TJ Gan - Böcker

Ileus is a general functional inhibition of the propulsive bowel activity in the absence of mechanical bowel obstruction. Postoperative ileus (POI) is a more specific condition which is a transient cessation of coordinated bowel motility after surgery, preventing effective transit of intestinal content. Depending on the type of surgery, and especially when the bowels are involved in the surgery, the incidence can be high, affecting 4 to 20 percent of abdominal surgery patients. Typically, in the small intestine, it can last up to 24 hours; in the stomach, between 24 and 48 hours; and in the colon, between 48 and 120 hours. During this time, the patient is prohibited from eating and drinking, often requiring nasogastric suction and parenteral feeds until passage is restored. Until then, the patient cannot be discharged from the hospital. POI is the most common reason for delays in discharge after abdominal surgery and can greatly increase the cost of healthcare. It is estimated that the healthcare costs as a result of complications of postoperative ileus may be as high as one billion dollars per year.Though there is some available literature on POI, there is a dearth in new, up-to-date information on the latest management trends and emerging pharmacological therapies.Accelerating recovery of gastrointestinal function improves clinical outcomes, enhances patient comfort, and has a positive economical effect in that it shortens the length of hospital stay and reduces hospital cost. Treatment options include pharmacological as well as non-pharmacological approaches, specifically epidural anesthesia and traditional, non-steroidal, anti-inflammatory drugs, as well as other opioid sparing analgesics. Part of the new Oxford American Pocket Notes series, this very concise guide presents a brief overview of the diagnosis, prevention, and management of postoperative ileus. A valuable resource in the hospital setting for surgeons, anesthesiologists, gastroenterologists, OB/GYNs, pharmacists, physician assistants, nurse practitioners, recovery nurses and other members of the hospital staff, this practical, up-to-date volume includes sections on the pathophysiology and clinical features of POI as well as on traditional and emerging therapies.Uniquely compact and affordable, this book provides helpful guidelines for fast track recovery in the hospital setting. In addition, it includes sections on differential diagnosis and non-pharmacological treatments.Helpful aids, such as patient assessment tools, medication tables, and illustrations will provide easily accessible insights.

Over the past decade, there have been a large number of important studies related to fluid management for the surgical patient, resulting in confusion on this critical aspect of patient care. Proper fluid therapy in the perioperative setting has always been important but has only recently had concrete outcome-based guidelines. This is the first comprehensive, up-to-date and practical summary book on the topic.