central to improving post-transplant survival. Given this, healthcare providers must develop an expertise in liver failure-related renal complications, specifically their management and perioperative implications. Notably, acute kidney injury may complicate intraoperative course, exacerbating hemodynamic instability, metabolic acidosis, and electrolyte and coagulation abnormalities. Adjunctive intraoperative continuous renal replacement therapy has been employed; however, prospective studies remain necessary to validate potential benefits.
Liver Transplantation For Acute-On-Chronic Liver Failure
- Abstract: Publication date: Available online 16 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Dana Tomescu, Mihai Popescu, Gianni BiancofioreAbstractAcute-on-chronic liver failure represents a newly defined entity in patients with liver disease leading to multiple organs failures and increased mortality. To date, no universally accepted definition exists, and different academic societies developed guidelines on the early diagnosis and classification of Acute-on-chronic liver failure. Recently published trials focused on factors associated with a poor outcome and on the development of severity scores aimed to identify patients who may benefit for advanced monitoring and treatment. No specific therapies are demonstrated to improve survival and liver transplantation remains the only treatment associated with improved outcome.Our review focuses on current evidence for early diagnosis and prognostication of disease in patients with Acute-on-chronic liver failure, as well of criteria for intensive care unit admission, indication and futility markers of liver transplantation, as well as bridging therapy and optimal timing of surgery.
Upper Extremity Regional Anesthesia Techniques: A Comprehensive Review for
Clinical Anesthesiologists
- Abstract: Publication date: Available online 20 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, Sudipta Sen, Nadia Hernandez, Johanna Blair De Haan, Rebecca A. Budish, Christopher Bailey, Joseph Ragusa, Pankaj Thakur, Vwaire Orhurhu, Ivan Urits, Elyse M. Cornett, Alan David KayeAbstractSurgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in clinical setting include the interscalene, supraclavicular, infraclavicular and axillary brachial plexus blocks. These blocks are most commonly performed with the use of ultrasound guided techniques whereby analgesia is achieved by anesthetizing the brachial plexus at different levels such as the roots, divisions, cords and branches. Additional regional anesthetic techniques for upper extremity surgery include wrist, intercostobrachial, and digital nerve blocks, which are most frequently performed using landmark anatomical techniques. This review provides a comprehensive summary of each of these blocks including anatomy, best practice techniques, and potential complications.
Measuring and Monitoring Cognition in the Postoperative Period
- Abstract: Publication date: Available online 18 January 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Lucy H. Piggin, Stanton P. NewmanAbstractIt is common for patients of all ages to experience some degree of cognitive disturbance following surgery. In most cases, impairment appears mild and is restricted to the acute post-operative period, resolving steadily and speedily. In a small number of cases, however, deficits may be more pronounced and/or endure for longer periods, significantly delaying recovery and increasing the risk of serious clinical complications. The ability to accurately measure postoperative cognition, and track recovery of function, is an important clinical task. This review explores practical and methodological issues that may confound this process, examining how best to obtain reliable and meaningful measures of cognition before and after surgery. It considers neuropsychological test selection, administration, analysis and interpretation and offers evidence-based practice points for clinicians and researchers.