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https://www.readbyqxmd.com/read/29031174/dynamic-right-ventricular-outflow-obstruction-a-rare-cause-of-hypotension-during-anestesia-induction
#1
Maria Enrica Antoniucci, Christian Colizzi, Gabriella Arlotta, Maria Calabrese, Michele Corrado, Sergio Guarneri, Lorenzo Martinelli, Andrea Scapigliati, Roberto Zamparelli, Franco Cavaliere
INTRODUCTION: Dynamic obstruction of right ventricle outflow tract (RVOTO) is a rare condition that may acutely cause severe heart failure. It has been reported in some hypertrophic cardiomyopathies, after lung transplantation, and in some cases of hemodynamic instability after cardiopulmonary bypass. PRESENTATION OF CASE: We report the case of a 71-year-old man who developed severe hypotension during the induction of general anesthesia for surgical coronary revascularization...
October 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29029356/total-hip-arthroplasty-dislocation-after-cardioversion-a-case-report
#2
Ahmed Siddiqi, Carl T Talmo, James V Bono
New onset postoperative atrial fibrillation (AF) is the most common perioperative arrhythmia in the elderly. The incidence after total joint arthroplasty is much lower than other non-cardiac surgeries. Since postoperative atrial fibrillation can cause increased length of hospital stay, mortality, and healthcare costs, it is critical to focus on prevention and prompt management. New onset atrial fibrillation is treated with rhythm control for patients who demonstrate hemodynamic instability or refractory to rate control measures...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29028637/hemorrhagic-shock-after-epicardial-pacing-wire-removal-a-case-report
#3
Paul A Warner, Lindsay L Warner, Alberto Pochettino, Tuhin K Roy
Epicardial pacing wires are routinely used to avoid hemodynamic instability due to perioperative arrhythmias after cardiac surgery. In rare cases, pacing wires themselves can be associated with potentially life-threatening complications. Herein, we present a novel case of hemorrhagic shock and hemoperitoneum after temporary epicardial pacing wire removal.
October 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29027773/perioperative-pain-management-in-cardiac-surgery-a-systematic-review
#4
Elena Bignami, Alberto Castella, Vincenzo Pota, Francesco Saglietti, Antonio Scognamiglio, Cinzia Trumello, Maria C Pace, Massimo Allegri
BACKGROUND: Every year, more than 1.5 million patients, who undergo cardiac surgery worldwide, are exposed to a series of factors that can trigger acute postoperative pain associated with hemodynamic instability, respiratory complications, and psychological disorders. Through an evaluation of literature data about postoperative pain in cardiac surgery we define unmet needs and potential objectives for future research on this often underestimated problem. METHODS: Following PRISMA Guidelines, a systematic literature search was carried out by two independent researchers on Scopus, CINAHL, the Cochrane Library, and PubMed using the keywords: [(perioperative OR postoperative) analgesia AND "cardiac surgery"]...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29027656/pulmonary-complications-after-non-cardiac-surgeries-temporal-patterns-and-risk-factors
#5
Cássia Toledo, Flávio Eduardo Nácul, Marcos Freitas Knibel, Nilton Brandão Silva, Ederlon Rezende, Cintia Magalhães Carvalho Grion, Murillo Assunção, Fernando Gutierrez, Joelma Villafanha Gandolfi, Suzana Margareth Lobo
BACKGROUND: Postoperative complications are the primary determinants of survival following major surgery. We aimed to characterize the early perioperative risk factors for postoperative pulmonary complications (POPCs) in patients undergoing major non-cardiac surgeries. METHODS: This study utilized a multicenter prospective observational cohort design. Adult patients undergoing non-cardiac surgeries and admitted to 21 Brazilian ICUs were screened for inclusion in the study...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#6
Christopher L Wray
Liver transplantation (LT) is a unique surgical procedure that has major hemodynamic and cardiovascular implications. Recently, there has been significant interest focused on cardiovascular issues that affect LT patients in all phases of the perioperative period. The preoperative cardiac evaluation is a major step in the selection of LT candidates. LT candidates are aging in concordance with the general population; cardiovascular disease and their risk factors are highly associated with older age. Underlying cardiovascular disease has the potential to affect outcomes in LT patients and has a major impact on candidate selection...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29021348/early-right-ventricular-assist-device-use-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation-incidence-and-risk-factors-from-the-interagency-registry-for-mechanically-assisted-circulatory-support
#7
Michael S Kiernan, E Wilson Grandin, Marshall Brinkley, Navin K Kapur, Duc Thinh Pham, Robin Ruthazer, J Eduardo Rame, Pavan Atluri, Edo Y Birati, Guilherme H Oliveira, Francis D Pagani, James K Kirklin, David Naftel, Robert L Kormos, Jeffrey J Teuteberg, David DeNofrio
BACKGROUND: To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. METHODS AND RESULTS: Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression...
October 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29017455/the-ec90-of-remifentanil-for-blunting-cardiovascular-responses-to-head-fixation-for-neurosurgery-under-total-intravenous-anesthesia-with-propofol-and-remifentanil-based-on-bispectral-index-monitoring-estimation-with-the-biased-coin-up-and-down-sequential-method
#8
Jung-Man Lee, Jae-Hyon Bahk, Young-Jin Lim, Jiwon Lee, Leerang Lim
BACKGROUND: Head fixation can induce hemodynamic instability. Remifentanil is commonly used with propofol for total intravenous anesthesia (TIVA) during neurosurgery. This study investigated the 90% effective concentration (EC90) of remifentanil for blunting of cardiovascular responses to head fixation during neurosurgery via bispectral index (BIS) monitoring. METHODS: Fifty patients undergoing neurosurgery requiring head fixation were enrolled. This study was performed using the biased coin up-and-down design sequential method (BCD)...
October 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28992869/valproic-acid-overdose-review-of-a-case-with-electrocardiographic-changes
#9
Antonio E Muñiz
BACKGROUND: Valproic acid (VPA) is increasingly used to treat a variety of medical disorders, such as seizures, psychiatric disorders, and headaches. Therefore, accidental and intentional ingestions with valproic acid are increasing. OBJECTIVES: A case is presented in an adolescent with ischemic electrocardiographic changes after an acute overdose with VPA. DISCUSSION: Major features of a valproic acid overdose include respiratory depression, progressive coma, hepatotoxicity, thrombocytopenia, and hemodynamic instability...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28991108/patient-harm-in-cataract-surgery-a-series-of-adverse-events-in-massachusetts
#10
Sarah A Roberto, Joseph Bayes, Paul E Karner, Michael G Morley, Karen C Nanji
Massachusetts state agencies received reports of 37 adverse events (AEs) involving cataract surgery from 2011 to 2015. Fifteen were anesthesia related, including 5 wrong eye blocks, 3 cases of hemodynamic instability, 2 retrobulbar hematoma/hemorrhages, and 5 globe perforations resulting in permanent loss of vision. While Massachusetts' reported AEs likely underrepresent the true number of AEs that occur during cataract surgery, they do offer useful signal data to indicate the types of patient harm occurring during these procedures...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28991060/hemodynamic-instability-and-cardiovascular-events-after-traumatic-brain-injury-predict-outcome-after-artifact-removal-with-deep-belief-network-analysis
#11
Hakseung Kim, Seung-Bo Lee, Yunsik Son, Marek Czosnyka, Dong-Joo Kim
BACKGROUND: Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the signals. A machine-learning model for the elimination of artifactual events shows promising results for improving signal quality. However, the actual impact of the improvements on the performance of the clinical parameters after the elimination of the artifacts is not well studied...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28986709/uterine-artery-pseudoaneurysm-in-the-setting-of-deep-endometriosis-an-uncommon-cause-of-hemoperitoneum-in-pregnancy
#12
Zoe Feld, Tami Rowen, Andrew Callen, Ruth Goldstein, Liina Poder
Uterine, ovarian, and placental pathologies are among the differential considerations for a pregnant woman presenting with abdominal and pelvic pain. Imaging plays a key role in the initial work-up of these patients. Sonography is often the first line test; however, evaluation of pelvic pathology can be limited in the gravid state, especially in mid- or late-term pregnancy. We present a case of a pregnant woman who came to the emergency room at 25 weeks with acute abdominal and pelvic pain. Both ultrasound and MR imaging findings revealed intraperitoneal hemorrhage, initially of unknown origin, as well as endometriomas and deep endometriosis...
October 6, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28986400/preoperative-selective-versus-non-selective-%C3%AE-blockade-in-ppgl-patients-undergoing-adrenalectomy
#13
Caojie Liu, Qingguo Lv, Xinlei Chen, Guangcheng Ni, Liru Hu, Yuwei Zhang, Nan Wei Tong
PURPOSE: Preoperative preparation for adrenalectomy for pheochromocytomas and paragangliomas (PPGL) is universally recognized as necessary, while the optimal strategy remains controversial. Our aims were to increase intraoperative hemodynamic stability, expedite postoperative recovery, decrease side effects, and reduce costs for patients with PPGL undergoing adrenalectomy. METHODS: We identified 526 patients undergoing open adrenalectomy for PPGL in the West China Hospital of Sichuan University between May, 2007 and December, 2016...
October 6, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28977198/anterior-minithoracotomy-a-safe-approach-for-surgical-asd-closure-asd-device-retrieval
#14
Vivek Wadhawa, Chirag Doshi, Manish Hinduja, Pankaj Garg, Kartik Patel, Amit Mishra, Pratik Shah
OBJECTIVE: Midline sternotomy is the preferred approach for device migration following transcatheter device closure of ostium secundum atrial septal defect. Results of patients operated for device migration were retrospectively reviewed after transcatheter closure of atrial septal defect. METHODS: Among the 643 patients who underwent atrial septal defect with closure device, 15 (2.3%) patients were referred for device retrieval and surgical closure of atrial septal defect...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28974833/comparing-hemodynamic-responses-to-diazepam-propofol-and-etomidate-during-anesthesia-induction-in-patients-with-left-ventricular-dysfunction-undergoing-coronary-artery-bypass-graft-surgery-a-double-blind-randomized-clinical-trial
#15
Aria Soleimani, Neda Heidari, Mohammad Reza Habibi, Farshad Hasanzadeh Kiabi, Mohammad Khademloo, Amir Emami Zeydi, Fatemeh Bozorg Sohrabi
BACKGROUND: Anesthesia induction is often accompanied by a period of hemodynamic instability, which could be deleterious in patients with coronary artery disease (CAD) and left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery. The aim of this study was to compare the hemodynamic responses to propofol, etomidate, and diazepam following anesthesia induction, laryngoscopy and intubation in CABG surgery patients with low ejection fraction (EF). METHODS: A double-blind randomized, clinical study was performed on 150 patients with CAD and left ventricular dysfunction (EF≤35%) scheduled for elective CABG surgery with Cardiopulmonary bypass (CPB)...
June 2017: Medical Archives
https://www.readbyqxmd.com/read/28971172/the-use-of-monocyte-to-hdl-ratio-to-predict-postoperative-atrial-fibrillation-after-aortocoronary-bypass-graft-surgery
#16
Ahmet Ilker Tekkesin, Mert Ilker Hayiroglu, Regayip Zehir, Ceyhan Turkkan, Muhammed Keskin, Goksel Cinier, Ahmet Taha Alper
OBJECTIVE: Postoperative atrial fibrillation (POAF) is a frequent and serious complication after aortocoronary bypass graft (ACBG) surgery and one that, unfortunately, increases morbidity and mortality. Postoperative stroke, hemodynamic instability, renal failure, infection, need for inotropic agent and coronary unit are complications caused by POAF. Inflammation and oxidative stress are among several mechanisms that contribute to pathogenesis of POAF. Monocyte to HDL (M/H) ratio is a newly defined parameter of both inflammation and oxidative stress...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28969411/distant-subcutaneous-spreading-of-fournier-s-gangrene-an-unusual-clinical-identification-by-preoperative-ultrasound-study
#17
Lucio Dell'Atti, Daniele Cantoro, Guevar Maselli, Andrea Benedetto Galosi
We present here the first case of successful management via preoperative ultrasonographic (US) study to detect a distant spreading of Fournier's gangrene (FG), which was happened in a 75-year-old man. US study showed the necrotizing infection in the periumbilical region distant 22 cm from the genital tract. A target incision of this periumbilical area and debridement of necrotic tissues was made. Computed tomography (CT) is superior to ultrasonography to confirm the diagnosis of FG and support in surgical management, but a CT evaluation in patients with FG may be limited by the frequent presence of concurrent acute renal failure or patient hemodynamic instability...
October 3, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28967624/hypertrophic-cardiomyopathy-and-left-ventricular-outflow-tract-obstruction-expecting-the-unexpected
#18
REVIEW
Pankaj Jain, Prakash A Patel, Michael Fabbro
Hypertrophic cardiomyopathy is an increasingly recognized clinical disease that carries perioperative risk. Patients may or may not carry a preoperative diagnosis, but provocable left ventricular outflow tract gradients place them at risk for hemodynamic compromise under surgical conditions. Early recognition of obstructive patterns and rapid management alterations in the face of instability are imperative for the treatment of these patients. This review focuses on the diagnostic criteria, risk factors, and management strategies for the perioperative hypertrophic cardiomyopathy patient...
May 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#19
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28964650/community-acquired-legionnaires-disease-at-a-medical-center-in-northern-taiwan
#20
Wei-Fang Kao, Jann-Tay Wang, Wang-Huei Sheng, Yee-Chun Chen
BACKGROUND/PURPOSE: Legionella pneumophila had been recognized as an important pathogen for community-acquired pneumonia. We aimed to investigate clinical features and outcomes of patients with Legionnaires' disease at a tertiary medical center in northern Taiwan. METHODS: From June 2012 to February 2017, a retrospective review of adult community-acquired. Legionnaires' disease at a medical center was conducted. All Legionella infections were confirmed by positive urinary Legionella antigen assay, sera indirect immunofluorescence assay, or sputum culture for Legionella...
September 18, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
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