SubSpecialties  |   April 2018
SOCCA: The ‘Value Added’ Contribution of Perioperative Critical Care
Author Affiliations
  • Avery Tung, M.D. FCCM
    Society of Critical Care Anesthesiologists
Article Information
Critical Care / SubSpecialties
SubSpecialties   |   April 2018
SOCCA: The ‘Value Added’ Contribution of Perioperative Critical Care
ASA Monitor 4 2018, Vol.82, 64-65.
ASA Monitor 4 2018, Vol.82, 64-65.
From the perspective of the O.R. anesthesiologist, an advantage to anesthesia-based critical care is the ability to create a continuum between intra- and postoperative care. Although such a continuum may already exist with ERAS protocols for patients undergoing relatively straightforward orthopedic and general procedures, anesthesiologist-intensivists can facilitate smooth transitions of care for more complex and high-risk cases such as major vascular, oncological or urological procedures. Arguably an anesthesia-trained intensivist is best-equipped to understand complex intraoperative management details, assess the relevance of temperature or adequacy of fluid resuscitation in hemodynamically fragile patients, manage neuromuscular blockade reversal, or manage a potentially swollen airway. More than one anesthesiologist has mentioned to me at meetings their frustration in handing off many hours of carefully titrated patient care to a medically trained intensivist who then proceeds to extubate inappropriately or start a vasoconstrictor infusion without first assessing volume responsiveness. Many anesthesiologists would feel better handing off a complex cystectomy or posterior spinal fusion to an intensivist who speaks their language and understands their issues.
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