Benefits of Prehabilitation before Complex ...
Document type :
Article dans une revue scientifique: Article de synthèse/Review paper
DOI :
PMID :
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Title :
Benefits of Prehabilitation before Complex Aortic Surgery.
Author(s) :
Mesnard, Thomas [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Dubosq, Maxime [Auteur]
Institut Coeur Poumon [CHU Lille]
Pruvot, Louis [Auteur]
Institut Coeur Poumon [CHU Lille]
Azzaoui, Richard [Auteur]
Institut Coeur Poumon [CHU Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Patterson, Benjamin O. [Auteur]
University Hospital Southampton NHS Foundation Trust
Sobocinski, Jonathan [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Advanced Drug Delivery Systems (ADDS) - U1008
Dubosq, Maxime [Auteur]
Institut Coeur Poumon [CHU Lille]
Pruvot, Louis [Auteur]
Institut Coeur Poumon [CHU Lille]
Azzaoui, Richard [Auteur]
Institut Coeur Poumon [CHU Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Patterson, Benjamin O. [Auteur]
University Hospital Southampton NHS Foundation Trust
Sobocinski, Jonathan [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Journal title :
Journal of Clinical Medicine
Abbreviated title :
J Clin Med
Volume number :
12
Publication date :
2023-06-16
ISSN :
2077-0383
English keyword(s) :
open aortic repair
enhanced recovery after surgery
prehabilitation
enhanced recovery after surgery
prehabilitation
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
The purpose of this narrative review was to detail and discuss the underlying principles and benefits of preoperative interventions addressing risk factors for perioperative adverse events in open aortic surgery (OAS). The ...
Show more >The purpose of this narrative review was to detail and discuss the underlying principles and benefits of preoperative interventions addressing risk factors for perioperative adverse events in open aortic surgery (OAS). The term “complex aortic disease” encompasses juxta/pararenal aortic and thoraco-abdominal aneurysms, chronic aortic dissection and occlusive aorto-iliac pathology. Although endovascular surgery has been increasingly favored, OAS remains a durable option, but by necessity involves extensive surgical approaches and aortic cross-clamping and requires a trained multidisciplinary team. The physiological stress of OAS in a fragile and comorbid patient group mandates thoughtful preoperative risk assessment and the implementation of measures dedicated to improving outcomes. Cardiac and pulmonary complications are one of the most frequent adverse events following major OAS and their incidences are correlated to the patient’s functional status and previous comorbidities. Prehabilitation should be considered in patients with risk factors for pulmonary complications including advanced age, previous chronic obstructive pulmonary disease, and congestive heart failure with the aid of pulmonary function tests. It should also be combined with other measures to improve postoperative course and be included in the more general concept of enhanced recovery after surgery (ERAS). Although the current level of evidence regarding the effectiveness of ERAS in the setting of OAS remains low, an increasing body of literature has promoted its implementation in other specialties. Consequently, vascular teams should commit to improving the current evidence through studies to make ERAS the standard of care for OAS.Show less >
Show more >The purpose of this narrative review was to detail and discuss the underlying principles and benefits of preoperative interventions addressing risk factors for perioperative adverse events in open aortic surgery (OAS). The term “complex aortic disease” encompasses juxta/pararenal aortic and thoraco-abdominal aneurysms, chronic aortic dissection and occlusive aorto-iliac pathology. Although endovascular surgery has been increasingly favored, OAS remains a durable option, but by necessity involves extensive surgical approaches and aortic cross-clamping and requires a trained multidisciplinary team. The physiological stress of OAS in a fragile and comorbid patient group mandates thoughtful preoperative risk assessment and the implementation of measures dedicated to improving outcomes. Cardiac and pulmonary complications are one of the most frequent adverse events following major OAS and their incidences are correlated to the patient’s functional status and previous comorbidities. Prehabilitation should be considered in patients with risk factors for pulmonary complications including advanced age, previous chronic obstructive pulmonary disease, and congestive heart failure with the aid of pulmonary function tests. It should also be combined with other measures to improve postoperative course and be included in the more general concept of enhanced recovery after surgery (ERAS). Although the current level of evidence regarding the effectiveness of ERAS in the setting of OAS remains low, an increasing body of literature has promoted its implementation in other specialties. Consequently, vascular teams should commit to improving the current evidence through studies to make ERAS the standard of care for OAS.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Collections :
Submission date :
2023-12-15T05:17:53Z
2024-02-26T10:15:47Z
2024-02-26T10:15:47Z
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