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Brazilian Journal of Cardiovascular... May 2022Early mobilization of patients in the postoperative period of cardiac surgery who are hospitalized in the intensive care unit (ICU) is a practice that has a positive... (Review)
Review
INTRODUCTION
Early mobilization of patients in the postoperative period of cardiac surgery who are hospitalized in the intensive care unit (ICU) is a practice that has a positive impact.
METHODS
This is a systematic review of studies published until September 2020 in the Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase, Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library Online (or SciELO), and Latin American and Caribbean Health Sciences Literature (or LILACS) databases. Randomized clinical trials describing mobilization protocols performed early in ICU patients after cardiac surgery were included.
RESULTS
According to the eligibility criteria, only 14 of the 1,128 articles found were included in the analysis. Early mobilization protocols were initiated in the immediate postoperative period or first postoperative day. The resources and technics used were progressive mobilization, cycle ergometer, early bed activities, walking protocols, resistance exercise, and virtual reality. Intensity of the mobilization activities was determined using the Borg scale and heart rate.
CONCLUSION
Early mobilization protocols are generalist (not individual), and low-intensity exercises are used, through progressive mobilization, with two daily physical therapy sessions, during 10 to 30 minutes.
Topics: Cardiac Surgical Procedures; Early Ambulation; Humans; Intensive Care Units; Postoperative Period; Prescriptions
PubMed: 35244377
DOI: 10.21470/1678-9741-2021-0140 -
JAMA Jan 2022
Topics: Anesthesia, General; Humans; Postoperative Period
PubMed: 34928317
DOI: 10.1001/jama.2021.22465 -
Der Chirurg; Zeitschrift Fur Alle... Feb 2020An appropriate perioperative infusion management is pivotal for the perioperative outcome of the patient. Optimization of the perioperative fluid treatment often results... (Review)
Review
An appropriate perioperative infusion management is pivotal for the perioperative outcome of the patient. Optimization of the perioperative fluid treatment often results in enhanced postoperative outcome, reduced perioperative complications and shortened hospitalization. Hypovolemia as well as hypervolemia can lead to an increased rate of perioperative complications. The main goal is to maintain perioperative euvolemia by goal-directed therapy (GDT), a combination of fluid management and inotropic medication, to optimize perfusion conditions in the perioperative period; however, perioperative fluid management should also include the preoperative and postoperative periods. This encompasses the preoperative administration of carbohydrate-rich drinks up to 2 h before surgery. In the postoperative period, patients should be encouraged to start per os hydration early and excessive i.v. fluid administration should be avoided. Implementation of a comprehensive multimodal, goal-directed fluid management within an enhanced recovery after surgery (ERAS) protocol is efficient but the exact status of indovodual items remains unclear at present.
Topics: Fluid Therapy; Humans; Perioperative Care; Perioperative Period; Postoperative Complications; Postoperative Period
PubMed: 32025774
DOI: 10.1007/s00104-020-01134-6 -
Anesthesiology Clinics Sep 2021Neuromuscular monitoring is essential for optimal management of neuromuscular blocking drugs. Postoperative residual neuromuscular blockade continues to occur with an... (Review)
Review
Neuromuscular monitoring is essential for optimal management of neuromuscular blocking drugs. Postoperative residual neuromuscular blockade continues to occur with an unacceptably high incidence and is associated with adverse patient outcomes. Use of a peripheral nerve stimulator and subjective tactile or visual assessment is useful for intraoperative management of neuromuscular blockade, especially when the patient's hand is accessible. Quantitative monitoring is necessary for confirmation of adequate reversal and for identification of patients who have recovered spontaneously and therefore should not receive pharmacologic reversal agents. Guidelines, as well as more user-friendly monitoring equipment, have created momentum toward improving routine perioperative neuromuscular monitoring.
Topics: Electric Stimulation; Humans; Neuromuscular Blockade; Neuromuscular Monitoring; Postoperative Period
PubMed: 34392879
DOI: 10.1016/j.anclin.2021.05.001 -
American Journal of Obstetrics and... Oct 2020
Topics: Cesarean Section; Enhanced Recovery After Surgery; Female; Humans; Length of Stay; Postoperative Period; Pregnancy
PubMed: 32497606
DOI: 10.1016/j.ajog.2020.05.054 -
Gastrointestinal Endoscopy Jun 2019
Topics: Drainage; Fistula; Humans; Postoperative Period
PubMed: 31104755
DOI: 10.1016/j.gie.2019.02.027 -
Journal of Vascular Surgery Sep 2019
Topics: Aortic Aneurysm, Abdominal; Humans; Kidney Diseases; Postoperative Period
PubMed: 31445646
DOI: 10.1016/j.jvs.2019.05.024 -
Obstetrics and Gynecology Mar 2024Gynecologic surgeons have traditionally restricted the physical activity of postoperative patients. Minimally invasive surgery and enhanced recovery after surgery... (Review)
Review
Gynecologic surgeons have traditionally restricted the physical activity of postoperative patients. Minimally invasive surgery and enhanced recovery after surgery programs have contributed to decreased hospital stays and more expeditious recovery. In this narrative review, we review the current state of postoperative activity restrictions in gynecology and other specialties, the purported risks and potential benefits of postoperative activity, the available evidence to refute or support activity in the postoperative activity, and, finally, the potential benefit of added activity in the postoperative period.
Topics: Female; Humans; Gynecologic Surgical Procedures; Length of Stay; Postoperative Period; Minimally Invasive Surgical Procedures
PubMed: 38207325
DOI: 10.1097/AOG.0000000000005501 -
Anesthesia and Analgesia Jan 2018
Topics: Atrial Fibrillation; Humans; Motivation; Postoperative Period
PubMed: 29252478
DOI: 10.1213/ANE.0000000000002414 -
Current Opinion in Anaesthesiology Feb 2020Lung transplantation can be performed off-pump, with sequential one-lung ventilation, or using mechanical circulatory support (MCS). MCS can either be in the form of... (Review)
Review
PURPOSE OF REVIEW
Lung transplantation can be performed off-pump, with sequential one-lung ventilation, or using mechanical circulatory support (MCS). MCS can either be in the form of cardiopulmonary bypass (CPB) or veno-arterial or veno-venous extracorporeal membrane oxygenation (VA ECMO or VV ECMO).This article reviews the indications, benefits and limitations of these different techniques and evaluates their effect on outcomes.
RECENT FINDINGS
Recently, there has been a shift toward intraoperative ECMO support and away from CPB. The first results of this strategy are promising. The use of intraoperative ECMO with the possibility of prolongation of MCS into the postoperative period has been shown to lead to improved survival when compared with lung transplants not receiving ECMO. Recipients of organs from extended criteria donors show encouraging survival rates when the lungs are reperfused using MCS. A recent metaanalysis comparing ECMO versus CPB showed favourable outcomes supporting the use of ECMO despite not finding a difference in mortality between the two methods.
SUMMARY
The trend toward ECMO and away from cardiopulmonary bypass is backed up with good survival rates. However, to date, there has not been a randomized controlled trial to further guide the choice of MCS strategy for lung transplantation.
Topics: Cardiopulmonary Bypass; Extracorporeal Membrane Oxygenation; Humans; Lung Transplantation; Postoperative Period
PubMed: 31714270
DOI: 10.1097/ACO.0000000000000806