Surgical intervention in older people is increasing in prevalance but is associated with higher rates of adverse postoperative outcomes as compared to younger people. Current models of preoperative risk assessment and optimisation may be indequate for this complex surgical population.
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Critical Care
March 4, 2016
Lactic acidosis is a very common biological issue for the postoperative patient with shock. This very nice review addresses thehemodynamic consequences of shock-associated lactic acidosis and highlights the various therapeutic options that can be considered by the bedside clinician.
March 4, 2016
The optimal timing of tracheotomy in critically ill patients remains a topic of debate. The Authors performed a systematic review to clarify the potential benefits of early versus late tracheotomy. Three categories of timing of tracheotomy (within 4 versus after 10 days, within 4 versus after 5 days, within 10 versus after 10 days) were analyzed.
February 28, 2016
In this trial 2100 undergoing coronary surgery were randomized to aspirin 100mg or placebo. The primary outcome was defined as a composite of death and thrombotic complications (myocardial infarction, stroke, pulmonary embolism, renal failure or bowel infarction) at 30 days.
February 23, 2016
This consensus effort provides a new definition for septic shock, which affects a subset of patients with sepsis. The definition requires the presence of circulatory disturbances (BP unresponsive to fluids and requiring pressors), cellular and metabolic abnormalities (serum lactate level >2 mmol/L). The presence of these criteria is associated
February 18, 2016
The authors studied the rate of publication of completed clinical trials performed in academic medical centers in the US. Among over 4,300 such trials, only 36% were published within 2 years of completion, and only 66% were ultimately published at any time. There was considerable variation in publication rates among institutions.
February 18, 2016
The authors studied the relationship of outcomes after non-cardiac surgery to blood transfusion among over 7,300 patients. Patients with significant bleeding were excluded. Patients were stratified according to the occurence of postoperative MI and the nadir hematocrit value (20-24%, 24-27%, 27-30%). The outcome was 30-day mortality. In the no-
February 1, 2016
A retrospective analysis of patients suffering blunt cardiac injury was performed to identify factors associated with mortality. Death was not associated with abnormal ECG or the site or number of bone fractures. Mortality was related to hypotension, elevated lactate, and elevated troponins.
January 13, 2016
Comprehensive review article on the role of periperative statin therapy in patients undergoing coronary revascularization.
November 16, 2015
Data from a large multicenter registry were evaluated to determine whether there is a sex difference in susceptibility to acute kidney injury after CBP related to nadir hematocrit levels. Based on a 21% hematocrit threshold, 9.5% of men and 31.9% of women were affected. Rates of AKI were similar between the sexes. There was a strong interaction be