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Current research priorities in perioperative intensive care medicine

Michael A. Gillies| Michael Sander| Andrew Shaw| Duminda N. Wijeysundera| John Myburgh| Cesar Aldecoa| Ib Jammer| Suzana M. Lobo| Naomi Pritchard| Michael P. W. Grocott| Marcus J. Schultz| Rupert M. Pearse
Review
Volume 43, Issue 9 / September , 2017

Pages 1173 - 1186

Abstract

Introduction

Surgical treatments are offered to more patients than ever before, and increasingly to older patients with chronic disease. High-risk patients frequently require critical care either in the immediate postoperative period or after developing complications. The purpose of this review was to identify and prioritise themes for future research in perioperative intensive care medicine.

Methods

We undertook a priority setting process (PSP). A panel was convened, drawn from experts representing a wide geographical area, plus a patient representative. The panel was asked to suggest and prioritise key uncertainties and future research questions in the field of perioperative intensive care through a modified Delphi process. Clinical trial registries were searched for on-going research. A proposed “Population, Intervention, Comparator, Outcome” (PICO) structure for each question was provided.

Results

Ten key uncertainties and future areas of research were identified as priorities and ranked. Appropriate intravenous fluid and blood component therapy, use of critical care resources, prevention of delirium and respiratory management featured prominently.

Conclusion

Admissions following surgery contribute a substantial proportion of critical care workload. Studies aimed at improving care in this group could have a large impact on patient-centred outcomes and optimum use of healthcare resources. In particular, the optimum use of critical care resources in this group is an area that requires urgent research.

Keywords

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