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Myocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing DiagnosticCriteria, Characteristics, Predictors, and 30-day Outcomes

TheVascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION)Writing Group, on behalf of The Vascular events In noncardiac Surgery patIentscOhort evaluatioN (VISION) Investigators. Anesthesiology 03 2014,Vol.120, 564-578.

International,prospective cohort study of 15,065 patients > 45 yr, having noncardiac surgery.

TroponinT was measured first 3 postoperative days. Diagnosticcriterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judgeddue to myocardial ischemia.

MINSwas an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87;95% CI, 2.96–5.08) and had the highest population-attributable risk (34.0%, 95%CI, 26.6–41.5) of the perioperative complications.

1,200 patients (8.0%) suffered MINS, and over half (58.2%) of these patients would nothave fulfilled the universal definition of myocardial infarction. Fewer than one in five (15.8%) patients with MINS experienced an ischemic symptom.

Among adults undergoing noncardiacsurgery, MINS is common and associated with substantial mortality.

For original paper click here:

http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917890

Myocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing DiagnosticCriteria, Characteristics, Predictors, and 30-day Outcomes

TheVascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION)Writing Group, on behalf of The Vascular events In noncardiac Surgery patIentscOhort evaluatioN (VISION) Investigators. Anesthesiology 03 2014,Vol.120, 564-578.

International,prospective cohort study of 15,065 patients > 45 yr, having noncardiac surgery.

TroponinT was measured first 3 postoperative days. Diagnosticcriterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judgeddue to myocardial ischemia.

MINSwas an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87;95% CI, 2.96–5.08) and had the highest population-attributable risk (34.0%, 95%CI, 26.6–41.5) of the perioperative complications.

1,200 patients (8.0%) suffered MINS, and over half (58.2%) of these patients would nothave fulfilled the universal definition of myocardial infarction. Fewer than one in five (15.8%) patients with MINS experienced an ischemic symptom.

Among adults undergoing noncardiacsurgery, MINS is common and associated with substantial mortality.

For original paper click here:

http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917890

Effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial)

Randomised Controlled Multicentre trial; n=420; GDHT vs Control

Conclusions:

"Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days."

Click here for full text.

http://bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

Dr Tim Miller, Anesthesiologist from Duke talks about opiods "we're definately opening our eyes in The States". Also, Dr Julie Thacker, President of the American Society of Enhanced Recovery features with her thoughts on colorectal surgery.

Effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial)

Randomised Controlled Multicentre trial; n=420; GDHT vs Control

Conclusions:

"Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days."

Click here for full text.

http://bjanaesthesia.org/article/S0007-0912(17)54207-5/fulltext

Dr Tim Miller, Anesthesiologist from Duke talks about opiods "we're definately opening our eyes in The States".   Also, Dr Julie Thacker, President of the American Society of Enhanced Recovery features with her thoughts on colorectal surgery.

A quick refresher on some of the hot topics from ASER 2017, including the messy issue of bowel prep and the prickly topic of opiates.

A couple of highlights from Professor Monty Mythen and Dr Joff Lacey's live coverage of ASER 2017 for TopMedTalk featuring Dr Julie Thacker, President of American Society of Enhanced Recovery and Desiree Chappell a CRNA in Louisville, Kentucky and board member of EBPOM USA.

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15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

A quick refresher on some of the hot topics from ASER 2017, including the messy issue of bowel prep and the prickly topic of opiates.

A couple of highlights from Professor Monty Mythen and Dr Joff Lacey's live coverage of ASER 2017 for TopMedTalk featuring Dr Julie Thacker, President of American Society of Enhanced Recovery and Desiree Chappell a CRNA in Louisville, Kentucky and board member of EBPOM USA.

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15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Dr Steve Flanagan - Chair of Physical Medicine and Rehabilitation at NYU Langone.

Taken from the Roundtable discussions hosted by Desiree Chappell live from the American College of Perioperative Medicine's Interdisciplinary Conference on Orthopedic Value-Based Care.

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The fuller version of this piece is here: http://topmedtalk.libsyn.com/physical-medicine-in-rehabilitation-applying-a-team-approach-in-care-and-pre-and-post-habilitation

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Also - don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/

Dr Steve Flanagan - Chair of Physical Medicine and Rehabilitation at NYU Langone.

Taken from the Roundtable discussions hosted by Desiree Chappell live from the American College of Perioperative Medicine's Interdisciplinary Conference on Orthopedic Value-Based Care.

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The fuller version of this piece is here: http://topmedtalk.libsyn.com/physical-medicine-in-rehabilitation-applying-a-team-approach-in-care-and-pre-and-post-habilitation

--

Also - don't forget: 15th - 17th March 2018 ASER/EBPOM 2018 Annual Congress of Enhanced Recovery and Perioperative Medicine, register here: http://aserhq.org/2018-annual-congress/