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the association of perioperative practice

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https://www.readbyqxmd.com/read/28803455/effect-of-positive-perioperative-donor-and-recipient-respiratory-bacterial-cultures-on-early-post-transplant-outcomes-in-lung-transplant-recipients
#1
Crystal K Howell, Christopher A Paciullo, Marshall G Lyon, David Neujahr, Peter Lyu, George Cotsonis, Michael Hurtik
BACKGROUND: It is standard practice to administer prophylactic antibiotics post lung transplantation. However, no studies have evaluated the impact of culture positivity. The purpose of this study was to evaluate early post-transplant outcomes of culture-positive and culture-negative lung transplant (LT) recipients and the appropriateness of the empiric regimens used. METHODS: Adult patients who received an LT at Emory University Hospital between January 1, 2010 and August 31, 2015 were reviewed and stratified into three groups: (i) culture-positive appropriate empiric treatment, (ii) culture-positive inappropriate empiric treatment, and (iii) culture-negative...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28800838/noncompliance-with-surgical-antimicrobial-prophylaxis-guidelines-a-jordanian-experience-in-cesarean-deliveries
#2
Mariam Hantash Abdel Jalil, Khawla Abu Hammour, Mervat Alsous, Rand Hadadden, Wedad Awad, Faris Bakri, Kamil Fram
BACKGROUND: Surgical site infections are common, especially in developing countries. Nevertheless, up to 60% of surgical site infections can be prevented with appropriate perioperative care, which includes among other measures using suitable surgical antimicrobial prophylaxis (SAP). METHODS: After a short interview with patients and retrospective review of medical charts, compliance with 6 SAP parameters was assessed for appropriateness; those parameters are indication, choice, dose, time of administration, intraoperative redosing interval, and duration of prophylaxis in 1,173 operations...
August 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28799117/concurrent-hydrocelectomy-during-inguinal-herniorrhaphy-is-a-risk-factor-for-complications-and-reoperation-data-from-rural-haiti
#3
D P Kuwayama, J Augustin
PURPOSE: Series of conventional inguinal herniorrhaphy from low and middle income countries (LMICs) suggest elevated rates of morbidity, mortality, and recurrence, although the reasons remain incompletely understood. We sought to identify risk factors for adverse outcomes from inguinal herniorrhaphy performed in a resource-limited LMIC setting. METHODS: We performed mesh-free modified Bassini inguinal herniorrhaphies on 141 consecutive patients with 156 inguinal hernias over 10 months in rural Haiti...
August 10, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28796731/quality-of-local-excision-for-rectal-neoplasms-using-transanal-endoscopic-microsurgery-versus-transanal-minimally-invasive-surgery-a-multi-institutional-matched-analysis
#4
Lawrence Lee, Kimberly Edwards, Iain A Hunter, John E Hartley, Sam B Atallah, Matthew R Albert, James Hill, John R Monson
BACKGROUND: There are no data comparing the quality of local excision of rectal neoplasms using transanal endoscopic microsurgery and transanal minimally invasive surgery. OBJECTIVE: The purpose of this study was to compare the incidence of tumor fragmentation and positive margins for patients undergoing local excision of benign and malignant rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery. DESIGN: This was a multi-institutional cohort study using coarsened exact matching...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28775218/predictive-factors-for-length-of-hospital-stay-following-primary-total-knee-replacement-in-a-total-joint-replacement-centre-in-hong-kong
#5
C K Lo, Q J Lee, Y C Wong
INTRODUCTION: The demand for total knee replacement in Hong Kong places tremendous economic burden on our health care system. Shortening hospital stay reduces the associated cost. The aim of this study was to identify perioperative predictors of length of hospital stay following primary total knee replacement performed at a high-volume centre in Hong Kong. METHODS: We retrospectively reviewed all primary total knee replacements performed at Yan Chai Hospital Total Joint Replacement Centre from October 2011 to October 2015...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28768427/enhanced-recovery-programmes-for-lower-limb-arthroplasty-in-the-uk
#6
N S Nagra, T W Hamilton, L Strickland, D W Murray, H Pandit
Introduction Enhanced recovery programmes (ERPs) reduce patient morbidity and mortality, and provide significant cost savings by reducing length of stay. Currently, no uniform ERP guidelines exist for lower limb arthroplasty in the UK. The aim of this study was to identify variations in ERPs and determine adherence to local policy. Methods Hospitals offering elective total knee arthroplasty (TKA) and total hip arthroplasty (THA) (23 and 22 centres respectively) contributed details of their ERPs, and performed an audit (15 patients per centre) to assess compliance...
August 3, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28763154/best-practices-in-peri-operative-management-of-patients-with-skeletal-dysplasias
#7
Klane K White, Viviana Bompadre, Michael J Goldberg, Michael B Bober, Tae-Joon Cho, Julie E Hoover-Fong, Melita Irving, William G Mackenzie, Shawn E Kamps, Cathleen Raggio, Gregory J Redding, Samantha S Spencer, Ravi Savarirayan, Mary C Theroux
Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia...
August 1, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28760151/pureair-protocol-randomized-controlled-trial-of-intensive-pulmonary-rehabilitation-versus-standard-care-in-patients-undergoing-surgical-resection-for-lung-cancer
#8
Stefania Fugazzaro, Stefania Costi, Carlotta Mainini, Besa Kopliku, Cristian Rapicetta, Roberto Piro, Roberta Bardelli, Patricia Filipa Sobral Rebelo, Carla Galeone, Giorgio Sgarbi, Filippo Lococo, Massimiliano Paci, Tommaso Ricchetti, Silvio Cavuto, Domenico Franco Merlo, Sara Tenconi
BACKGROUND: Non-small cell lung cancer is the most common type of lung cancer. Surgery is proven to be the most effective treatment in early stages, despite its potential impact on quality of life. Pulmonary rehabilitation, either before or after surgery, is associated with reduced morbidity related symptoms and improved exercise capacity, lung function and quality of life. METHODS: We describe the study protocol for the open-label randomized controlled trial we are conducting on patients affected by primary lung cancer (stages I-II) eligible for surgical treatment...
July 31, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28758756/-current-possibilities-to-influence-surgical-site-infection
#9
F Bělina
Infections associated with surgical procedures, also referred to as surgical site infections (SSIs), are the most common nosocomial infections (HAIs - Health Care-Associated Infections) in surgery departments. Although effectively preventable in most cases, they are still associated with significant morbidity and mortality, prolonged or repeated hospitalizations and increased treatment costs. Therefore, compliance with applicable procedures and guidelines is essential for SSI prevention, which was also shown in numerous EBM studies...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28756046/a-preoperative-risk-score-for-transfusion-in-infrarenal-endovascular-aneurysm-repair-to-avoid-type-and-cross
#10
Thomas F X O'Donnell, Katie E Shean, Sarah E Deery, Thomas C F Bodewes, Mark C Wyers, Kerry L O'Brien, Robina Matyal, Marc L Schermerhorn
OBJECTIVE: Preoperative type and cross are often routinely ordered before elective endovascular aneurysm repair (EVAR), but the cost of this practice is high, and transfusion is rare. We therefore aimed to stratify patients by their risk of transfusion to identify a cohort in whom a type and screen would be sufficient. METHODS: We queried the targeted vascular module of the National Surgical Quality Improvement Program (NSQIP) for all elective EVARs from 2011 to 2015...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28755675/professional-development-strategies-to-enhance-nurses-knowledge-and-maintain-safe-practice
#11
Susan L Bindon
Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical...
August 2017: AORN Journal
https://www.readbyqxmd.com/read/28754423/gender-differences-and-outcomes-in-left-ventricular-assist-device-support-the-european-registry-for-patients-with-mechanical-circulatory-support
#12
Christina Magnussen, Alexander M Bernhardt, Francisco M Ojeda, Florian M Wagner, Jan Gummert, Theo M M H de By, Thomas Krabatsch, Paul Mohacsi, Meike Rybczynski, Dorit Knappe, Bjoern Sill, Tobias Deuse, Stefan Blankenberg, Renate B Schnabel, Hermann Reichenspurner
BACKGROUND: Despite the increasing use of ventricular assist devices (VADs), gender differences in indications, hemodynamics, and outcome are not well understood. We examined gender differences and gender-specific predictors for perioperative outcome in patients on ventricular support. METHODS: Multicenter data of 966 patients (median age 55 years, 151 women) from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) were analyzed. Median follow-up was 1...
July 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28752004/survey-of-knowledge-and-attitudes-about-obstructive-sleep-apnoea-among-italian-anaesthetists
#13
Ruggero Massimo Corso, Massimiliano Sorbello, Matteo Buccioli, Elisa Carretta, Oriana Nanni, Emanuele Piraccini, Guido Merli, Flavia Petrini, Arturo Guarino, Giulio Frova
OBJECTIVE: As the care of Obstructive Sleep Apnoea (OSA) patients remains heterogeneous, we hypothesized that it may reflect insufficient OSA knowledge/awareness among clinicians. METHODS: OSA Knowledge/Attitude Questionnaire (OSAKA) was translated into Italian and distributed to anaesthetists attending SIAARTI National Congress and Airways courses and Hands-on Workshops from October 2012 to June 2013. RESULTS: In total, 370 anaesthetists returned the questionnaires (response rate, 62%); the median (interquartile range [IQR]) knowledge score was 12 (10-14), and the range was 1-17 with no difference by gender, age, professional title or years of practice...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28743152/-prevention-of-perioperative-hypothermia-guidelines-for-daily-clinical-practice
#14
Timo Iden, Jan Höcker
Inadvertent perioperative hypothermia (body core temperature < 36 °C) is a serious complication leading to increased rates of wound infection, higher blood loss associated with increased transfusion requirements as well as patient dissatisfaction among others. Body core temperature is a vital parameter and needs constant monitoring just like heart rate, blood pressure and arterial oxygen saturation. Patient-, anesthesia-, surgery- and environment-related risk factors were identified for occurring perioperative hypothermia...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#15
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742697/are-thoracotomy-and-or-intrathoracic-anastomosis-still-predictors-of-postoperative-mortality-after-esophageal-cancer-surgery-a-nationwide-study
#16
Sébastien Degisors, Arnaud Pasquer, Florence Renaud, Hélène Béhal, Flora Hec, Anne Gandon, Marguerite Vanderbeken, Gilbert Caranhac, Alain Duhamel, Guillaume Piessen, Christophe Mariette
BACKGROUND: Intrathoracic (vs cervical) anastomosis and a thoracotomy (vs absence) have previously been associated with increasing postoperative mortality (POM). Recent improvements in surgical practices and perioperative management may have changed these dogmas. OBJECTIVES: The aim of this study was to evaluate the impact of performing intrathoracic anastomosis and/or thoracotomy on POM after esophageal cancer surgery in recent years. METHODS: All consecutive patients who underwent esophageal cancer surgery with reconstruction between 2010 and 2012 in France were included (n = 3286)...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28741039/association-of-opioid-prescription-and-perioperative-complications-in-obstructive-sleep-apnea-patients-undergoing-total-joint-arthroplasties
#17
Eva E Mörwald, Ashley Olson, Crispiana Cozowicz, Jashvant Poeran, Madhu Mazumdar, Stavros G Memtsoudis
PURPOSE: Obstructive sleep apnea (OSA) has been linked to higher rates of perioperative complications. Practice guidelines recommend minimizing opioids in this cohort to reduce complications. However, a paucity of evidence exists relating different levels of opioid prescription to perioperative complications. Our aim was to investigate if different levels of opioid prescription are related to perioperative complication risk in patients with OSA. METHODS: A total of 107,610 OSA patients undergoing total knee or hip arthroplasty between 2006 and 2013 were identified in a nationwide database and divided into subgroups according to the amount of opioids prescribed...
July 24, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28738957/gaps-in-the-postoperative-conversation-a-comprehensive-review-of-current-practices-and-the-unmet-needs-of-surgeons-families-and-waiting-room-personnel
#18
Brandon Singletary, Nisha Patel, Andrew Mims, Andrew Smedley, Jacob Swords, Ronan O'Bierne, Melanie S Morris, Monika Safford, Martin Heslin
Perioperative communication between surgeons and caregivers is an important aspect of patient care, with postoperative conversations (POCs) being critical. Literature suggests current communication practices may be suboptimal. Identifying barriers and opportunities could improve patient and caregiver satisfaction and increase surgeon efficiency. This mixed method study included 1) prospective study of all patients undergoing a surgery at an academic medical center between September 2014 and March 2016 and 2) nominal groups of physicians, caregivers, and waiting room personnel (WRP)...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#19
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28732219/perioperative-systemic-corticosteroids-in-orthognathic-surgery-a-systematic-review-and-meta-analysis
#20
REVIEW
Simon Jean, Pierre-Luc Dionne, Carl Bouchard, Luc Giasson, Alexis F Turgeon
PURPOSE: Perioperative systemic corticosteroids are broadly used in orthognathic surgery to prevent postoperative complications, but it is unclear whether this practice is beneficial and concerns about potential side effects have been raised. The purpose of this systematic review and meta-analysis was to assess the effects of perioperative systemic corticosteroids on clinically important outcomes in patients undergoing orthognathic surgery. MATERIALS AND METHODS: The authors conducted a systematic review of randomized controlled trials evaluating the effect of systemic corticosteroids in orthognathic surgery compared with placebo or any other intervention...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
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