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https://www.readbyqxmd.com/read/29792721/-use-of-viscoelastic-methods-in-surgery
#1
D Šmíd, J Zatloukal, T Kural, J Fichtl, V Opatrný, J Moláček
INTRODUCTION: Major liver resections are associated with high morbidity and mortality. The main causes of this fact include a significant blood loss which may be associated with this surgical procedure. Hemocoagulation disorder, diagnosed by standard laboratory tests, is very frequent in the postoperative period and often requires the administration of blood derivatives. Several recent studies, however, have questioned the presence of such coagulopathy when viscoelastic methods are used to assess the coagulation process...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29791712/surgical-management-after-hysteroscopic-sterilization-minimally-invasive-approach-incorporating-intraoperative-fluoroscopy-for-symptomatic-patients-with-2-essure%C3%A2-devices
#2
E Scott Sills, Natalie S Rickers, Xiang Li
OBJECTIVE: To describe a non-hysterectomy surgical technique for symptomatic patients with >2 Essure® (Bayer Healthcare, Whippany, New Jersey) devices. DESIGN: Patients (n=4) presented with sharp pelvic pain, irregular vaginal bleeding, dyspareunia, weight gain, hair loss, fatigue, and/or diffuse skin rash, all of which were absent before undergoing hysteroscopic sterilization (HS). Hysterosalpingogram obtained before surgical excision of contraceptive tubal implants confirmed more than two Essure® devices in all patients...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29790423/improved-cost-effectiveness-and-blood-product-utilization-from-instituting-a-blood-ordering-algorithm-for-cardiac-surgical-cases
#3
Kelly Ural, Jay Trusheim, Yamah Amiri, Mariella Gastañaduy
BACKGROUND: Results of a previous study revealed an over-ordering of blood products for cardiac surgery and led to the creation of a new blood ordering algorithm. This follow-up study has been conducted to evaluate improvement in ordering practices. METHODS: Retrospective data were collected for 171 patients who underwent coronary artery bypass grafting or valve surgery from March 2015 to March 2016 to determine the crossmatch-to-transfusion ratio (C:tx) and potential cost savings...
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29790125/management-of-major-bleeding-and-outcomes-in-patients-treated-with-direct-oral-anticoagulants-results-from-the-start-event-registry
#4
Sophie Testa, Walter Ageno, Emilia Antonucci, Rossella Morandini, Jan Beyer-Westendorf, Maurizio Paciaroni, Marc Righini, Piera Sivera, Peter Verhamme, Vittorio Pengo, Daniela Poli, Gualtiero Palareti
The management of major bleeding in patients treated with direct oral anticoagulants (DOACs) is still not well established. START-Events, a branch of the START registry (Survey on anTicoagulated pAtients RegisTer) (NCT02219984), aims to describe the actual management of bleeding or recurrent thrombotic events in routine clinical practice. We here present the results of the management of bleeding patients. The START-Event registry is a prospective, observational, multicenter, international study. Baseline characteristics (demographic, clinical, risk factors) of patients, laboratory data at admission and during follow-up, site of bleeding, therapeutic strategies, and outcomes at the time of hospital discharge and after 6 months were recorded on a web-based case report form...
May 22, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29790061/acute-bleeding-obstruction-pancreatitis-after-roux-en-y-anastomosis-in-total-gastrectomy-a-single-center-experience
#5
J Weindelmayer, S Laiti, R La Mendola, M Bencivenga, L Scorsone, V Mengardo, S Giacopuzzi
Anastomotic intraluminal bleeding is a well-known complication after total gastrectomy. Nevertheless, few data are published on acute bleeding obstruction pancreatitis (BOP) due to a bleeding from the jejunojejunostomy (JJ). In this paper we describe our experience. A total of 140 gastrectomies for EGJ cancer were performed in our Institute from January 2012 to January 2017. All reconstructions were performed with a Roux-en-Y anastomosis: a mechanical end-to-side esophago-jejunostomy and a mechanical end-to-side JJ...
May 22, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29789931/relationship-between-fresh-frozen-plasma-to-packed-red-blood-cell-transfusion-ratio-and-mortality-in-cardiovascular-surgery
#6
Akito Tsukinaga, Takuma Maeda, Shunsuke Takaki, Nobuaki Michihata, Yoshihiko Ohnishi, Takahisa Goto
PURPOSE: The aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery. METHODS: This is a single center retrospective cohort study performed in a cardiovascular center. Patients undergoing cardiovascular surgery between January 2012 and October 2016 with or without massive transfusion (n = 1453). Patients' outcomes were compared based on FFP/pRBC transfusion ratio (FFP/pRBC > 1 or FFP/pRBC ≤ 1)...
May 22, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#7
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789798/the-relation-between-sarcopenia-and-mortality-in-patients-at-intensive-care-unit
#8
Mehmet Toptas, Mazhar Yalcin, İbrahim Akkoc, Eren Demir, Cagatay Metin, Yildiray Savas, Muhsin Kalyoncuoglu, Mehmet Mustafa Can
Background and Aim: Psoas muscle area (PMA) can reflect the status of skeletal muscle in the whole body. It has been also reported that decreased PMA was associated with postoperative mortality or morbidity after several surgical procedures. In this study, we aimed to investigate the relation between PMA and mortality in all age groups in intensive care unit (UNIT). Materials and Method: The study consists of 362 consecutive patients. The demographic characteristics of patients, indications for ICU hospitalization, laboratory parameters, and clinical parameters consist of mortality and length of stay, and surgery history was obtained from intensive care archive records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29787604/laparoscopic-uterine-surgery-as-a-risk-factor-for-uterine-rupture-during-pregnancy
#9
An-Shine Chao, Yao-Lung Chang, Lan-Yan Yang, Angel Chao, Wei-Yang Chang, Sheng-Yuan Su, Chin-Jung Wang
The incidence of uterine rupture through a previous cesarean scar (CS) is declining as a result of a lower parity and fewer options for vaginal birth after cesarean. However, uterine ruptures attributable to other causes that traumatize the myometrium are on the rise. To determine whether changes in the causes of uterine rupture had occurred in recent years, we retrospective retrieved the clinical records of all singletons with uterine rupture observed in the delivery room of a Taiwanese tertiary obstetric center over a 15-year period...
2018: PloS One
https://www.readbyqxmd.com/read/29787545/recent-advances-in-austere-combat-surgery-use-of-aortic-balloon-occlusion-as-well-as-blood-challenges-by-special-operations-medical-forces-in-recent-combat-operations
#10
D Marc Northern, Justin D Manley, Regan Lyon, Daniel Farber, Benjamin J Mitchell, Kristopher J Filak, Jonathan Lundy, Joe J DuBose, Todd E Rasmussen, John B Holcomb
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) for control of non-compressible torso hemorrhage is a technology that is increasingly being utilized in the combat casualty setting. Its use in the resource restricted environment holds potential to improve hemorrhage control, decrease blood product utilization, decrease morbidity, and improve combat mortality. The objective of this report is to present the single largest series of REBOA use on severely injured combat casualties...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787301/innovative-surgical-treatment-of-severe-cherubism
#11
Ji H Son, Danielle C Marshall, Manish Valiathan, Todd Otteson, Gerald Ferretti, Paula A Grigorian, Carol Rosen, Devra Becker, David Rowe, Hooman Soltanian, Gregory Lakin
BACKGROUND: Cherubism is an autosomal dominant syndrome characterized by excessive bilateral maxillomandibular bony degeneration and fibrous tissue hyperplasia. Conservative management is the preferred treatment as cherubism has a self-limiting course. Functional or emotional disturbances may, however, demand surgical intervention. We report a patient who underwent surgical intervention. Method/Description: He had significant enlargement of lower cheeks and bilateral lower lid scleral show...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29786044/prognostic-value-of-model-for-end-stage-liver-disease-incorporating-with-serum-sodium-score-for-development-of-acute-kidney-injury-after-liver-transplantation
#12
Yuan Cheng, Guo-Qing Wei, Qiu-Cheng Cai, Yi Jiang, Ai-Ping Wu
Background: Contribution of model for end-stage liver disease incorporating with serum sodium (MELD-Na) score in predicting acute kidney injury (AKI) after orthotopic liver transplantation (OLT) is yet to be identified. This study assessed the prognostic value of MELD-Na score for the development of AKI following OLT. Methods: Preoperative and surgery-related variables of 321 adult end-stage liver disease patients who underwent OLT in Fuzhou General Hospital were collected...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785675/transfusion-triggers-in-cardiac-surgery-where-do-we-go-from-here
#13
EDITORIAL
Nishith N Patel, Gavin J Murphy
No abstract text is available yet for this article.
May 21, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#14
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#15
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#16
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29780070/chronic-obstructive-pulmonary-disease-and-off-pump-coronary-surgery
#17
Cengiz Ovalı, Aykut Şahin
PURPOSE: To determine to what extent chronic obstructive pulmonary disease (COPD) affects mortality and morbidity rates in patients treated with off-pump coronary artery bypass graft (CABG). METHODS: A total of 321 patients treated with off-pump CABG were included in the present study. Of the 321 patients, 46 patients had COPD and they were designated as Group 1 and the remaining 275 patients did not have COPD and they were considered as Group 2. We compared the data obtained from the patients in both groups...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29779316/-the-necessity-of-artificial-kidney-seeper-in-the-ultrasonography-guided-percutaneous-nephrolithotomy-a-randomized-controlled-study
#18
J J Ye, Y Yang, H J Zhang, Y C Zheng, Y Pan, H Xie
Objective: To investigate the necessity of artificial kidney seeper which made through inserting a ureteral tube in the ureter to the ultrasonography-guided percutaneous nephrolithotomy (PCNL). Methods: This was a randomized prospective study. Patients who conformed to the inclusion and exclusion criteria were enrolled at Department of Urology, Frist Affiliated Hospital of Wenzhou Medical University from January 2016 to May 2017. Totally 291 patients were included in the study. Patients were randomly assigned into two groups (artificial kidney seeper group and non-artificial kidney seeper group) in different kidney seeper level (5 to <10 mm, 10 to 20 mm) respectively...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29779312/-the-safety-and-effect-of-transhepatic-hilar-approach-for-the-treatment-of-bismuth-type-%C3%A2-and-%C3%A2-hilar-cholangiocarcinoma
#19
M He, H L Wang, J Y Yan, S W Xu, W Chen, J Wang
Objective: To compare the efficiency between the transhepatic hilar approach and conventional approach for the surgical treatment of Bismuth type Ⅲ and Ⅳ hilar cholangiocarcinoma. Methods: There were 42 consecutive patients with hilar cholangiocarcinoma of Bismuth type Ⅲ and Ⅳ who underwent surgical treatment at Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University from January 2008 to December 2013.The transhepatic hilar approach was used in 19 patients and conventional approach was performed in 23 patients...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29778331/goal-directed-perfusion-to-reduce-acute-kidney-injury-a-randomized-trial
#20
Marco Ranucci, Ian Johnson, Timothy Willcox, Robert A Baker, Christa Boer, Andreas Baumann, George A Justison, Filip de Somer, Paul Exton, Seema Agarwal, Rachael Parke, Richard F Newland, Renard G Haumann, Dirk Buchwald, Nathaen Weitzel, Rajamiyer Venkateswaran, Valeria Pistuddi
OBJECTIVE: To determine whether a goal-directed perfusion (GDP) strategy aimed at maintaining oxygen delivery (DO2 ) at ≥280 mL·min-1 ·m-2 reduces the incidence of acute kidney injury (AKI). METHODS: This multicenter randomized trial enrolled a total of 350 patients undergoing cardiac surgery in 9 institutions. Patients were randomized to receive either GDP or conventional perfusion. A total of 326 patients completed the study and were analyzed. Patients in the treatment arm were treated with a GDP strategy during cardiopulmonary bypass (CPB) aimed to maintain DO2 at ≥280 mL·min-1 ·m-2 ...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
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