Leukotrienes (LTs), highly bioactive lipid mediators play a major role in inflammation, wound healing and in the development of atherosclerosis. LTs biosynthesis have been suggested to be increased in myocardial infarction (MI) and in surgical patients with abdominal aortic aneurysms. Among LTs, Cysteinyl-LTs have the most potent biological properties and their production is well reflected by L...

Heart failure with preserved ejection fraction (HFPEF) is a diagnosis encountered with increasing frequency in the aging population. We present a case of postoperative pulmonary edema in 63-year-old male with HFPEF. This patient highlights the gap in risk stratification with respect to diastolic heart failure.

Distress is defined as feelings and ideas that lead to unpleasant problems in diseases and treatments. Distress has meanings such as sadness, hopelessness, weakness, fear, excitement, anxiety, panic, depression, indecision and burnout. The pre-operative period is a crisis period for many people. During this period individuals may experience many of the feelings, emotions and ideas that cause di...

Recent advances in nutrition therapy of the patient undergoing elective surgery have focused on greater utilization of the gut, feeding closer to the time of surgery, avoiding extensive bowel preparations or use of nasogastric tubes and drains, and measures to promote and maintain intestinal motility. Failure to have protocols in place for delivery of enteral nutrition (EN) through the perioper...

Intravenous acetaminophen (IVA) has rapid and effective analgesic properties. Recent studies have shown several benefits of using IVA perioperatively. However, due to its relatively high cost and limited clinical data concerning its efficacy compared with other agents, physicians are hesitant to use IVA in the perioperative period. This brief review examines the utility of this medication in th...

BACKGROUND Determining whether systemic corticosteroids impair wound healing is a clinically relevant topic that has important management implications. METHODS We reviewed literature on the effects of corticosteroids on wound healing from animal and human studies searching MEDLINE from 1949 to 2011. RESULTS Some animal studies show a 30% reduction in wound tensile strength with perioperativ...

In the perioperative period, physicians strive to provide optimal care for their patients by first performing a thorough evaluation of all organ systems. This is most important for elective and nonelective highrisk procedures and for procedures performed on critically ill or medically complex patients. The perioperative period is unique as it is a distinct event in a patient’s health where cert...

One of the most frequent questions asked of a pediatric anesthesiologist is "What are the risks of anesthesia for my child?" Unfortunately, few studies have examined the consequences of general anesthesia in children. We used data from a large pediatric anesthesia follow-up program at Winnipeg Children's Hospital (1982-1987) to determine rates of perioperative adverse events among children of d...

A prospective study of 10 neonates with congenital diaphragmatic hernia and five controls to determine the importance of prostanoid concentrations perioperatively and the relation with persistent pulmonary hypertension (PPH) is reported. In neonates with congenital diaphragmatic hernia postoperative concentrations of the vasoconstrictor thromboxane B2 rose significantly and were higher during e...