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Intraoperative fluid management

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https://www.readbyqxmd.com/read/29457117/goal-directed-therapy-reduces-fluid-balance-while-maintaining-hemodynamic-stability-in-intraoperative-management-of-pancreaticoduodenectomy-a-retrospective-comparative-study
#1
Satoshi Ishihara, Takeshi Yokoyama, Katsuyuki Katayama
Background: Goal-directed therapy (GDT) is beneficial for surgical patients, especially for those undergoing high-risk surgery. However, little has been reported on the hemodynamic effects of GDT in extensive surgery. We conducted a study to determine the impact of GDT on intraoperative management of extensive surgery. Findings: We retrospectively collected data from 90 patients who underwent pancreaticoduodenectomy: 44 who received intraoperative GDT (GDT group) and 46 who received conventional hemodynamic management (control group)...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29455120/amyand-s-hernia-with-acute-gangrenous-appendicitis-and-cecal-perforation-a-case-report-and-review-of-the-literature
#2
William Kromka, Aline S Rau, Charles J Fox
INTRODUCTION: An Amyand's hernia is a heterogeneous clinical condition defined by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not contain other abdominal contents or pathologic inflammatory changes. Herein we present an exceptionally rare case of an Amyand's hernia containing acute appendicitis and a perforated cecum. PRESENTATION OF CASE: A 46-year-old male with a right inguinal hernia of 2-3 year duration presented to our Emergency Department complaining of acute onset abdominal and groin pain...
February 14, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29451938/the-management-of-cerebrospinal-fluid-leak-after-anterior-cervical-decompression-surgery
#3
Jiliang Zhai, Ripul R Panchal, Ye Tian, Shujie Wang, Lijuan Zhao
Cerebrospinal fluid (CSF) leak is a rare but potentially troublesome and occasionally catastrophic complication after anterior cervical decompression surgery. There is limited literature describing this complication, and the management of CSF leak varies. The aim of this study was to retrospectively review the treatment of cases with CSF leak and develop a management algorithm. A series of 14 patients with CSF leak from January 2011 to May 2016 were included in this study. Their characteristics, management of CSF leak, and outcomes were documented...
February 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29436139/incidence-and-factors-contributing-to-postdischarge-nausea-and-vomiting-in-pediatric-ambulatory-surgical-cases
#4
Proshad N Efune, Abu Minhajuddin, Peter Szmuk
BACKGROUND: Little is known regarding the incidence and contributing factors of postdischarge nausea and vomiting in children. AIMS: The aim of this study was to determine the incidence of postdischarge nausea and vomiting in day surgery patients and to identify demographic, intraoperative, and postoperative variables that influence the risk. METHODS: In this prospective observational study, a postdischarge questionnaire was administered to parents of ambulatory patients who received anesthesia and the electronic records were reviewed...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29424819/temporal-bone-meningo-encephalic-herniation-etiological-categorization-and-surgical-strategy
#5
Golda Grinblat, Manjunath Dandinarasaiah, Sampath Chandra Prasad, Gianluca Piras, Enrico Piccirillo, Andrea Fulcheri, Mario Sanna
OBJECTIVE: To study the clinical presentation, intraoperative findings and surgical management in meningo-encephalic-herniation (MEH) based on the etiology. STUDY DESIGN: A retrospective clinical study and is a follow-up on the previously published report in 2009. SETTING: A quaternary referral otology and skull base center PATIENTS AND METHODS:: The inclusion criteria were intraoperatively verified MEH in patients with a minimum follow-up of 12 months, which yielded 262 operated ears...
March 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29424017/perioperative-blood-management-strategies-for-total-knee-arthroplasty
#6
REVIEW
Qiang Lu, Hao Peng, Guan-Jin Zhou, Dong Yin
Total knee arthroplasty (TKA) often causes a significant amount of blood loss with an accompanying decline in hemoglobin and may increase the frequency of allogeneic blood transfusion rates. Unfortunately, allogeneic blood transfusions have associated risks including postoperative confusion, infection, cardiac arrhythmia, fluid overload, increased length of hospital stay, and increased mortality. Other than reducing the need for blood transfusions, reducing perioperative blood loss in TKA may also minimize intra-articular hemorrhage, limb swelling, and postoperative pain, and increase the range of motion during the early postoperative period...
February 9, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29416252/perioperative-use-of-transthoracic-echocardiography-in-a-patient-with-congenitally-corrected-transposition-of-great-arteries-atrial-septal-defect-and-severe-pulmonary-stenosis-for-lower-segment-cesarean-section
#7
Vikas Saini, Tanvir Samra, Gurpreet Kaur
A 25-year-old female with congenitally corrected transposition of great arteries (CCTGAs), atrial septal defect, and severe pulmonary stenosis underwent lower segment cesarean section at 34 weeks of gestation using combined spinal epidural anesthesia (CSEA). We used transthoracic echocardiography (TTE) for intraoperative monitoring of the cardiovascular system because these patients are reported to have a high prevalence of myocardial perfusion defects, regional wall motion abnormalities, and impaired ventricular contractility...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29406186/current-concepts-of-fluid-management-in-enhanced-recovery-pathways
#8
REVIEW
R Makaryus, T E Miller, T J Gan
Perioperative fluid management impacts outcomes and plays a pivotal role in enhanced recovery pathways (ERPs). There have been major advances in understanding the effects of fluid therapy and administration during the perioperative period. Improving fluid management during this period leads to a decrease in complications, decrease in length of stay (LOS), and enhanced patient outcomes. It is important to consider preoperative and postoperative fluid management to be just as critical as intraoperative management given multiple associated benefits to the patients...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29380190/comparison-of-cardiac-output-optimization-with-an-automated-closed-loop-goal-directed-fluid-therapy-versus-non-standardized-manual-fluid-administration-during-elective-abdominal-surgery-first-prospective-randomized-controlled-trial
#9
Marc Lilot, Amandine Bellon, Marine Gueugnon, Marie-Christine Laplace, Bruno Baffeleuf, Pauline Hacquard, Felicie Barthomeuf, Camille Parent, Thomas Tran, Jean-Luc Soubirou, Philip Robinson, Lionel Bouvet, Olivia Vassal, Jean-Jacques Lehot, Vincent Piriou
An intraoperative automated closed-loop system for goal-directed fluid therapy has been successfully tested in silico, in vivo and in a clinical case-control matching. This trial compared intraoperative cardiac output (CO) in patients managed with this closed-loop system versus usual practice in an academic medical center. The closed-loop system was connected to a CO monitoring system and delivered automated colloid fluid boluses. Moderate to high-risk abdominal surgical patients were randomized either to the closed-loop or the manual group...
January 27, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29311539/tolvaptan-for-fluid-management-in-living-donor-liver-transplant-recipients
#10
Shunichi Imai, Masahiro Shinoda, Hideaki Obara, Minoru Kitago, Taizo Hibi, Yuta Abe, Hiroshi Yagi, Kentaro Matsubara, Hisanobu Higashi, Osamu Itano, Yuko Kitagawa
BACKGROUND Tolvaptan, an antagonist of the vasopressin V2 receptor is a novel oral diuretic that promotes water excretion selectively. We have used furosemide as a primary diuretic and added human atrial natriuretic peptide (hANP) if necessary for fluid management postoperatively in living-donor liver transplantation (LDLT) recipients. Recently we introduced tolvaptan and used both tolvaptan and furosemide as primary diuretics. MATERIAL AND METHODS Clinical outcomes were compared between LDLT recipients whose postoperative fluid management was performed before (control group, n=10) and after (tolvaptan group, n=16) introduction of tolvaptan...
January 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29259630/abdominopelvic-tuberculosis-secondary-to-a-nontuberculous-mycobacterium-in-an-immunocompetent-patient
#11
Beng Kwang Ng, Kembang Aziah Yakob, Wendy Yin Ling Ng, Pei Shan Lim, Rahana Abd Rahman, Abdul Kadir Abdul Karim, Ani Amelia Zainuddin, Zaleha Abdullah Mahdy
Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10-20% of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29248141/impact-of-volume-status-and-volume-therapy-on-the-kidney
#12
REVIEW
David A Roberts, Andrew D Shaw
Volume resuscitation to correct hypotension in surgical and critically ill patients is a common practice. Available evidence suggests that iatrogenic volume overload is associated with worse outcomes in established acute kidney injury. Intraoperative arterial hypotension is associated with postoperative renal dysfunction, and prompt correction with fluid management protocols that combine inotrope infusions with volume therapy targeted to indices of volume responsiveness should be considered. From the perspective of renal function, the minimum amount of intravenous fluid required to maintain perfusion and oxygen delivery is desirable...
September 2017: Best Practice & Research. Clinical Anaesthesiology
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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