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Perioperative Care of Patients With Liver Cirrhosis: A Review
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| Zeitschriftentitel: | Health Services Insights |
|---|---|
| Personen und Körperschaften: | , , , |
| In: | Health Services Insights, 10, 2017, S. 117863291769127 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
SAGE Publications
|
| Schlagwörter: |
| author_facet |
Abbas, Naeem Makker, Jasbir Abbas, Hafsa Balar, Bhavna Abbas, Naeem Makker, Jasbir Abbas, Hafsa Balar, Bhavna |
|---|---|
| author |
Abbas, Naeem Makker, Jasbir Abbas, Hafsa Balar, Bhavna |
| spellingShingle |
Abbas, Naeem Makker, Jasbir Abbas, Hafsa Balar, Bhavna Health Services Insights Perioperative Care of Patients With Liver Cirrhosis: A Review Public Health, Environmental and Occupational Health Health Policy |
| author_sort |
abbas, naeem |
| spelling |
Abbas, Naeem Makker, Jasbir Abbas, Hafsa Balar, Bhavna 1178-6329 1178-6329 SAGE Publications Public Health, Environmental and Occupational Health Health Policy http://dx.doi.org/10.1177/1178632917691270 <jats:p>The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients. Perioperative management of patients with cirrhosis warrants special attention to nutritional status, fluid and electrolyte balance, control of ascites, excluding preexisting infections, correction of coagulopathy and thrombocytopenia, and avoidance of nephrotoxic and hepatotoxic medications. Transjugular intrahepatic portosystemic shunt may improve the CTP class, and semielective surgeries may be feasible. Emergency surgery, whenever possible, should be avoided.</jats:p> Perioperative Care of Patients With Liver Cirrhosis: A Review Health Services Insights |
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| title |
Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_unstemmed |
Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_full |
Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_fullStr |
Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_full_unstemmed |
Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_short |
Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_sort |
perioperative care of patients with liver cirrhosis: a review |
| topic |
Public Health, Environmental and Occupational Health Health Policy |
| url |
http://dx.doi.org/10.1177/1178632917691270 |
| publishDate |
2017 |
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117863291769127 |
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<jats:p>The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients. Perioperative management of patients with cirrhosis warrants special attention to nutritional status, fluid and electrolyte balance, control of ascites, excluding preexisting infections, correction of coagulopathy and thrombocytopenia, and avoidance of nephrotoxic and hepatotoxic medications. Transjugular intrahepatic portosystemic shunt may improve the CTP class, and semielective surgeries may be feasible. Emergency surgery, whenever possible, should be avoided.</jats:p> |
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| author | Abbas, Naeem, Makker, Jasbir, Abbas, Hafsa, Balar, Bhavna |
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| description | <jats:p>The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients. Perioperative management of patients with cirrhosis warrants special attention to nutritional status, fluid and electrolyte balance, control of ascites, excluding preexisting infections, correction of coagulopathy and thrombocytopenia, and avoidance of nephrotoxic and hepatotoxic medications. Transjugular intrahepatic portosystemic shunt may improve the CTP class, and semielective surgeries may be feasible. Emergency surgery, whenever possible, should be avoided.</jats:p> |
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| spelling | Abbas, Naeem Makker, Jasbir Abbas, Hafsa Balar, Bhavna 1178-6329 1178-6329 SAGE Publications Public Health, Environmental and Occupational Health Health Policy http://dx.doi.org/10.1177/1178632917691270 <jats:p>The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients. Perioperative management of patients with cirrhosis warrants special attention to nutritional status, fluid and electrolyte balance, control of ascites, excluding preexisting infections, correction of coagulopathy and thrombocytopenia, and avoidance of nephrotoxic and hepatotoxic medications. Transjugular intrahepatic portosystemic shunt may improve the CTP class, and semielective surgeries may be feasible. Emergency surgery, whenever possible, should be avoided.</jats:p> Perioperative Care of Patients With Liver Cirrhosis: A Review Health Services Insights |
| spellingShingle | Abbas, Naeem, Makker, Jasbir, Abbas, Hafsa, Balar, Bhavna, Health Services Insights, Perioperative Care of Patients With Liver Cirrhosis: A Review, Public Health, Environmental and Occupational Health, Health Policy |
| title | Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_full | Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_fullStr | Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_full_unstemmed | Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_short | Perioperative Care of Patients With Liver Cirrhosis: A Review |
| title_sort | perioperative care of patients with liver cirrhosis: a review |
| title_unstemmed | Perioperative Care of Patients With Liver Cirrhosis: A Review |
| topic | Public Health, Environmental and Occupational Health, Health Policy |
| url | http://dx.doi.org/10.1177/1178632917691270 |