Context And Objective: Although it is generally agreed that a medical history and physical examination should be obtained as part of preoperative evaluation, there is still substantial controversy about the additional benefits of preoperative screening tests. The objective of the present study was to determine the percentage of abnormalities on laboratory tests among a population that underwent non-cardiac surgery and to correlate these tests with changes in preoperative evaluation management.
Design And Setting: Cross-sectional study, carried out in a University Hospital.
Methods: 991 patients aged over 40 years undergoing elective non-cardiac surgery from July 1997 to January 2000 were studied. Blood cell count, serum sodium, potassium, urea and creatinine, prothrombin, thrombin and partial thromboplastin time, electrocardiogram and chest X-ray were evaluated.
Results: Out of the 957 electrocardiograms performed, some type of abnormality was found in 504 cases (50.9%) and, among the 646 chest X-rays requested, 271 (42.0%) displayed alterations. Laboratory tests showed abnormal values ranging from 5.1% (prothrombin time) to 41.0% (hematocrit). Increased percentages of abnormal tests with increasing patient age were also observed.
Conclusions: Although there were substantial numbers of screening test abnormalities in preoperative evaluations, these results seldom interfered in patient management.
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http://dx.doi.org/10.1590/s1516-31802005000200003 | DOI Listing |
BMJ Open
January 2025
Department of Anesthesia and Operation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Introduction: Acute normovolaemic haemodilution (ANH) is a perioperative blood management technique involving the removal of whole blood and simultaneous infusion of colloids or crystalloids to achieve haemodilution while maintaining normovolaemia. However, its efficacy in reducing the requirement for perioperative allogeneic blood transfusion remains controversial due to inconsistent findings in the literature. An individualised red cell transfusion strategy, guided by the West China Liu's Score, has demonstrated effectiveness in reducing the need for allogeneic red cell transfusion.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
Background: Depression affects individuals across various ages but is of significance in the older surgical population due to its adverse impact on cognitive function, surgical recovery, and overall functional disability. This study aimed to determine the overall prevalence and trajectory of depression in older surgical patients preoperatively, and at 30-, 90- and 180-days postoperatively.
Method: This study is a prespecified sub-study and analysis of the Postoperative Functional Disability in Unrecognized Cognitive Impairment Study.
Eur Heart J Acute Cardiovasc Care
January 2025
Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea.
Background: The long-term effects of early left ventricular unloading after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain unclear.
Methods: The EARLY-UNLOAD trial was a single-center, investigator-initiated, open-label, randomized clinical trial involving 116 patients with cardiogenic shock (CS) undergoing VA-ECMO. The patients were randomly assigned to undergo either early routine left ventricular unloading by transseptal left atrial cannulation within 12 hours after randomization or the conventional approach, which permitted rescue transseptal cannulation in case of an increased left ventricular afterload.
Crit Care
December 2024
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Background: Excessive exposure to adrenergic vasopressors may be harmful. Non-adrenergic vasopressors may spare adrenergic agents and potentially improve outcomes. We aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of non-adrenergic vasopressors in adult patients receiving vasopressor therapy for vasodilatory shock or perioperative vasoplegia.
View Article and Find Full Text PDFJ Cardiothorac Surg
December 2024
Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, No. 134 Dongjie, Fuzhou, 350001, China.
The letter to the editor was written in response to the recent article by Wang et al. "The influence of low-dose s-ketamine on postoperative delirium and cognitive function in older adults undergoing thoracic surgery", which is published in Journal of Cardiothoracic Surgery. 2024; 19(1):324.
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