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Intraoperative fluid management

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https://www.readbyqxmd.com/read/29202703/the-ability-of-left-ventricular-end-diastolic-volume-variations-measured-by-tee-to-monitor-fluid-responsiveness-in-high-risk-surgical-patients-during-craniotomy-a-prospective-cohort-study
#1
Haidan Lan, Xiaoshuang Zhou, Jing Xue, Bin Liu, Guo Chen
BACKGROUND: This study was aimed to evaluate the ability of left ventricular end-diastolic volume variations (LVEDVV) measured by transesophageal echocardiography (TEE) compared with stroke volume variation (SVV) obtained by the FloTrac/Vigileo monitor to predict fluid responsiveness, in patients undergoing craniotomy with goal direct therapy. METHODS: We used SVV obtained by the FloTrac/Vigileo monitor to manage intraoperative hypotension in adult patients undergoing craniotomy (ASA III - IV) after obtaining IRB approval and informed consent...
December 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29193942/-perioperative-management-protocol-of-patients-undergoing-microsurgical-flaps-in-main-healthcare-centers
#2
Alejandro Cruz-Segura, Pedro Grajeda-López
Microsurgery is one of the most fertile and innovative area in reconstructive surgery. Today it is considered an indispensable technique in plastic surgery with flaps survival rates over 95% in main healthcare centers. The factors involved in achieving these results are: the improvement of the surgical technique, adequate patient selection and careful perioperative care. Perioperative care starts at the initial assessment of the patient where it's very important to consider the indications and contraindications of these procedures...
September 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29181355/group-b-streptococcal-prosthetic-knee-joint-infection-linked-to-the-consumption-of-raw-fish
#3
Gin Way Law, Limin Wijaya, Andrew Hwee Chye Tan
Introduction: Group B Streptococcal (GBS) prosthetic joint infections (PJI) are rare, accounting for only 4.6-6% of primary and revision total knee replacements (TKRs). In 2015, there was an outbreak of GBS infections in Singapore with an association confirmed between consumption of Chinese-style raw fish dishes (snakehead fish, Asian bighead carp) and GBS infection, Type III GBS ST283 strain, affecting more than 200 patients in Singapore. This outbreak is the largest of its kind in the world and also the first time that foodborne transmission of GBS has been proven...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29176490/incidental-durotomy-in-open-versus-tubular-revision-microdiscectomy-a-retrospective-controlled-study-on-incidence-management-and-outcome
#4
Evangelos Kogias, Jan-Helge Klingler, Pamela Franco Jimenez, Ioannis Vasilikos, Ronen Sircar, Christoph Scholz, Ulrich Hubbe
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To compare the incidence, management, and outcome of incidental durotomy in revision microdiscectomy with open and minimal-access surgery. SUMMARY OF BACKGROUND DATA: Incidental durotomy occurs with a variable incidence of 3%-27% in spine surgery. The highest rate occurs in revision microdiscectomy. The intraoperative and postoperative management of dural tears varies in the literature and the definite impact on clinical outcome has to be clarified...
December 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29174123/intraoperative-anesthetic-management-of-lung-transplantation-center-specific-practices-and-geographic-and-centers-size-differences
#5
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29162303/cervical-intradural-disc-herniation-a-systematic-review
#6
REVIEW
Qing Guan, Fei Xing, Ye Long, Zhou Xiang
BACKGROUND: Cervical intradural disc herniation (CIDH) is rare, and diagnosis and treatment are challenging. We conducted a systematic review and meta-analysis of the literature on the diagnosis and treatment of CIDH. METHOD: The presentation, imaging manifestations, diagnosis, management, prognosis and possible pathogenesis were reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies and case reports published from inception to 2017 were retrieved...
November 18, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29125632/median-sternotomy-versus-intercostal-thoracotomy-for-lung-lobectomy-a-comparison-of-short-term-outcome-in-134-dogs
#7
Seth Bleakley, Kevin Phipps, Brian Petrovsky, Eric Monnet
OBJECTIVE: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT). STUDY DESIGN: Retrospective case control study. METHODS: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded...
November 10, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29121283/postoperative-pulmonary-complications-pulmonary-and-systemic-inflammatory-responses-after-lung-resection-surgery-with-prolonged-one-lung-ventilation-randomized-controlled-trial-comparing-intravenous-and-inhalational-anaesthesia
#8
F de la Gala, P Piñeiro, A Reyes, E Vara, L Olmedilla, P Cruz, I Garutti
Background: Recent studies report the immunomodulatory lung-protective role of halogenated anaesthetics during lung resection surgery (LRS) but have not investigated differences in clinical postoperative pulmonary complications (PPCs). The main goal of the present study was to compare the effect of sevoflurane and propofol on the incidence of PPCs in patients undergoing LRS. The second aim was to compare pulmonary and systemic inflammatory responses to LRS. Methods: Of 180 patients undergoing LRS recruited, data from 174 patients were analysed...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#9
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29099890/the-role-of-synovial-cytokines-in-the-diagnosis-of-periprosthetic-joint-infections-current-concepts
#10
Jared M Newman, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
Periprosthetic joint infection (PJI) is a serious and potentially devastating complication of total joint arthroplasty. Accurate diagnosis of PJI is of utmost importance, but differentiating septic from aseptic failed total joint arthroplasty is extremely challenging, and improper management can lead to significant morbidity. The gold standard for PJI diagnosis is based on standardized laboratory and clinical criteria but relies on preoperative and intraoperative findings, which can be unreliable. Given these limitations, research has focused on new methods for diagnosing PJI...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29094066/surgical-repair-of-spontaneous-cerebrospinal-fluid-csf-leaks-a-systematic-review
#11
REVIEW
Brian C Lobo, Maraya M Baumanis, Rick F Nelson
Objectives: To review the safety and efficacy of surgical management for spontaneous cerebrospinal fluid (CSF) leaks of the anterior and lateral skull base. Data Sources: A systematic review of English articles using MEDLINE. Review Methods: Search terms included spontaneous, CSF, cerebrospinal fluid, endoscopic, middle fossa, transmastoid, leak, rhinorrhea. Independent extraction of articles by 3 authors. Results: Patients with spontaneous CSF leaks are often obese (average BMI of 38 kg/m2) and female (72%)...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29073613/impact-of-the-flotrac-vigileotm-monitoring-on-intraoperative-fluid-management-and-outcome-after-liver-resection
#12
Enrico Giustiniano, Fabio Procopio, Nadia Ruggieri, Stefania Grimaldi, Guido Torzilli, Ferdinando Raimondi
BACKGROUNDS: Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. METHODS: We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs...
October 26, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29064899/variation-in-drain-management-after-pancreatoduodenectomy-early-versus-delayed-removal
#13
Joal D Beane, Michael G House, Eugene P Ceppa, Scott C Dolejs, Henry A Pitt
OBJECTIVE: The objectives are to report practice patterns and management of operatively placed drains and to compare outcomes in patients with early versus delayed drain removal after pancreatoduodenectomy. BACKGROUND: Early drain removal after pancreatoduodenectomy, when guided by postoperative day (POD) 1 drain fluid amylase (DFA-1), is associated with reduced rates of clinically relevant postoperative pancreatic fistula (CR-POPF). However, whether surgeons have altered their management based on this strategy is unknown...
October 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29053561/recognizing-and-managing-bullous-descemet-detachment-secondary-to-accidental-hydroseparation-during-phacoemulsification-cataract-surgery-by-relaxing-descemetotomy
#14
Soosan Jacob, Amar Agarwal, Athiya Agarwal, Saijimol Ai
PURPOSE: To report a new technique called relaxing Descemetotomy for treatment of bullous Descemet detachment (BDD) secondary to accidental hydroseparation of Descemet membrane (DM) during stromal hydration in cataract surgery. METHODS: A clear corneal keratome entry was created close to the limbus extending inward to create a relaxing cut (ab externo relaxing Descemetotomy) on taut DM, thus creating an egress route for supra-Descemetic fluid (SDF). This was followed by pneumodescemetopexy to drain SDF internally...
October 17, 2017: Cornea
https://www.readbyqxmd.com/read/29047069/postoperative-visceral-tissue-edema-assessed-by-computed-tomography-is-a-predictor-for-severe-complications-after-pancreaticoduodenectomy
#15
Atsushi Shimizu, Manabu Kawai, Seiko Hirono, Ken-Ichi Okada, Motoki Miyazawa, Yuji Kitahata, Masaki Ueno, Shinya Hayami, Atsushi Miyamoto, Yoshiki Kimoto, Toshio Shimokawa, Hiroki Yamaue
BACKGROUND/AIMS: In pancreatoduodenectomy (PD), the adverse impact of tissue edema owing to intraoperative fluid overload remains unclear. This study aims to evaluate how visceral tissue edema due to fluid overload affects severe postoperative complications after PD. It aims to clarify the usefulness of assessment by computed tomography (CT) of postoperative tissue edema. METHODS: We classified 200 patients who underwent PD as either liberal fluid management (LFM) group (n = 100) or goal-directed fluid therapy (GDFT) group (n = 100), based on intraoperative fluid management...
October 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29025781/subclinical-meningoventriculitis-as-a-cause-of-obstructive-hydrocephalus
#16
Ravindran Visagan, Laurent James Livermore, Dominic Kelly, Shailendra Magdum
Communicating hydrocephalus may complicate infantile bacterial meningitis, typically presenting with systemic features of infection. We report a rare case of 'subclinical meningoventriculitis' causing obstructive hydrocephalus and its challenging management. A healthy 10-week-old immunocompetent male patient presented with failure to thrive and vomiting, secondary to presumed gastro-oesophageal reflux. The child was neurologically alert, afebrile with normal inflammatory markers. Progressive macrocephaly prompted an MRI confirming triventricular hydrocephalus secondary to aqueductal stenosis...
October 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29019146/spinal-cord-injury-after-thoracic-endovascular-aortic-aneurysm-repair
#17
Hamdy Awad, Mohamed Ehab Ramadan, Hosam F El Sayed, Daniel A Tolpin, Esmerina Tili, Charles D Collard
PURPOSE: Thoracic endovascular aortic aneurysm repair (TEVAR) has become a mainstay of therapy for aneurysms and other disorders of the thoracic aorta. The purpose of this narrative review article is to summarize the current literature on the risk factors for and pathophysiology of spinal cord injury (SCI) following TEVAR, and to discuss various intraoperative monitoring and treatment strategies. SOURCE: The articles considered in this review were identified through PubMed using the following search terms: thoracic aortic aneurysm, TEVAR, paralysis+TEVAR, risk factors+TEVAR, spinal cord ischemia+TEVAR, neuromonitoring+thoracic aortic aneurysm, spinal drain, cerebrospinal fluid drainage, treatment of spinal cord ischemia...
December 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29016590/endoscopic-endonasal-transsphenoidal-approach-to-pituitary-adenoma-a-multi-disciplinary-approach
#18
Deepak Regmi, Amit Thapa, Bidur Kc, Bikram Shakya
BACKGROUND: The excellent visualization and minimally invasive approach employed in endoscopic endonasal procedures has now revolutionized the pituitary surgery, replacing the transnasal microscopic technique worldwide. However, it involves major shift in hand-eye co-ordination from static 3 dimensional images of microscope to 2 dimensional endoscopic images hence demands training and inter-disciplinary approach. Here we present our experiences in learning and developing a safe endonasal transsphenoidal endoscopic approach to resect pituitary adenomas...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28992877/perioperative-fluid-management-in-major-hepatic-resection-an-integrative-review
#19
REVIEW
Osamu Yoshino, Marcos Vinicius Perini, Christopher Christophi, Laurence Weinberg
BACKGROUND: Fluid intervention and vasoactive pharmacological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult patients undergoing major hepatic resection...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28991116/incidence-and-operative-factors-associated-with-discretional-postoperative-mechanical-ventilation-after-general-surgery
#20
Juliet J Ray, Meredith Degnan, Krishnamurti A Rao, Jonathan P Meizoso, Charles A Karcutskie, Danielle B Horn, Luis Rodriguez, Richard P Dutton, Carl I Schulman, Roman Dudaryk
BACKGROUND: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors...
October 4, 2017: Anesthesia and Analgesia
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