BioAcyl Corp
BioAcyl Corp |
|
 |
 |
 |
|
Dobson, G. P. (2020). Trauma of major surgery: A global problem that is not going away. Int J surg, 81, 47. Added by: Dr. Enrique Feoli (17/07/2022, 09:28) Last edited by: Dr. Enrique Feoli (17/07/2022, 15:28) |
 |
| Resource type: Journal Article DOI: 10.1016/j.ijsu.2020.07.017 ID no. (ISBN etc.): 1757-9708 BibTeX citation key: Dobson2020 View all bibliographic details  |
Categories: BioAcyl Corp, BioAcyl Corp Subcategories: Heridas quirúrgicas, SSI China Creators: Dobson Collection: Int J surg |
Views: 2/255
|
| Abstract |
|
Globally, a staggering 310 million major surgeries are performed each year; around 40 to 50 million in USA and 20 million in Europe. It is estimated that 1–4% of these patients will die, up to 15% will have serious postoperative morbidity, and 5–15% will be readmitted within 30 days. An annual global mortality of around 8 million patients places major surgery comparable with the leading causes of death from cardiovascular disease and stroke, cancer and injury. If surgical complications were classified as a pandemic, like HIV/AIDS or coronavirus (COVID-19), developed countries would work together and devise an immediate action plan and allocate resources to address it. Seeking to reduce preventable deaths and post-surgical complications would save billions of dollars in healthcare costs. Part of the global problem resides in differences in institutional practice patterns in high- and low-income countries, and part from a lack of effective perioperative drug therapies to protect the patient from surgical stress. We briefly review the history of surgical stress and provide a path forward from a systems-based approach. Key to progress is recognizing that the anesthetized brain is still physiologically ‘awake’ and responsive to the sterile stressors of surgery. New intravenous drug therapies are urgently required after anesthesia and before the first incision to prevent the brain from switching to sympathetic overdrive and activating secondary injury progression such as hyperinflammation, coagulopathy, immune activation and metabolic dysfunction. A systems-based approach targeting central nervous system-mitochondrial coupling may help drive research to improve outcomes following major surgery in civilian and military medicine.
Added by: Dr. Enrique Feoli Last edited by: Dr. Enrique Feoli |
| Notes |
|
Molecules that fulfill the criteria of pro-resolving mediators include specialized lipid mediators (lipoxins, resolvins, protectins, and maresins) (126, 166), proteins and peptides (annexin A1, adrenocorticotropic hormone), gaseous mediators (H2S and CO), purines (adenosine), as well as neuromodulators (acetylcholine and other neuropeptides) released under the control of the vagus nerve (126, 165, 167–169).
Added by: Dr. Enrique Feoli Last edited by: Dr. Enrique Feoli |