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Intraoperative 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/28336475/intraoperative-rupture-of-ovarian-dermoid-cysts-in-the-pediatric-and-adolescent-population-should-this-change-your-surgical-management
#2
Krista J Childress, Gisselle Perez-Milicua, Julie Hakim, Oluyemisi Adeyemi-Fowode, Jennifer L Bercaw-Pratt, Xiomara M Santos, Jennifer E Dietrich
STUDY OBJECTIVE: 1) To determine the incidence of chemical peritonitis after cystectomy for ovarian dermoid cysts with intraoperative cyst rupture in the pediatric and adolescent population. 2) To examine the intraoperative and postoperative outcomes of cystectomies performed for ovarian dermoid cysts by laparoscopy and laparotomy, especially those with intraoperative cyst rupture. DESIGN: A retrospective cohort study of females who underwent ovarian cystectomy with proven ovarian dermoid pathology between July 2007 and July 2015...
March 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28321372/treatment-outcomes-of-rathke-s-cleft-cysts-managed-with-marsupialization
#3
Edward C Kuan, Frederick Yoo, Jennifer Chyu, Marvin Bergsneider, Marilene B Wang
Objectives Rathke's cleft cysts (RCC) are benign cystic lesions of the sella resulting from incomplete obliteration of Rathke's cleft. Symptomatic lesions often require surgical decompression, which is often amenable to a transnasal, transsphenoidal (TNTS) approach. We report our experience with marsupialization of RCC and describe a novel technique to promote re-epithelization of the cyst cavity. Design Retrospective review. Setting Tertiary academic medical center. Participants Patients who underwent TNTS for RCC between 2007 and 2015...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#4
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28296723/surgical-treatment-for-bacterial-meningitis-after-spinal-surgery-a-case-report
#5
Li-Min Zhang, Liang Ren, Zhen-Qi Zhao, Yan-Rui Zhao, Yin-Feng Zheng, Jun-Lin Zhou
RATIONALE: Bacterial meningitis (BM) has been recognized as a rare complication of spinal surgery. However, there are few reports on the management of postoperative BM in patients who have undergone spinal surgery. The initial approach to the treatment of patients suspected with acute BM depends on the stage at which the syndrome is recognized, the speed of the diagnostic evaluation, and the need for antimicrobial and adjunctive therapy. PATIENT CONCERNS: Here, we report the case of a patient with lumbar spinal stenosis and underwent a transforaminal lumbar interbody fusion at L4-L5...
March 2017: Medicine (Baltimore)
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
#6
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/28288059/effects-of-intraoperative-fluid-management-on-postoperative-outcomes-a-hospital-registry-study
#7
Christina H Shin, Dustin R Long, Duncan McLean, Stephanie D Grabitz, Karim Ladha, Fanny P Timm, Tharusan Thevathasan, Alberto Pieretti, Cristina Ferrone, Andreas Hoeft, Thomas W L Scheeren, Boyd Taylor Thompson, Tobias Kurth, Matthias Eikermann
OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols driven by such measures are limited in their ability to define the optimal fluid state during surgery. METHODS: This analysis of data on file included 92,094 adult patients undergoing noncardiac surgery with endotracheal intubation between 2007 and 2014 at an academic tertiary care hospital and two affiliated community hospitals...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28277363/fetoscopic-open-neural-tube-defect-repair-development-and-refinement-of-a-two-port-carbon-dioxide-insufflation-technique
#8
Michael A Belfort, William E Whitehead, Alireza A Shamshirsaz, Zhoobin H Bateni, Oluyinka O Olutoye, Olutoyin A Olutoye, David G Mann, Jimmy Espinoza, Erin Williams, Timothy C Lee, Sundeep G Keswani, Nancy Ayres, Christopher I Cassady, Amy R Mehollin-Ray, Magdalena Sanz Cortes, Elena Carreras, Jose L Peiro, Rodrigo Ruano, Darrell L Cass
OBJECTIVE: To describe development of a two-port fetoscopic technique for spina bifida repair in the exteriorized, carbon dioxide-filled uterus and report early results of two cohorts of patients: the first 15 treated with an iterative technique and the latter 13 with a standardized technique. METHODS: This was a retrospective cohort study (2014-2016). All patients met Management of Myelomeningocele Study selection criteria. The intraoperative approach was iterative in the first 15 patients and was then standardized...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28241234/laparoscopic-total-pancreatectomy-with-islet-autotransplantation-and-intraoperative-islet-separation-as-a-treatment-for-patients-with-chronic-pancreatitis
#9
Caleb J Fan, Kenzo Hirose, Christi M Walsh, Michael Quartuccio, Niraj M Desai, Vikesh K Singh, Rita R Kalyani, Daniel S Warren, Zhaoli Sun, Marie N Hanna, Martin A Makary
Importance: Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective: To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants: Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015...
February 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#10
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
#11
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/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#12
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28183081/management-of-abdominal-drainage-after-hepatic-resection
#13
Yoshihiro Inoue, Yoshiro Imai, Nao Kawaguchi, Fumitoshi Hirokawa, Michihiro Hayashi, Kazuhisa Uchiyama
BACKGROUND: Routine drainage after partial hepatic resection has long been controversial. METHODS: Three hundred and twenty-eight patients who underwent hepatic resections for liver tumors without biliary-enteric and gastrointestinal anastomoses were analyzed using propensity score matching analysis with respect to if and when a prophylactic drain was used and for how long. The criteria for drain placement were established and validated. RESULTS: Our criteria for drain placement were chosen according to postoperative percutaneous abdominal drainage risk factors, organ/space surgical site infections (SSIs), hepatic resection method, intraoperative bile leakage and operative time (≥300 min)...
February 10, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#14
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
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
#15
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/28134637/experiences-in-performing-posterior-calvarial-distraction
#16
Kevin McMillan, Mark Lloyd, Martin Evans, Nicholas White, Hiroshi Nishikawa, Desiderio Rodrigues, Melanie Sharp, Pete Noons, Guirish Solanki, Stephen Dover
The use of posterior calvarial distraction (PCD) for the management of craniosynostosis is well recognized. The advantages of using this technique include increased cranial volume, decreased intracranial pressure, relief of posterior fossa crowding, improved cerebrospinal fluid (CSF) circulation at the cranio-cervical junction with cessation, and possible resolution of syrinx.The authors retrospectively review their first 50 patients who have undergone PCD under the senior author's care in our unit.The demographics, diagnoses, intraoperative approach with techniques in distractor placement and outcomes of each patient were obtained through an electronic craniofacial database and written patient records...
January 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28129264/management-of-pericardial-fluid-in-blunt-trauma-variability-in-practice-and-predictors-of-operative-outcome-in-patients-with-computed-tomography-evidence-of-pericardial-fluid
#17
Cordelie E Witt, Ken F Linnau, Ronald V Maier, Frederick P Rivara, Monica S Vavilala, Eileen M Bulger, Saman Arbabi
BACKGROUND: The objectives of this study were to assess current variability in management preferences for blunt trauma patients with pericardial fluid, and to identify characteristics associated with operative intervention for patients with pericardial fluid on admission computed tomography (CT) scan. METHODS: This was a mixed-methods study of blunt trauma patients with pericardial fluid. The first portion was a research survey of members of the Eastern Association for the Surgery of Trauma conducted in 2016, in which surgeons were presented with four clinical scenarios of blunt trauma patients with pericardial fluid...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#18
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
#19
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/28121282/how-to-identify-patients-at-risk-of-abdominal-compartment-syndrome-after-surgical-repair-of-ruptured-abdominal-aortic-aneurysms-in-the-operating-room-a-pilot-study
#20
Betty Leclerc, Lucie Salomon Du Mont, Guillaume Besch, Simon Rinckenbach
Objectives Abdominal compartment syndrome (ACS) is poorly identified in surgery for ruptured abdominal aortic aneurysm and an early management is crucial. The aim of this study was to validate how many risk factors were needed to predict ACS. Secondary objectives were to assess its prevalence and the 30-day mortality. Methods All patients operated for ruptured abdominal aortic aneurysm during 5 years were included. An independent committee performed a retrospective diagnosis of ACS. Eight criteria were selected from the literature, and corresponded to pre- and intraoperative period: anemia (hemoglobin lower than 10 g/dL), prolonged shock (systolic blood pressure <90 mmHg more than 18 min), preoperative cardiac arrest, obesity (body mass index > 30), massive fluid resuscitation (≥3500 mL per hour for at least 1 h) and transfusions (>10 units packed blood red cell since the beginning of the treatment), severe hypothermia (≤33℃), acidosis (pH < 7...
January 1, 2017: Vascular
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