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"Perioperative fluid management"

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
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
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
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
Ellis Muggleton, Tülin Muggleton
No abstract text is available yet for this article.
December 12, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Timothy E Miller, Andrew D Shaw, Michael G Mythen, Tong J Gan
The 1st POQI Consensus Conference occurred in Durham, NC, on March 4-5, 2016, and was supported by the American Society of Enhanced Recovery (ASER) and Evidence-Based Perioperative Medicine (EBPOM). The conference focused on enhanced recovery for colorectal surgery and discussed four topics-perioperative analgesia, perioperative fluid management, preventing nosocomial infection, and measurement and quality in enhanced recovery pathways.
2016: Perioperative Medicine
Robert H Thiele, Karthik Raghunathan, C S Brudney, Dileep N Lobo, Daniel Martin, Anthony Senagore, Maxime Cannesson, Tong Joo Gan, Michael Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery "bundles" because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated)...
2016: Perioperative Medicine
Nicolò Pecorelli, Olivia Hershorn, Gabriele Baldini, Julio F Fiore, Barry L Stein, A Sender Liberman, Patrick Charlebois, Franco Carli, Liane S Feldman
INTRODUCTION: Guidelines recommend incorporation of more than 20 perioperative interventions within an enhanced recovery program (ERP). However, the impact of overall adherence to the pathway and the relative contribution of each intervention are unclear. The aim of this study was to estimate the extent to which adherence to ERP elements is associated with outcomes and identify key ERP elements predicting successful recovery following bowel resection. METHODS: Prospectively collected data entered in a registry specifically designed for ERPs were reviewed...
August 18, 2016: Surgical Endoscopy
Patchareya Nivatpumin, Pawinee Pangthipampai, Tachawan Jirativanont, Sukanya Dej-Arkom, Namtip Triyasunant, Thongchai Tempeetikul
BACKGROUND: Nowadays, fetoscopic surgery has been accepted to be a procedure to correct numerous congenital anomalies. This operation can be successfully done under general, regional or local anesthesia with sedation. Incidence of complications from anesthesia in fetoscopic surgery has not been reported in Thailand. OBJECTIVE: To describe anesthetic techniques and incidence of complications in fetoscopic surgery. MATERIAL AND METHOD: Data of 152 pregnant women undergoing fetoscopic surgery in a single university hospital was retrospectively chart reviewed from June 2005 to November 2015...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Thomas Kratz, Christina Simon, Volker Fendrich, Ralph Schneider, Hinnerk Wulf, Caroline Kratz, Turgay Efe, Karl F Schüttler, Martin Zoremba
BACKGROUND: Goal directed fluid management in major abdominal surgery has shown to reduce perioperative complications. The approach aims to optimize the intravascular fluid volume by use of minimally invasive devices which calculate flow-directed variables such as stroke volume (SV) and stroke volume variation (SVV). OBJECTIVE: We aimed to show the feasibility of routinely implementing this type of hemodynamic monitoring during pancreatic surgery, and to evaluate its effects in terms of perioperative fluid management and postoperative outcomes...
November 14, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Florence Grant, Murray F Brennan, Peter J Allen, Ronald P DeMatteo, T Peter Kingham, Michael D'Angelica, Mary E Fischer, Mithat Gonen, Hao Zhang, William R Jarnagin
OBJECTIVE: The aim of this study is to examine, by a prospective randomized controlled trial, the influence of liberal (LIB) vs restricted (RES) perioperative fluid administration on morbidity following pancreatectomy. SUMMARY OF BACKGROUND DATA: Randomized controlled trials in patients undergoing major intra-abdominal surgery have challenged the historical use of LIB fluid administration, suggesting that a more restricted regimen may be associated with fewer postoperative complications...
October 2016: Annals of Surgery
Karthik Madhavan, Lee Onn Chieng, Hanyao Foong, Michael Y Wang
OBJECTIVE Cervical spondylotic myelopathy usually presents in the 5th decade of life or later but can also present earlier in patients with congenital spinal stenosis. As life expectancy continues to increase in the United States, the preconceived reluctance toward operating on the elderly population based on older publications must be rethought. It is a known fact that outcomes in the elderly cannot be as robust as those in the younger population. There are no publications with detailed meta-analyses to determine an acceptable level of outcome in this population...
June 2016: Neurosurgical Focus
Julien Picard, Damien Bedague, Pierre Bouzat, Céline Ollinet, Pierre Albaladejo, Jean-Luc Bosson, Jean-François Payen
BACKGROUND: Intraoperative use of oesophageal Doppler (OD) was associated with improved postoperative outcomes through the optimization of perioperative fluid management. We studied the effect on haemodynamics of a goal-directed fluid management approach, guided by OD, during elective spine surgery in the prone position. METHODS: Intraoperative fluid and vasopressor administration were directed according to one of two randomly chosen decision-making algorithms driven by either OD (OD group; n=33 patients) or standard parameters (standard group; n=34 patients)...
August 2016: Anaesthesia, Critical Care & Pain Medicine
Lars S Bjerregaard, Christoffer C Jorgensen, Henrik Kehlet
BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs...
March 30, 2016: Minerva Anestesiologica
José Luis Muñoz, Tanya Gabaldón, Elena Miranda, Diana Lorena Berrio, Jaime Ruiz-Tovar, José María Ronda, Nuria Esteve, Antonio Arroyo, Ana Pérez
BACKGROUND: In bariatric surgery, there are no guidelines available for intraoperative fluid administration. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management that has been shown to improve the prognosis of patients undergoing abdominal surgery. The aim of our study is to assess the impact of the implementation of a GDFT protocol in morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG). METHODS: A before-after intervention study, in morbidly obese patients who underwent LSG, was conducted at the Obesity Unit of the General University Hospital Elche...
March 19, 2016: Obesity Surgery
S-K Kim, S-S Choi, J-H Sim, J Baik, S Hwang, S-G Lee, Y-K Kim
BACKGROUND: Concerns about the adverse effects of hydroxyethyl starch (HES) on renal function have been raised in recent studies involving critically ill patients. We aimed to evaluate the effect of HES on acute kidney injury (AKI) after living donor right hepatectomy. METHODS: We performed a 1:3 propensity score matching analysis of the medical records of 1641 living donors who underwent a donor right hepatectomy. They were divided into the control group (n = 60), who received only crystalloids, and the colloid group (n = 1,581), who received HES 130/0...
January 2016: Transplantation Proceedings
David A Scott, Hon-Ming Andrew Tung, Reuben Slater
Preoperative anemia and nadir hemoglobin (Hb) during cardiopulmonary bypass (CPB) have been identified as significant risk factors for blood transfusion during cardiac surgery. The aim of this study was to confirm the association between preoperative anemia, perioperative fluid management, and blood transfusion. In addition, the proportion of elective cardiac surgery patients presenting for surgery with anemia was identified to examine whether the opportunity exists for timely diagnosis and intervention. Data from referral until hospital discharge were comprehensively reviewed over a 12-month period for all nonemergency cardiac surgical patients operated on in our institution...
September 2015: Journal of Extra-corporeal Technology
Calin Iosif Mitre, David M Corda, Flavius Dunca, Cornel Iancu
Dyskeratosis congenita is a rare and complex congenital disease that may complicate surgical treatment and impact anesthetic care. We present the perioperative management of a patient with severe pancytopenia, respiratory dysfunction, and oral leukoplakia who presented for urgent surgery for removal of a gastric hemorrhagic malignant tumor. Important issues in the management of this patient include choice of anesthetic technique, correction of pancytopenia (thrombocytopenia in particular), judicious perioperative fluid management to avoid dilutional coagulopathy, antibiotic prophylaxis, and strict aseptic technique...
November 2015: Journal of Clinical Anesthesia
Ramy Behman, Sherif Hanna, Natalie Coburn, Calvin Law, David P Cyr, Jessica Truong, Jenny Lam-McCulloch, Paul McHardy, Jason Sawyer, Chris Idestrup, Paul J Karanicolas
BACKGROUND: Pancreaticoduodenectomy remains a major undertaking with substantial perioperative morbidity and mortality. Previous studies in the colorectal population have noted a correlation between excessive postoperative fluid resuscitation and anastomotic complications. This study sought to assess the relationship between perioperative fluid management and clinical outcomes in patients undergoing pancreaticoduodenectomy. METHODS: Data from a single institution, prospective database over a 10-year period (2002 to 2012) were reviewed...
November 2015: American Journal of Surgery
Yanna Pi, Sanqing Jin
Perioperative fluid management in gastrointestinal surgery is one of the key points to maintain sufficient blood perfusion and oxygen delivery for the organs, tissues and cells. Different strategies of fluid management have different influences on postoperative complications and mortality. After systematic review of related literature, we found that compared with the conventional liberal liquid administration, restricted liquid management and goal directed liquid management would benefit patients in general...
July 2015: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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