Perioperative Quality Initiative and Enhanced Recovery After Surgery-Cardiac Society Consensus Statement on the Management of Preoperative Anemia and Iron Deficiency in Adult Cardiac Surgery Patients.

Preoperative anemia is common in patients presenting for cardiac surgery, with a prevalence of approximately 1 in 4, and has been associated with worse outcomes including increased risk of blood transfusion, kidney injury, stroke, infection, and death. Iron deficiency, a major cause of anemia, has also been shown to have an association with worse outcomes in patients undergoing cardiac surgery, even in the absence of anemia. Although recent guidelines have supported diagnosing and treating anemia and iron deficiency before elective surgery, details on when and how to screen and treat remain unclear.

Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine.

Background: Perioperative arterial blood pressure management is a physiologically complex challenge influenced by multiple factors.

Methods: A multidisciplinary, international working subgroup of the Third Perioperative Quality Initiative (POQI) consensus meeting reviewed the (patho)physiology and measurement of arterial pressure as applied to perioperative medicine. We addressed predefined questions by undertaking a modified Delphi analysis, in which primary clinical research and review articles were identified using MEDLINE.

Correction to: American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery.

[This corrects the article DOI: 10.1186/s13741-016-0049-9.].

Analgesia in the surgical intensive care unit.

Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists.

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery.

Background: Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery "bundles" because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated).

Fluid resuscitation practice patterns in intensive care units of the USA: a cross-sectional survey of critical care physicians.

Background: Fluid resuscitation is a cornerstone of intensive care treatment, yet there is a lack of agreement on how various types of fluids should be used in critically ill patients with different disease states. Therefore, our goal was to investigate the practice patterns of fluid utilization for resuscitation of adult patients in intensive care units (ICUs) within the USA.

Methods: We conducted a cross-sectional online survey of 502 physicians practicing in medical and surgical ICUs.

Four phases of intravenous fluid therapy: a conceptual model.

I.V. fluid therapy plays a fundamental role in the management of hospitalized patients.

Postoperative delirium: etiology and management.

Purpose Of Review: Postoperative delirium is a pervasive and complicated process that poses numerous challenges for the perioperative physician and entails significant consequences for the patient.

Recent Findings: Postoperative delirium affects on average 36.8% of surgical patients, ranging from 9 to 87% depending on age, setting, type of surgery and other risk factors.

ABO blood group and bleeding after coronary artery bypass graft surgery.

Low circulating von Willebrand factor levels increase the risk of bleeding after cardiac surgery. Patients with blood group O may be at greatest risk owing to lower baseline levels of von Willebrand factor compared with patients with other blood groups, and perioperative hemodilution during cardiac surgery may reduce von Willebrand factor to critical levels in these patients. This study tested the hypothesis that patients with blood group O are at increased risk for postoperative bleeding following cardiac surgery, and determined whether the blood group affected perioperative assessment of primary hemostasis.

The kaolin-activated Thrombelastograph predicts bleeding after cardiac surgery.

Objective: The objective of this study was to determine the relationship of the kaolin-activated Thrombelastograph (TEG) with postoperative bleeding and laboratory tests of coagulation in the setting of cardiac surgery with the routine use of -aminocaproic acid.

Design: Prospective observational study.

Setting: An adult heart center at a tertiary referral, university hospital.

Pulmonary and renal function following cardiopulmonary bypass is associated with systemic capillary leak.

Objective: The purpose of this study was to compare perioperative capillary permeability during cardiac surgery with subsequent pulmonary and renal function.

Design: An observational prospective comparison of capillary permeability (microalbuminuria) during and after cardiopulmonary bypass (CPB), with postoperative pulmonary and renal function.

Setting: A university teaching hospital.