Management of peri-operative complications:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2012
|
| Schriftenreihe: | Surgical clinics of North America
92,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Includes bibliographical references and index Preface: Management of peri-operative complications -- Fluid and electrolyte management for the surgical patient -- Hypoperfusion, shock states, and abdominal compartment syndrome (ACS) -- Massive transfusion of blood in the surgical patient -- Postoperative gastrointestinal hemmorrhage -- Damage control for intra-abdominal sepsis -- Pathogenesis and clinical and economic consequences of postoperative ileus -- Perioperative nutritional support: immunonutrition, probiotics, and anabolic steroids -- Surgical prophylaxis and other complication avoidance care bundles -- Organ failure avoidance and mitigation strategies in surgery -- Postoperative pulmonary complications: pneumonia and acute respiratory failure -- Multidrug-resistant organisms and antibiotic management -- Prevention of chronic pain after surgical nerve injury: amputation and thoracotomy -- Postoperative complications: delirium -- Rescue therapies in the surgical patient -- The American College of Surgeons Trauma Quality Improvement Program |
| Beschreibung: | XV S., S. 189 - 470 Ill., graph. Darst. 24 cm |
| ISBN: | 9781455739387 1455739383 |
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| 245 | 1 | 0 | |a Management of peri-operative complications |c guest ed. Lewis J. Kaplan ; Stanley H. Rosenbaum |
| 264 | 1 | |a Philadelphia, PA |b Saunders |c 2012 | |
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| 490 | 1 | |a Surgical clinics of North America |v 92,2 | |
| 500 | |a Includes bibliographical references and index | ||
| 500 | |a Preface: Management of peri-operative complications -- Fluid and electrolyte management for the surgical patient -- Hypoperfusion, shock states, and abdominal compartment syndrome (ACS) -- Massive transfusion of blood in the surgical patient -- Postoperative gastrointestinal hemmorrhage -- Damage control for intra-abdominal sepsis -- Pathogenesis and clinical and economic consequences of postoperative ileus -- Perioperative nutritional support: immunonutrition, probiotics, and anabolic steroids -- Surgical prophylaxis and other complication avoidance care bundles -- Organ failure avoidance and mitigation strategies in surgery -- Postoperative pulmonary complications: pneumonia and acute respiratory failure -- Multidrug-resistant organisms and antibiotic management -- Prevention of chronic pain after surgical nerve injury: amputation and thoracotomy -- Postoperative complications: delirium -- Rescue therapies in the surgical patient -- The American College of Surgeons Trauma Quality Improvement Program | ||
| 650 | 4 | |a Surgery / Complications | |
| 650 | 4 | |a Surgical Procedures, Operative / adverse effects | |
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Datensatz im Suchindex
| _version_ | 1804149070355234816 |
|---|---|
| adam_text | Titel: Management of peri-operative complications
Autor: Kaplan, Lewis J
Jahr: 2012
Management of Peri-operative Complications
Contents
Foreword: Management of Peri-operative Complications xiii
Ronald F. Martin
Preface: Management of Peri-operative Complications xv
Lewis J. Kaplan and Stanley H. Rosenbaum
Fluid and Electrolyte Management for the Surgical Patient 189
Greta L. Piper and Lewis J. Kaplan
For surgical patients, appropriate selection and administration of fluids can
mitigate against organ failure, whereas improper dosing can exacerbate
already injured systems. Fluid and electrolyte goals and deficiencies
must be defined for individual patients to provide the appropriate combi-
nation of resuscitation and maintenance fluids. Specific electrolyte abnor-
malities should be anticipated, identified, and corrected to optimize organ
functions. Using the strong-ion approach to acid-base assessment, deliv-
ered fluids that contain calculated amounts of electrolytes will interact with
the patient s plasma charge and influence the patient s pH, allowing the
clinician to achieve a more precise end point.
Hypoperfusion, Shock States, and Abdominal Compartment Syndrome (ACS) 207
Koen Ameloot, Carl Gillebert, Nele Desie, and Manu L.N.G. Malbrain
Cardiovascular dysfunction and failure are commonly encountered in pa-
tients with intra-abdominal hypertension or abdominal compartment syn-
drome. Accurate assessment and optimization of preload, afterload, and
contractility are essential to restoring end-organ perfusion and maximizing
patient survival. Application of a goal-directed resuscitation strategy, in-
cluding abdominal decompression, when indicated, improves cardiac
function, reverses end-organ failure, and minimizes intra-abdominal hy-
pertension-related patient morbidity and mortality.
Massive Transfusion of Blood in the Surgical Patient 221
Jordan M. Raymer, Lisa M. Flynn, and Ronald F. Martin
Hemorrhage remains a leading cause of morbidity and death in both civil-
ian and military trauma. Restoration of effective end-organ perfusion by
stopping hemorrhage and restoring intravascular volume in such a way
as to minimize acidosis, hypothermia, and coagulopathy, almost always
requires the use of blood and/or blood-component therapy. The best
method to manage life-threatening hemorrhage is to avoid the circum-
stance that prompted it or to mitigate blood loss early in the injury cycle;
otherwise, blood replacement must suffice. This article reviews current
understanding of massive transfusion, along with its attendant unintended
consequences, in the management of patients with profound hemorrhage.
Contents
Postoperative Gastrointestinal Hemorrhage 235
Seon Jones and Addison K. May
Significant gastrointestinal (Gl) bleeding in the postoperative period is an
uncommon complication of surgery. The management of Gl bleeding
within the postoperative period is complex because of a larger differential
for the source of bleeding and a more complex risk/benefit analysis. There
is minimal published literature specific to the management of postopera-
tive Gl bleeding, and the infrequency, complexity, and variability of the
clinical setting of this complication confound simplistic consideration of
its cause and therapy. This article outlines a systematic evaluation of the
patient, treatment options, and assessment of risk/benefit ratio for various
treatment options.
Damage Control for Intra-Abdominal Sepsis 243
Brett H. Waibel and Michael F. Rotondo
With the success of damage-control surgery for the treatment of exsangui-
nating truncal trauma, it has been adapted to other surgical diseases
associated with shock states, such as severe secondary peritonitis. The
structured approach of damage control is easily adapted to and can incor-
porate the fundamental elements of the Surviving Sepsis Campaign. It is
not meant to replace tried and true surgical principles, such as source
control, but is a usable framework in managing the complicated circum-
stances seen with these patients.
Pathogenesis and Clinical and Economic Consequences of Postoperative Ileus 259
Michael G. Doorly and Anthony J. Senagore
Postoperative ileus is a preventable disease with surprising economic
consequences. Understanding the triad of dysmotility in conjunction with
an enhanced recovery program improves patient outcome, decreases
length of stay in hospital, and lowers the cost. Alvimopan and other inves-
tigational promotility medications can help attain these goals. Surgeons
should avoid labeling all postoperative abdominal distention as ileus,
which not only prevents timely diagnosis and treatment of early postoper-
ative small bowel obstruction or acute colonic pseudo-obstruction but
also increases patient morbidity and mortality.
Perioperative Nutritional Support: Immunonutrition, Probiotics, and
Anabolic Steroids 273
Adrian A. Maung and Kimberly A. Davis
Nutritional support in surgical patients has evolved from simple provision
of adequate calories to retard loss of lean body mass to the provision of
specific nutrients in an attempt to manipulate metabolic and immune
responses. Although still limited, the current understanding of this complex
subject indicates that the type, route, amount, and composition of nu-
tritional support provided to patients can affect their outcome. Further
studies are, however, needed to better characterize the exact nutritional
support that is most beneficial for a specific disease state and a specific
patient.
Contents
Surgical Prophylaxis and Other Complication Avoidance Care Bundles 285
Steven J. Schwulst and John E. Mazuski
Individual health care quality measures that have been shown to improve
outcome can be combined together into what are called care bundles, with
the expectation that this set of practices produces further improvements in
outcome. Prevention of surgical site infection is the focus of several quality
measures put forward by the Surgical Care Improvement Project; these
can collectively be considered a bundle as well. Whether these process
measures, which include several components related to the administration
of antibiotic prophylaxis, are effective in decreasing rates of surgical site
infection has come under considerable debate recently.
Organ Failure Avoidance and Mitigation Strategies in Surgery 307
Kevin W. McConnell and Craig M. Coopersmith
Postoperative organ failure is a challenging disease process that is better
prevented than treated. Providers should use close observation and clini-
cal judgment, and checklists of best practices to minimize the risk of organ
failure in their patients. The treatment of multiorgan dysfunction syndrome
(MODS) generally remains supportive, outside of rapid initiation of source
control (when appropriate) and targeted antibiotic therapy. More specific
treatments may be developed as the complex pathophysiology of
MODS is better understood and more homogenous patient populations
are selected for study.
Postoperative Pulmonary Complications: Pneumonia and Acute Respiratory Failure 321
Gaurav Sachdev and Lena M. Napolitano
Postoperative pulmonary complications (atelectasis, pneumonia, pulmo-
nary edema, acute respiratory failure) are common, particularly after ab-
dominal and thoracic surgery, pneumonia and atelectasis being the
most common. Postoperative pneumonia is associated with increased
morbidity, length of hospital stay, and costs. Few institutions have pneu-
monia prevention programs for surgical patients, and these should be
strongly considered. Acute respiratory failure is a life-threatening pulmo-
nary complication that requires institution of mechanical ventilation and
admission to the intensive care unit, and is associated with increased
risk for ventilator-associated pneumonia. This article discusses epidemiol-
ogy, risk factors, diagnosis, treatment, and prevention of these pulmonary
complications in surgical patients.
Multidrug-Resistant Organisms and Antibiotic Management 345
Philip S. Barie
The increasing prevalence of multidrug-resistant (MDR) infections in clinical
practice stems from clinical and veterinary antibiotic use, and animal
husbandry. As resistance to antibiotics becomes more common, a vicious
circle develops wherein increasingly broad-spectrum agents must be pre-
scribed empirically to ensure that initial antibiotic therapy is adequate to the
task, and new, ever more powerful agents are needed for the treatment of
Contents
MDR bacteria. Unfortunately, a dearth of new agents and drugs is in devel-
opment. As clinicians we must learn to make do with what we have for the
foreseeable future, according to the principles of antibiotic stewardship.
Prevention of Chronic Pain After Surgical Nerve Injury: Amputation and
Thoracotomy 393
Thomas Buchheit and Srinivas Pyati
Although techniques for acute pain management have improved in recent
years, a dramatic reduction in the incidence and severity of chronic pain
following surgery has not occurred. Amputation and thoracotomy, al-
though technically different, share the commonalities of unavoidable nerve
injury and the frequent presence of persistent postsurgical neuropathic
pain. The authors review the risk factors for the development of chronic
pain following these surgeries and the current evidence that supports
analgesic interventions. The inconclusive results from many preemptive
analgesic studies may require us to reconceptualize the perioperative
treatment period as a time of gradual neurologic remodeling.
Postoperative Complications: Delirium 409
Steven R. Allen and Heidi L. Frankel
Delirium is a common feature of the postoperative period, leading to in-
creased morbidity and mortality and significant costs. Multiple factors pre-
dispose a patient to delirium in its hypoactive, hyperactive, or mixed forms.
Tools have been validated for its quick and accurate identification to en-
sure timely and effective multidisciplinary intervention and treatment. A
significant percentage of patients may require placement in skilled nursing
facilities or similar care environments because of the long-lasting effects.
The physician must be vigilant in the search for and identification of all
forms of delirium and must effectively treat the underlying medical condi-
tion and symptoms.
Rescue Therapies in the Surgical Patient 433
Samuel A. Tisherman
In the perioperative period, patients may suffer complications leading to
serious adverse events. Patient deterioration needs to be rapidly identified,
and a rapid response system must be initiated. Additional personnel may
also be needed. Rescue therapies, beyond the routine resuscitative ef-
forts, may be needed in some cases. The types of complications that
may be faced include a difficult airway, refractory hypoxemia, pulmonary
embolism, myocardial infarction, cardiac arrest with restoration of pulse
but ongoing coma, and stroke. Although perioperative complications
can be catastrophic, rapid intervention, including rescue therapies when
necessary, can improve outcomes.
The American College of Surgeons Trauma Quality Improvement Program 441
Avery B. Nathens, H. Gill Oyer, and John Fildes
The American College of Surgeons Trauma Quality Improvement Program
(ACS TQIP) is a recent addition to the many quality improvement col-
laboratives that have been established in surgery. On the background of
Contents
a well-established trauma center and its performance improvement activ-
ities, ACS TQIP offers the potential to advance trauma care and offers par-
ticipating centers the opportunity to better understand their strengths and
areas for improvement. The rationale for ACS TQIP s development, imple-
mentation challenges, and potential for advancing the quality of trauma
care are described.
Index 455
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| physical | XV S., S. 189 - 470 Ill., graph. Darst. 24 cm |
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| series | Surgical clinics of North America |
| series2 | Surgical clinics of North America |
| spelling | Management of peri-operative complications guest ed. Lewis J. Kaplan ; Stanley H. Rosenbaum Philadelphia, PA Saunders 2012 XV S., S. 189 - 470 Ill., graph. Darst. 24 cm txt rdacontent n rdamedia nc rdacarrier Surgical clinics of North America 92,2 Includes bibliographical references and index Preface: Management of peri-operative complications -- Fluid and electrolyte management for the surgical patient -- Hypoperfusion, shock states, and abdominal compartment syndrome (ACS) -- Massive transfusion of blood in the surgical patient -- Postoperative gastrointestinal hemmorrhage -- Damage control for intra-abdominal sepsis -- Pathogenesis and clinical and economic consequences of postoperative ileus -- Perioperative nutritional support: immunonutrition, probiotics, and anabolic steroids -- Surgical prophylaxis and other complication avoidance care bundles -- Organ failure avoidance and mitigation strategies in surgery -- Postoperative pulmonary complications: pneumonia and acute respiratory failure -- Multidrug-resistant organisms and antibiotic management -- Prevention of chronic pain after surgical nerve injury: amputation and thoracotomy -- Postoperative complications: delirium -- Rescue therapies in the surgical patient -- The American College of Surgeons Trauma Quality Improvement Program Surgery / Complications Surgical Procedures, Operative / adverse effects Kaplan, Lewis J. Sonstige (DE-588)1022102796 oth Surgical clinics of North America 92,2 (DE-604)BV000003239 92,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=024970516&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Management of peri-operative complications Surgical clinics of North America Surgery / Complications Surgical Procedures, Operative / adverse effects |
| title | Management of peri-operative complications |
| title_auth | Management of peri-operative complications |
| title_exact_search | Management of peri-operative complications |
| title_full | Management of peri-operative complications guest ed. Lewis J. Kaplan ; Stanley H. Rosenbaum |
| title_fullStr | Management of peri-operative complications guest ed. Lewis J. Kaplan ; Stanley H. Rosenbaum |
| title_full_unstemmed | Management of peri-operative complications guest ed. Lewis J. Kaplan ; Stanley H. Rosenbaum |
| title_short | Management of peri-operative complications |
| title_sort | management of peri operative complications |
| topic | Surgery / Complications Surgical Procedures, Operative / adverse effects |
| topic_facet | Surgery / Complications Surgical Procedures, Operative / adverse effects |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=024970516&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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