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Perioperative fluid management

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https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#1
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28289542/complications-after-pancreaticoduodenectomy-are-associated-with-higher-amounts-of-intra-and-postoperative-fluid-therapy-a-single-center-retrospective-cohort-study
#2
Birte Kulemann, Marianne Fritz, Torben Glatz, Goran Marjanovic, Olivia Sick, Ulrich T Hopt, Jens Hoeppner, Frank Makowiec
BACKGROUND: Perioperative mortality after pancreaticoduodenectomy has decreased significantly in high-volume centers, but morbidity remains high. Restrictive perioperative fluid management may contribute to reduced complication rates after various surgical procedures. The aim of this study was to determine whether there is a correlation between the amount of fluid administered and postoperative complications. We hypothesized that higher amounts of intra- and total fluid is associated with greater postoperative morbidity...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28239802/anesthetic-management-of-patients-with-dilated-cardiomyopathy-for-noncardiac-surgery
#3
C-Q Chen, X Wang, J Zhang, S-M Zhu
Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesia considerations of patients with DCM undergoing non-cardiac surgery. Patient pathophysiology and clinical status, such as ventricular function, degree of myocardial fibrosis, resting heart rate and high-sensitivity C-reactive protein can affect survival rates...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28217157/emergency-anesthesia-for-evacuating-a-traumatic-acute-subdural-hemorrhage-in-a-child-overdosed-with-hypertonic-saline
#4
Chulananda Goonasekera, James Bedford, Sodhi Harpreet, Mariangela Giombini, Asme Sheikh
A previously healthy 1-year-old child with a traumatic acute subdural hemorrhage received 10 times higher dose of hypertonic saline inadvertently immediately before surgery. This case report describes deviations in fluid management needed to alleviate salt toxicity and its adverse effects during surgery under anesthesia perioperatively. The child made an uneventful recovery with no evident residual damage at follow-up.
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#5
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#6
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28187752/targeting-urine-output-and-30-day-mortality-in-goal-directed-therapy-a-systematic-review-with-meta-analysis-and-meta-regression
#7
Esther N van der Zee, Mohamud Egal, Diederik Gommers, A B Johan Groeneveld
BACKGROUND: Oliguria is associated with a decreased kidney- and organ perfusion, leading to organ damage and increased mortality. While the effects of correcting oliguria on renal outcome have been investigated frequently, whether urine output is a modifiable risk factor for mortality or simply an epiphenomenon remains unclear. We investigated whether targeting urine output, defined as achieving and maintaining urine output above a predefined threshold, in hemodynamic management protocols affects 30-day mortality in perioperative and critical care...
February 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28169966/perioperative-management-of-adult-patients-with-external-ventricular-and-lumbar-drains-guidelines-from-the-society-for-neuroscience-in-anesthesiology-and-critical-care
#8
Abhijit V Lele, Amie L Hoefnagel, Nina Schloemerkemper, David A Wyler, Nophanan Chaikittisilpa, Monica S Vavilala, Bhiken I Naik, James H Williams, Lakshmikumar Venkat Raghavan, Ines P Koerner
External ventricular drains and lumbar drains are commonly used to divert cerebrospinal fluid and to measure cerebrospinal fluid pressure. Although commonly encountered in the perioperative setting and critical for the care of neurosurgical patients, there are no guidelines regarding their management in the perioperative period. To address this gap in the literature, The Society for Neuroscience in Anesthesiology & Critical Care tasked an expert group to generate evidence-based guidelines. The document generated targets clinicians involved in perioperative care of patients with indwelling external ventricular and lumbar drains...
February 6, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#9
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28139242/the-effect-of-perioperative-fluid-management-on-postoperative-ileus-in-rectal-cancer-patients
#10
Matthew S VandeHei, Christina M Papageorge, Matthew M Murphy, Gregory D Kennedy
BACKGROUND: Postoperative ileus is a common cause of increased morbidity and cost after operative intervention. The aim of this study was to assess how fluid type, volume, and timing may affect incidence of postoperative ileus. METHODS: A retrospective cohort study was performed on patients undergoing operative intervention for rectal cancer from 2008 to 2015 at a single institution. Univariate and multivariate analyses were used to assess the effect of type (crystalloid versus colloid), volume by quartile, and timing (perioperative versus postoperative) on rate of postoperative ileus...
January 27, 2017: Surgery
https://www.readbyqxmd.com/read/28133683/restrictive-and-liberal-fluid-administration-in-major-abdominal-surgery
#11
Qianyun Pang, Hongliang Liu, Bo Chen, Yan Jiang
To determine whether perioperative fluid restrictive administration can reduce specific postoperative complications in adults undergoing major abdominal surgery.  Methods: We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, Google scholar, and article reference lists (up to December 2015) for studies that assessed fluid therapy and morbidity or mortality in patients undergoing major abdominal surgeries. The quality of the trials was assessed using the Jadad scoring system, and a meta-analysis of the included randomized, controlled trials was conducted using Review Manager software, version 5...
February 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#12
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28124540/intraoperative-breakage-of-sachse-s-knife-blade-a-rare-complication-of-optical-internal-urethrotomy-one-case-managing-experience
#13
Gautam Kumar Kanodia, Satyanarayan Sankhwar, Ankur Jhanwar, Ankur Bansal, Manoj Kumar, Ashok Gupta
Optical internal urethrotomy (OIU) is the most common procedure performed for short segment bulbar urethral stricture worldwide. This procedure most commonly performed using Sachse's cold knife. Various perioperative complications of internal urethrotomy have been described in literature including bleeding, urinary tract infection, extravasation of fluid, incontinence, impotence, and recurrence of stricture. Here we report a unique complication of breakage of Sachse knife blade intraoperatively and its endoscopic management...
January 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#14
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#15
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28086855/postoperative-fluid-overload-is-a-risk-factor-for-adverse-surgical-outcome-in-patients-undergoing-esophagectomy-for-esophageal-cancer-a-retrospective-study-in-335-patients
#16
Torben Glatz, Birte Kulemann, Goran Marjanovic, Svenja Bregenzer, Frank Makowiec, Jens Hoeppner
BACKGROUND: Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome. METHODS: We retrospectively examined 335 patients who had undergone esophagectomy for esophageal cancer at the University Hospital Freiburg between 1996 and 2014 to investigate the relation between intra- and postoperative fluid management and postoperative morbidity after esophagectomy...
January 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28062325/a-system-based-nursing-approach-to-improve-outcomes-in-the-postoperative-esophagectomy-patient
#17
REVIEW
Susan Collazo, Nicole L Graf
OBJECTIVE: To review essential nursing implications in the care of postoperative esophagectomy patients. DATA SOURCES: Peer-reviewed literature, institutional experience, journal articles. CONCLUSION: Utilizing a system-based approach to assess the post-esophagectomy patient will assist the nurse in ensuring safe and comprehensive care. IMPLICATIONS FOR NURSING PRACTICE: Nursing care measures to reduce perioperative esophagectomy morbidity includes aggressive fluid management, pain management, use of epidural analgesia, and early ambulation...
February 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28054107/-evidence-based-supportive-measures-to-secure-pancreatic-anastomoses
#18
O Belyaev, W Uhl
BACKGROUND: Pancreatic anastomosis is the Achilles heel of pancreatic surgery. Despite substantial progress in surgical techniques the rate of postoperative pancreatic fistulas remains very high. For this reason various supportive measures to secure pancreatic anastomoses are of continuing interest. OBJECTIVE: This review presents the newest evidence-based data on supportive measures designed to secure a pancreatic anastomosis. MATERIAL AND METHODS: The most recent meta-analyses, randomized controlled trials and the largest retrospective studies on the role of pancreatic duct stenting, double loop reconstruction, autologous patches and drainage in pancreaticoduodenectomy were taken into account...
January 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27965073/outcomes-of-endonasal-and-lateral-approaches-to-petroclival-meningiomas
#19
Maria Koutourousiou, Juan C Fernandez-Miranda, Francisco Vaz-Guimaraes Filho, John R de Almeida, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE: Transpetrosal approaches for the treatment of petroclival meningiomas are often associated with substantial morbidity and long recovery. With the goal of early clinical improvement, we have used less invasive surgical approaches for petroclival meningiomas. METHODS: We retrospectively reviewed 32 patients with petroclival meningiomas. Eleven patients (34.4%) were managed with lateral approaches (retrosigmoid or far lateral approach), 17 (53.1%) with anterior midline approaches (endoscopic endonasal approach [EEA]), and 4 (12...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27958191/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#20
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
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