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blood pressure and surgery

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https://www.readbyqxmd.com/read/29454185/preterm-infants-undergoing-laparotomy-for-necrotizing-enterocolitis-or-spontaneous-intestinal-perforation-display-evidence-of-impaired-cerebrovascular-autoregulation
#1
Sara J Kuik, Michelle E van der Laan, Margot T Brouwer-Bergsma, Jan B F Hulscher, Anthony R Absalom, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Preterm infants requiring surgery are at risk of impaired neurocognitive development caused, possibly, by cerebral ischemia associated with impaired cerebrovascular autoregulation (CAR). We evaluated CAR before, during, and after laparotomy. STUDY DESIGN: This was a hypothesis generating prospective observational cohort study. SUBJECTS: We included preterm infants requiring surgery for necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP)...
February 14, 2018: Early Human Development
https://www.readbyqxmd.com/read/29452806/steroid-administration-after-anaesthetic-induction-with-etomidate-does-not-reduce-in-hospital-mortality-or-cardiovascular-morbidity-after-non-cardiac-surgery
#2
R Komatsu, J You, S Rajan, Y Kasuya, D I Sessler, A Turan
BACKGROUND: We tested the primary hypothesis that corticosteroid administration after etomidate exposure reduces a composite of in-hospital mortality and cardiovascular morbidity after non-cardiac surgery. METHODS: We evaluated ASA physical status III and IV patients who had non-cardiac surgery with general anaesthesia at the Cleveland Clinic. Amongst 4275 patients in whom anaesthesia was induced with etomidate, 804 were also given steroid intraoperatively, mostly dexamethasone at a median dose of 6 mg...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452370/blood-cardioplegia-for-cardiac-surgery-in-acute-myocardial-infarction-rat-experiments-with-two-widely-used-solutions
#3
Andreas Boening, Lena Assling-Simon, Martina Heep, Kerstin Boengler, Bernd Niemann, Julia Schipke, Christian Mühlfeld, Philippe Grieshaber
OBJECTIVES: Blood cardioplegia (BCP) can be used in different ways to protect the heart from ischaemia-reperfusion injury during cardiac surgery. Because there could be differences between warm and cold intermittent cardioplegia with or without warm reperfusion, we investigated the influence of 2 blood cardioplegia solutions on cardiac function, metabolism and infarct size in stable and infarcted rat hearts. METHODS: The hearts of 32 male Wistar rats were excised and inserted into a blood-perfused isolated heart apparatus...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29451642/damage-control-surgery-are-we-losing-control-over-indications
#4
Silvânia Klug Pimentel, Tulio Rucinski, Melina Paula DE Araújo Meskau, Guilherme Pasquini Cavassin, Nathan Harmuch Kohl
OBJECTIVE: to analyze the surgeons' subjective indications for damage control surgery, correlating with objective data about the patients' physiological state at the time the surgery was chosen. METHODS: we carried out a prospective study between January 2016 and February 2017, with 46 trauma victims who were submitted to damage control surgery. After each surgery, we applied a questionnaire to the attending surgeon, addressing the motivations for choosing the procedure...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29449343/extrahepatic-angiogenesis-hinders-recovery-of-portal-hypertension-and-collaterals-in-rats-with-cirrhosis-resolution
#5
Shao-Jung Hsu, Ming-Hung Tsai, Ching-Chih Chang, Yu-Hsin Hsieh, Hui-Chun Huang, Fa-Yauh Lee, Chiao-Lin Chuang, Ming-Chih Hou, Shou-Dong Lee
Liver cirrhosis is characterized by portal hypertension. However, the alteration of portal hypertension-related derangements during cirrhosis resolution is not well known. This study aimed to establish animal models with cirrhosis resolution and to investigate the relevant changes during this process.Male Spraque-Dawley rats were applied. In reverse thioacetamide (rTAA) model, rats were randomly allocated into four groups with control, TAA cirrhosis and rTAA groups that discontinued TAA for 4 or 8 weeks after cirrhosis induction...
February 15, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29444785/longitudinal-changes-in-intraocular-pressure-and-association-with-systemic-factors-and-refractive-error-lingtou-eye-cohort-study
#6
Xiaotong Han, Tangjian Yang, Jian Zhang, Sha Yu, Xinxing Guo, William Yan, Yin Hu, Mingguang He
OBJECTIVES: To investigate the longitudinal changes in intraocular pressure (IOP) and its associations with refractive error and systemic determinants in a Chinese geriatric population. DESIGN: Prospective cohort study. SETTING: Guangzhou Government Servant Physical Check-up Center, Guangzhou, China. PARTICIPANTS: 4413 government employees aged no less than 40 years (41.9% female) attending annual physical and eye examinations were included in this study...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29443767/effect-of-oxycodone-hydrochloride-combined-with-flurbiprofen-axetil-for-intravenous-patient-controlled-analgesia-in-lower-abdominal-patients-a-randomized-trial
#7
Xiaobing Xiang, Xiaohong Yuan, Yanhong Lian, Jun Fang, Yingli Wu
BACKGROUND: Problems like postoperative pain are still common phenomena after general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid with a safe and excellent therapeutic effect on visceral pain. Flurbiprofen axetil has the efficacy of targeted analgesia. We hypothesize that different doses of oxycodone hydrochloride combined with flurbiprofen axetil would generate great results on postoperative intravenous analgesia in lower abdominal patients. METHODS: In the clinical trial, 90 American Society of Anesthesiologists I or II patients scheduled for elective general anesthesia were randomly divided into 3 groups, 30 cases in each group...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#8
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29439814/teaching-operative-cardiac-surgery-in-the-era-of-increasing-patient-complexity-can-it-still-be-done
#9
George Tolis, Philip J Spencer, Jordan P Bloom, Serguei Melnitchouk, David A D'Alessandro, Mauricio A Villavicencio, Thoralf M Sundt
OBJECTIVE: Teaching the next generation operative cardiac surgery while maintaining the highest level of patient care is an ever-increasing challenge given the growing proportion of patients with multiple comorbidities, the loss of more straightforward cases to percutaneous interventions, and the pressure of public reporting. No study to date has compared the outcomes of similar cases performed entirely ("skin-to-skin") by the resident with those performed entirely by the staff to confirm the safety of this practice...
February 10, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29439762/the-treatment-of-temporomandibular-joint-dislocation
#10
Ulla Prechel, Peter Ottl, Oliver M Ahlers, Andreas Neff
BACKGROUND: The estimated incidence of temporomandibular joint dislocation in Germany is at least 25/100 000 per year. A correct diagnosis and the initiation of appropriate treatment without delay are essential if permanent damage to the joint is to be avoided. METHODS: This review is based on pertinent publications retrieved by a systematic search in the PubMed, Cochrane, Embase, and ZB Med databases. RESULTS: The initial search yielded 24 650 hits; duplicates were removed and 136 studies were chosen for further analysis...
February 2, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29435595/-blood-management-in-complex-reconstructive-spine-surgery-in-asd-patients-do-effective-measures-to-reduce-bleeding-exist
#11
REVIEW
V Bullmann, M Granitzka
BACKGROUND: Blood management in reconstructive spine surgery is a challenge and must be managed interdisciplinarily. An experienced team of anesthesiologists and spine surgeons needs to work closely together. THERAPY: After optimal preoperative preparation, the patient is given an initial dose of 1000 mg tranexamic acid. The most adequate medium blood pressure is about 80 mm Hg during surgery. The surgeon must watch for subperiosteal preparation and subtle stypsis...
February 12, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29435465/missed-massive-pulmonary-embolism-and-the-hidden-threat-of-a-distal-deep-vein-thrombosis
#12
Cynthia Wong
A 47-year-old woman presented to her GP (general practitioner) surgery with a left leg pain of 4 days duration after a recent 4-hour flight. She was taking the oral combined contraceptive pill and had no past medical history. She had a low predictive Wells score for deep vein thrombosis, but her D-dimer was positive, so she had a proximal lower limb vein ultrasound scan as per the National Institute for Clinical Excellence guidelines, which was negative. Two days later, she presented to the emergency department with a collapse and dyspnea...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29433967/role-of-myocardial-collagen-degradation-and-fibrosis-in-right-ventricle-dysfunction-in-transposition-of-the-great-arteries-after-atrial-switch
#13
Magalie Ladouceur, Stephanie Baron, Valérie Nivet-Antoine, Gérard Maruani, Gilles Soulat, Helena Pereira, Anne Blanchard, Pierre Boutouyrie, Jean Louis Paul, Elie Mousseaux
BACKGROUND: Heart failure is a serious event in patients with transposition of the great arteries (D-TGA) after atrial redirection surgery. We aimed to determine the association between myocardial fibrosis and systolic and diastolic systemic right ventricle (sRV) dysfunction. METHODS: Diastolic and systolic function of sRV was prospectively assessed using echocardiography and cardiac magnetic resonance imaging (CMR) in 48 patients with atrially switched D-TGA and 26 healthy subjects...
January 31, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29430440/interaction-between-peri-operative-blood-transfusion-tidal-volume-airway-pressure-and-postoperative-ards-an-individual-patient-data-meta-analysis
#14
Ary Serpa Neto, Nicole P Juffermans, Sabrine N T Hemmes, Carmen S V Barbas, Martin Beiderlinden, Michelle Biehl, Ana Fernandez-Bustamante, Emmanuel Futier, Ognjen Gajic, Samir Jaber, Alf Kozian, Marc Licker, Wen-Qian Lin, Stavros G Memtsoudis, Dinis Reis Miranda, Pierre Moine, Domenico Paparella, Marco Ranieri, Federica Scavonetto, Thomas Schilling, Gabriele Selmo, Paolo Severgnini, Juraj Sprung, Sugantha Sundar, Daniel Talmor, Tanja Treschan, Carmen Unzueta, Toby N Weingarten, Esther K Wolthuis, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
Background: Transfusion of blood products and mechanical ventilation with injurious settings are considered risk factors for postoperative lung injury in surgical Patients. Methods: A systematic review and individual patient data meta-analysis was done to determine the independent effects of peri-operative transfusion of blood products, intra-operative tidal volume and airway pressure in adult patients undergoing mechanical ventilation for general surgery, as well as their interactions on the occurrence of postoperative acute respiratory distress syndrome (ARDS)...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29429928/effect-of-remote-ischemic-preconditioning-on-intestinal-ischemia-reperfusion-injury-in-adults-undergoing-on-pump-cabg-surgery-a-randomized-controlled-pilot-trial
#15
Rafael Struck, Maria Wittmann, Stefan Müller, Patrick Meybohm, Andreas Müller, Soyhan Bagci
OBJECTIVE: Cardiopulmonary bypass (CPB) surgery commonly threatens the heart and remote organs with ischemia-reperfusion injury. Transient episodes of ischemia to nonvital tissue, known as remote ischemic preconditioning (RIPC), is thought to help local and remote vital organs to withstand subsequent ischemic insults. DESIGN: Prospective, randomized, double-blinded control trial. SETTING: Tertiary referral academic teaching hospital. PARTICIPANTS: Thirty patients undergoing elective CPB surgery INTERVENTION: RIPC was achieved via three 5-minute cycles of upper limb ischemia using a blood pressure cuff or control (sham cuff)...
July 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29428034/impact-of-trauma-certified-registered-nurse-anesthetists-team-on-intra-operative-resuscitation-and-postoperative-outcomes-of-trauma-patients
#16
Juan Duchesne, Chad Majoue, Marquinn Duke, Rosemarie Robledo, Chad Achord, Leslie McHale, Brandy Davis, Lusine Nahapetyan
A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS)...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29427619/the-association-of-aortic-valve-pathology-with-renal-resistive-index-as-a-kidney-injury-biomarker
#17
Benjamin Y Andrew, Anne D Cherry, Jennifer N Hauck, Alina Nicoara, Cory D Maxwell, Ryan M Konoske, Annemarie Thompson, Lakshmi D Kartha, Madhav Swaminathan, Mark Stafford-Smith
BACKGROUND: Acute kidney injury (AKI) is a common serious complication following cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (insufficiency and/or stenosis) and RRI is unknown. This study aimed to investigate RRI variability related to aortic valve pathology. METHODS: In a retrospective review of cardiac surgery patients, RRI and aortic valve pathology were assessed prior to cardiopulmonary bypass using transesophageal echocardiography...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29423504/nonlinear-dynamics-of-dacron-aortic-prostheses-conveying-pulsatile-flow
#18
Eleonora Tubaldi, Michael Paidoussis, Marco Amabili
This study addresses the dynamic response to pulsatile physiological blood flow and pressure of a woven Dacron graft currently used in thoracic aortic surgery. The model of the prosthesis assumes a cylindrical orthotropic shell described by means of nonlinear Novozhilov shell theory. The blood flow is modeled as Newtonian pulsatile flow, and unsteady viscous effects are included. Coupled fluid-structure Lagrange equations for open systems with wave propagation subject to pulsatile flow are applied. Physiological waveforms of blood pressure and velocity are approximated with the first eight harmonics of the corresponding Fourier series...
February 8, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29419895/pulmonary-artery-perfusion-versus-no-perfusion-during-cardiopulmonary-bypass-for-open-heart-surgery-in-adults
#19
REVIEW
Katrine B Buggeskov, Lars Grønlykke, Emilie C Risom, Mao Ling Wei, Jørn Wetterslev
BACKGROUND: Available evidence has been inconclusive on whether pulmonary artery perfusion during cardiopulmonary bypass (CPB) is associated with decreased or increased mortality, pulmonary events, and serious adverse events (SAEs) after open heart surgery. To our knowledge, no previous systematic reviews have included meta-analyses of these interventions. OBJECTIVES: To assess the benefits and harms of single-shot or continuous pulmonary artery perfusion with blood (oxygenated or deoxygenated) or a preservation solution compared with no perfusion during cardiopulmonary bypass (CPB) in terms of mortality, pulmonary events, serious adverse events (SAEs), and increased inflammatory markers for adult surgical patients...
February 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29419552/is-speed-a-desirable-difficulty-for-learning-procedures-an-initial-exploration-of-the-effects-of-chronometric-pressure
#20
Becca L Gas, EeeLN H Buckarma, David A Cook, David R Farley, Martin V Pusic
PURPOSE: To determine if "chronometric pressure" (i.e., a verbal prompt to increase speed) could predictably alter medical learners' speed-accuracy trade-off during a simulated surgical task, thus modifying the challenge. METHOD: The authors performed a single-task, interrupted time-series study, enrolling surgery residents and medical students from two institutions in September and October 2015. Participants completed ten repetitions of a simulated blood vessel ligation (placement of two ligatures 1 cm apart)...
February 6, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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