Safety amid the scalpels: creating psychological safety in the operating room.

Purpose Of Review: We briefly review the concept of psychological safety and discuss the actions that can create it in the anesthesiologist's work environment.

Recent Findings: The interest in psychological safety has grown in popularity since the publication of Amy Edmondson's book The Fearless Organization in 2018. While the concept and its benefits are described in the healthcare literature, the specific actions necessary to create it are often not.

Planned Venovenous-Extracorporeal Membrane Oxygenation as a Bridge to Orthotopic Liver Transplant Performed for Very Severe Hepatopulmonary Syndrome: A Case Report.

Concerns related to poor oxygenation in patients with severe hepatopulmonary syndrome (HPS) may be prohibitive when considering their candidacy for liver transplantation. Extracorporeal membrane oxygenation (ECMO) has been utilized in only a few case reports as a bridge to liver transplant in patients with severe respiratory failure. We report a case of a 66-year-old man with cirrhosis and very severe (arterial oxygen pressure (PaO2) < 50 mmHg) hepatopulmonary syndrome who underwent an orthotopic liver transplant with the planned use of venovenous-ECMO.

Single center outcomes from parenchymal-sparing resections and microwave ablations for neuroendocrine tumor liver metastases.

Background: Reported outcomes after surgical debulking in patients with advanced neuroendocrine tumor liver metastases (NETLM) are sparse.

Methods: NETLM patients that underwent surgical debulking from 2019 to 2021 were reviewed. Trends in perioperative liver function, complications, symptom response, and progression-free survival were examined.

Whole blood use in trauma resuscitation: targeting prehospital transfusion.

Purpose Of Review: Trauma resuscitation management has evolved over the years with a more nuanced understanding of the injured patient's physiologic state of shock. The purpose of this review is to discuss the role of whole blood administration in the prehospital setting in the resuscitation of the trauma patient.

Recent Findings: In traumatically injured patients, whole blood administration initiated in the prehospital setting may improve early shock severity, coagulopathy, and survival when used over traditional resuscitation fluids such as crystalloid administration or component therapy.

Combined heart-liver-kidney transplant: The university of Chicago medicine experience.

Background: Until recently, combined heart-liver-kidney transplantation was considered too complex or too high-risk an option for patients with end-stage heart failure who present with advanced liver and kidney failure as well.

Aims: The objective of this paper is to present our institution's best practices for successfully executing this highly challenging operation. At our institution, referral patterns are most often initiated through the cardiac team.

Guide to Enhanced Recovery for Cancer Patients Undergoing Surgery: ERAS for Patients Undergoing Cytoreductive Surgery with or Without HIPEC.

ERAS protocols may reduce length of stay and return to full functional recovery after cytoreductive surgery and HIPEC. Prehabilitation programs and post-operative goal directed pathways, along with other essential components of ERAS are discussed with supporting evidence.

Preoperative Risk and the Association between Hypotension and Postoperative Acute Kidney Injury.

Background: Despite the significant healthcare impact of acute kidney injury, little is known regarding prevention. Single-center data have implicated hypotension in developing postoperative acute kidney injury. The generalizability of this finding and the interaction between hypotension and baseline patient disease burden remain unknown.

Association between postoperative complications and lingering post-surgical pain: an observational cohort study.

Background: Post-surgical pain that lingers beyond the initial few-week period of tissue healing is a major predictor of pain chronification, which leads to substantial disability and new persistent opioid analgesic use. We investigated whether postoperative medical complications increase the risk of lingering post-surgical pain.

Methods: The study population consisted of patients undergoing diverse elective surgical procedures in an academic referral centre in the USA, between September 2013 and May 2017.

Modifiable and Nonmodifiable Factors Associated With Perioperative Failure of Extraglottic Airway Devices.

Background: Extraglottic airway device (EGA) failure can be associated with severe complications and adverse patient outcomes. Prior research has identified patient- and procedure-related predictors of EGA failure. In this retrospective study, we assessed the incidence of perioperative EGA failure at our institution and identified modifiable factors associated with this complication that may be the target of preventative or mitigating interventions.

Explaining racial disparities in outcomes after cardiac surgery: the role of hospital quality.

Importance: Racial disparities in mortality rates after coronary artery bypass graft (CABG) surgery are well established. We have yet to fully understand how care at high-mortality, low-quality hospitals contributes to racial disparities in surgical outcomes.

Objective: To determine the effects of hospital quality on racial disparities in mortality rates after CABG surgery.

Portrayal of organ donation and transplantation on American primetime television.

Recently, both living and deceased organ donation rates have hit a plateau, despite increases in need for viable organs. One approach to improve donation rate is public education and policy; thus, it is necessary to understand the information the public is receiving regarding organ donation. We hypothesized that primetime medical dramas portray organ donation and transplantation in a negative manner.