12Frailty in perioperative medicine
01 June 2019
As the proportion of older people in the population increases so too will the prevalence of age-related diseases, many of which are amenable to surgery. This will result in higher numbers of older people considering and undergoing surgical treatment. However, syndromes such as frailty, multimorbidity and functional dependenc render this cohort prone to adverse postoperative outcomes. Identifying frailty early can facilitate timely shared decision making, resource planning and optimization of health to improve outcomes.
11The importance of pain management in perioperative outcomes
01 April 2019
Recent focus by leading experts on enhanced recovery after surgery has been on not only a patient-specific but also a procedure-specific approach to analgesia in the perioperative period. Analgesic planning should begin at the earliest possible opportunity, not least to adequately counsel patients about what their anaesthetic will likely entail.
01 Feb 2019
Discusses recent evidence for the effectiveness of perioperative exercise programmes in reducing complications.
20 Dec 2018
Discusses evidence for and against stopping renin-angiotensin-aldosterone antagonists perioperatively in cardiac and non cardiac surgery.
8Assessing volume status and fluid responsiveness in critical care
01 Oct 2018
Although insufficient and excessive resuscitation are both associated with worse clinical outcomes, most decisions regarding fluid therapy are still made empirically.
The quintessential questions in fluid resuscitation are what the current state of the patient’s intravascular volume is and whether the patient’s physiological variables will improve if he/she receives continued fluid resuscitation or a fluid bolus?