Adopting newer strategies of perioperative quality improvement: The bandwagon moves on….

Bajwa, Sukhminder Jit Singh; Mehdiratta, Lalit

doi:10.4103/ija.ija_866_21

Cited by 15 publications

(4 citation statements)

References 28 publications

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“…The technology in POCUS can thus improve the quality of care of the obstetric patient including perioperative care which is the need of the day. [ 47 ] Further studies are needed to find out faster and more simplified US techniques and to compare various POCUS parameters including their sensitivity and specificity for the early detection of EVLW in the pre-eclamptic parturient. Further studies on the number of B-lines that herald the onset of clinical signs and symptoms of pulmonary oedema are warranted.…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Bajwa¹,

Kurdi²,

Sutagatti³

et al. 2021

Indian J Anaesth

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Background and Aims: Appropriate volume assessment and fluid management can prevent maternal deaths in the severely pre-eclamptic (SPE) parturients. We planned a systematic review and meta-analysis (MA) to evaluate the role and ability of point-of-care ultrasound (POCUS) in the assessment of volume status and early detection of lung oedema in an SPE parturient. Methods: An e-literature search was done from several databases. Data were extracted under five domains including POCUS-derived parameters like echo comet score (ECS), lung ultrasound (LUS) scores, B-patterns, optic nerve sheath diameter (ONSD), E/e' ratio, presence of pleural effusion, pulmonary interstitial syndrome and pulmonary congestion. The risk of bias was assessed. Extracted data were analysed using MetaXL and Revman 5.3. Heterogeneity in the studies was evaluated using the Cochrane Q test and I 2 statistics. Funnel plots were used for the assessment of publication bias. Results: Seven prospective studies including 574 parturients (including 396 pre-eclamptics) were selected. POCUS included lung, optic nerve, cardiac and thoracic US. In two studies, the ECS and LUS scores pre-delivery were higher in pre-eclamptics. Two studies found a mean ONSD of 5–5.84 mm before delivery. MA revealed a significantly lower mean ECS score at post-delivery than pre-delivery, and the summary prevalence of B-pattern and pleural effusion among SPE parturients was found to be 0.28 (0.03–0.84) and 0.1 (0–0.2), respectively. A good correlation was observed between B-line patterns and diastolic dysfunction (increased E/e' ratio), LUS score and thoracic fluid content, ONSD and ECS in individual studies. Conclusion: POCUS parameters can be useful as early markers of fluid status and serve as useful tools in the precise clinical management of pre-eclampsia.

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Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Bajwa¹,

Kurdi²,

Sutagatti³

et al. 2021

Indian J Anaesth

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“…[ 3 ] Nevertheless, good patient comfort, satisfaction, quality of recovery, post-operative functional outcomes, and quality of life are currently the goals that drive peri-operative health care. [ 7 - 9 ] This means that in addition to pain, the quality of recovery too needs to be assessed. In a randomised controlled trial being published in this issue of the IJA, the effect of bolus intravenous lignocaine (1.5 mg/kg at induction followed by an intravenous infusion 1 mg/kg/h for 24 hours) on post-operative pain relief and the quality of recovery has been evaluated by assessing the Quality of Recovery 15 (QoR15) score on post-operative day 1 and at suture removal in patients undergoing surgery for breast cancer.…”

Section: Current Peri-operative Pain Practice Patternsmentioning

confidence: 99%

Predicting and evaluating pain after surgery…Newer methods to the rescue?

et al. 2023

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“…It is clear that most of the advances in anaesthesia are directed toward improving the safety of the patient and improving patient comfort, satisfaction, and quality of life postoperatively. [ 27 ] There is a huge potential for further developments in technology that can aid perioperative care in this direction. As discussed in an article in this issue, advances in AI, telemedicine, and blockchain technology are attempting to improve perioperative care.…”

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confidence: 99%

Innovative research and technological advancements: Oars of the boat of progress

2023

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Adopting newer strategies of perioperative quality improvement: The bandwagon moves on….

Cited by 15 publications

References 28 publications

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Predicting and evaluating pain after surgery…Newer methods to the rescue?

Innovative research and technological advancements: Oars of the boat of progress

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