An Update on Systemic Sclerosis and its Perioperative Management
| Autor: | Kunal Karamchandani, Jean Charchaflieh, Zyad J. Carr, John Klick, Brittany J. McDowell |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Disease Scleroderma 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Anesthesiology medicine Anesthesia Perioperative Myocardial infarction Preoperative Evaluation (BJ Sweitzer Section Editor) skin and connective tissue diseases Intensive care medicine integumentary system business.industry Interstitial lung disease 030208 emergency & critical care medicine medicine.disease Anesthesiology and Pain Medicine Systemic sclerosis Airway management Airway business |
| Zdroj: | Current Anesthesiology Reports |
| ISSN: | 2167-6275 |
| Popis: | Purpose of Review Systemic sclerosis or scleroderma (SSc) is a systemic, immune-mediated disease characterized by abnormal cutaneous and organ-based fibrosis that results in progressive end-organ dysfunction and decreased survival. SSc results in significant challenges for the practicing anesthesiologist due to its rarity, multi-system involvement, and limited evidence-based guidance for optimal perioperative care. In this update, we briefly discuss the recent evidence on the pathophysiology and current management of SSc, review the anesthesia-related literature, and extrapolate these observations into an optimal perioperative strategy for the care of SSc patients. Recent Findings Evidence shows that patients with SSc demonstrate an increased risk for perioperative myocardial infarction, high rates of interstitial lung disease, pulmonary arterial hypertension, neurological disease, gastric dysmotility disorders, and challenging airway management, all findings that may result in suboptimal perioperative outcomes. Summary Advances in SSc medical management have resulted in improved survival, likely increasing the number of patients who will be exposed to perioperative care. Optimal perioperative management and risk stratification should expand beyond the well-described airway challenges and consider numerous systemic manifestations of systemic sclerosis such as pulmonary arterial hypertension, interstitial lung disease, and cardiac sequelae. |
| Databáze: | OpenAIRE |
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