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https://www.readbyqxmd.com/read/29681109/safety-and-efficacy-of-noncardiac-surgical-procedures-in-the-management-of-patients-with-trisomy-13-a-single-institution-based-detailed-clinical-observation
#1
Soichi Shibuya, Yuichiro Miyake, Shigeru Takamizawa, Eriko Nishi, Katsumi Yoshizawa, Tomoko Hatata, Kazuki Yoshizawa, Kenya Fujita, Masahiko Noguchi, Jun Ohata, Takehiko Hiroma, Tomohiko Nakamura, Tomoki Kosho
Intensive treatment including surgery for patients with trisomy 13 (T13) remains controversial. This study aimed to evaluate the safety and efficacy of noncardiac surgical intervention for T13 patients. Medical records of patients with karyotypically confirmed T13 treated in the neonatal intensive care unit in Nagano Children's Hospital from January 2000 to October 2016 were retrospectively reviewed, and data from patients who underwent noncardiac surgery were analyzed. Of the 20 patients with T13, 15 (75%) underwent a total of 31 surgical procedures comprising 15 types, including tracheostomy in 10 patients and gastrostomy in 4...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29661126/gnao1-mutation-induced-pediatric-dystonic-storm-rescue-with-pallidal-deep-brain-stimulation
#2
C Michael Honey, Armaan K Malhotra, Maja Tarailo-Graovac, Clara D M van Karnebeek, Gabriella Horvath, Adi Sulistyanto
Dystonic storm or status dystonicus is a life-threatening hyperkinetic movement disorder with biochemical alterations due to the excessive muscle contractions. The medical management can require pediatric intensive care unit admission and a combination of medications while the underlying trigger is managed. Severe cases may require general anesthesia and paralytic agents with intubation and may relapse when these drugs are weaned. Deep brain stimulation of the globus pallidum has been reported to terminate dystonic storm in several pediatric cases...
May 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#3
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#4
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29623236/does-use-of-oral-anticoagulants-at-the-time-of-admission-affect-outcomes-following-hip-fracture
#5
Ariana Lott, Jack Haglin, Rebekah Belayneh, Sanjit R Konda, Philipp Leucht, Kenneth A Egol
Purpose: The purpose of this study was to compare hospital quality outcomes in patients over the age of 60 undergoing fixation of hip fracture based on their anticoagulation status. Materials and Methods: Patients aged 60 and older with isolated hip fracture injuries treated operatively at 1 academic medical center between October 2014 and September 2016 were analyzed. Patients on the following medications were included in the anticoagulation cohort: warfarin, clopidogrel, aspirin 325 mg, rivaroxaban, apixaban, dabigatran, and dipyridamole/aspirin...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#6
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29621379/fluorescein-angiographic-characteristics-of-macular-edema-during-infancy
#7
Xi Chen, Shwetha Mangalesh, Du Tran-Viet, Sharon F Freedman, Lejla Vajzovic, Cynthia A Toth
Importance: Macular edema during infancy, a subclinical feature identified in premature infants by handheld spectral-domain optical coherence tomography (SD-OCT), has been associated with poorer visual acuity and neurodevelopmental outcomes. Features of macular edema on fluorescein angiography (FA) are needed to understand its pathophysiology, but to date have not been reported previously. Objective: To investigate the FA features of macular edema during infancy...
April 5, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29621201/remote-ischemic-preconditioning-does-not-affect-the-release-of-humoral-factors-in-propofol-anesthetized-cardiac-surgery-patients-a-secondary-analysis-of-the-ripheart-study
#8
Julia Ney, Katleen Hoffmann, Patrick Meybohm, Andreas Goetzenich, Sandra Kraemer, Carina Benstöm, Nina C Weber, Johannes Bickenbach, Rolf Rossaint, Gernot Marx, Kai Zacharowski, Jürgen Bernhagen, Christian Stoppe
In contrast to several smaller studies, which demonstrate that remote ischemic preconditioning (RIPC) reduces myocardial injury in patients that undergo cardiovascular surgery, the RIPHeart study failed to demonstrate beneficial effects of troponin release and clinical outcome in propofol-anesthetized cardiac surgery patients. Therefore, we addressed the potential biochemical mechanisms triggered by RIPC. This is a predefined prospective sub-analysis of the randomized and controlled RIPHeart study in cardiac surgery patients ( n = 40) that was recently published...
April 5, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29615276/-cr-possum-and-surgical-apgar-score-as-predictive-factors-for-patients-allocation-after-colorectal-surgery
#9
Sílvia Pinho, Filipa Lagarto, Blandina Gomes, Liliana Costa, Catarina S Nunes, Carla Oliveira
BACKGROUND AND OBJECTIVES: Surgical patients frequently require admission in high-dependency units or intensive care units. Resources are scarce and there are no universally accepted admission criteria, so patients' allocation must be optimized. The purpose of this study was to investigate the relationship between postoperative destination of patients submitted to colorectal surgery and the scores ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) and Surgical Apgar Score (SAS) and, secondarily find cut-offs to aid this allocation...
March 31, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29571640/comparison-of-clinical-outcomes-between-general-anesthesiologists-and-cardiac-anesthesiologists-in-the-management-of-left-ventricular-assist-device-patients-in-noncardiac-surgeries-and-procedures
#10
Tod A Brown, Jocelyn Kerpelman, Bethany J Wolf, Julie R McSwain
OBJECTIVE: To describe the authors' experience and comparative results after introducing noncardiac fellowship-trained anesthesiologists to a service previously managed by fellowship-trained cardiac anesthesiologists caring for left ventricular assist device (LVAD) patients undergoing low-risk noncardiac procedures with anesthesia. DESIGN: A retrospective chart review. SETTING: Single-site academic medical center in the United States. INTERVENTIONS: Anesthesia and intraoperative therapy...
February 12, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29566803/conscious-sedation-versus-general-anesthesia-in-transcatheter-aortic-valve-replacement-the-german-aortic-valve-registry
#11
Oliver Husser, Buntaro Fujita, Christian Hengstenberg, Christian Frerker, Andreas Beckmann, Helge Möllmann, Thomas Walther, Raffi Bekeredjian, Michael Böhm, Costanza Pellegrini, Sabine Bleiziffer, Rüdiger Lange, Friedrich Mohr, Christian W Hamm, Timm Bauer, Stephan Ensminger
OBJECTIVES: The aims of this study were to report on the use of local anesthesia or conscious sedation (LACS) and general anesthesia in transcatheter aortic valve replacement and to analyze the impact on outcome. BACKGROUND: Transcatheter aortic valve replacement can be performed in LACS or general anesthesia. Potential benefits of LACS, such as faster procedures and shorter hospital stays, need to be balanced with safety. METHODS: A total of 16,543 patients from the German Aortic Valve Registry from 2011 to 2014 were analyzed, and propensity-matched analyses were performed to correct for potential selection bias...
March 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29559211/tracheotomy-in-the-intensive-care-unit-guidelines-from-a-french-expert-panel-the-french-intensive-care-society-and-the-french-society-of-anaesthesia-and-intensive-care-medicine
#12
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29546588/tracheotomy-in-the-intensive-care-unit-guidelines-from-a-french-expert-panel
#13
REVIEW
Jean Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sebastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method...
March 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29546449/-extracorporeal-renal-replacement-therapy-in-acute-kidney-injury-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#14
REVIEW
V Schwenger, D Kindgen-Milles, C Willam, A Jörres, W Druml, D Czock, S J Klein, M Oppert, M Schmitz, J T Kielstein, A Zarbock, M Joannidis, S John
BACKGROUND: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients. The incidence of AKI in ICU patients exceeds 50% and the associated morbidity and mortality rates increase with severity of AKI. In addition, long-term consequences of AKI are underestimated and several studies show impaired long-term outcome after AKI. In about 5-25% of ICU patients with AKI renal replacement therapy (RRT) is required. OBJECTIVES: To assist in indication, timing, modality and application of renal replacement therapy of adult patients, current recommendations from the renal sections of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
March 15, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29545513/intraoperative-acute-respiratory-failure-in-an-immunocompromised-patient-with-human-metapneumovirus
#15
Justin S Merkow, Erik J Nelson
BACKGROUND Providing anesthesia to immunocompromised patients introduces unique challenges, including difficulty in detecting respiratory infections. Detailed preoperative evaluation and preparation for perioperative complications is crucial. Human metapneumovirus is a common but lesser known respiratory virus that can lead to pneumonia and respiratory compromise and is challenging to detect in the immunocompromised patient. CASE REPORT We present a case of an immunocompromised individual scheduled for umbilical hernia repair who developed severe bronchospasm and intraoperative respiratory failure after induction of general anesthesia...
March 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29521937/intraoperative-traction-may-be-a-viable-alternative-to-anterior-surgery-in-cerebral-palsy-scoliosis-%C3%A2-100-degrees
#16
Taylor J Jackson, Burt Yaszay, Joshua M Pahys, Anuj Singla, Firoz Miyanji, Suken A Shah, Paul D Sponseller, Peter O Newton, John M Flynn, Patrick J Cahill
BACKGROUND: For large scoliosis, 2 strategies to maximize correction include intraoperative traction and/or anterior release. It is unclear which patients will benefit the most form either approach. The purpose of our study is to compare the radiographic, perioperative clinical outcomes, and health-related quality of life (HRQoL) outcomes of 2 approaches when used in severe neuromuscular scoliosis in the setting of cerebral palsy (CP). METHODS: In total, 23 patients with minimum 2-year follow-up, major curves ≥100 degrees, and in whom treatment included posterior spinal fusion were evaluated...
March 8, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29521816/incidence-and-causes-of-adverse-events-in-diagnostic-radiological-studies-requiring-anesthesia-in-the-wake-up-safe-registry
#17
Asad A Khawaja, Dmitry Tumin, Ralph J Beltran, Joseph D Tobias, Joshua C Uffman
OBJECTIVES: General anesthesia or sedation can facilitate the completion of diagnostic radiological studies in children. We evaluated the incidence, predictors, and causes of adverse events (AEs) when general anesthesia is provided for diagnostic radiological imaging. METHODS: Deidentified data from 24 pediatric tertiary care hospitals participating in the Wake-Up Safe registry during 2010-2015 were obtained for analysis. Children 18 years or younger receiving general anesthesia for radiological procedures were identified using Current Procedural Terminology codes, and reported AEs were analyzed if they were associated with anesthetic care at magnetic resonance imaging or computed tomography locations...
March 8, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29505006/clinically-suspected-anaphylaxis-induced-by-sugammadex-in-a-patient-with-weaver-syndrome-undergoing-restrictive-mammoplasty-surgery-a-case-report-with-the-literature-review
#18
REVIEW
Nurdan Bedirli, Berrin Işık, Mehrnoosh Bashiri, Kutluk Pampal, Ömer Kurtipek
RATIONALE: Sugammadex is a cylodextrin derivate that encapsulates steroidal neuromuscular blocker agents and is reported as a safe and well-tolerated drug. In this case report, we present a patient who developed grade 3 anaphylaxis just after sugammadex administration. PATIENT CONCERNS: A 22-year-old woman with diagnosis of Weaver syndrome was scheduled for bilateral mammoplasty and resection of unilateral accessory breast tissue resection. Anesthesia was induced and maintained by propofol, rocuronium, and remifentanil...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29501307/respiratory-events-after-adenotonsillectomy-requiring-escalated-admission-status-in-children-with-obstructive-sleep-apnea
#19
Alexandra M Arambula, Deborah X Xie, Amy S Whigham
OBJECTIVES: To characterize postoperative respiratory complications following adenotonsillectomy (AT) in children with obstructive sleep apnea (OSA) and to identify variables associated with pediatric intensive care unit (PICU) admission. METHODS: Retrospective analysis of 133 pediatric OSA patients with prior AT. Assessment of the postoperative hospital course informed patient stratification based on respiratory event severity, PICU admission status, and unscheduled escalation of care...
April 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29481427/neuraxial-anesthesia-during-cesarean-delivery-for-placenta-previa-with-suspected-morbidly-adherent-placenta-a-retrospective-analysis
#20
John C Markley, Michaela K Farber, Nicola C Perlman, Daniela A Carusi
BACKGROUND: General anesthesia (GA) is often selected for cesarean deliveries (CD) with placenta previa and suspected morbidly adherent placenta (MAP) due to increased risk of hemorrhage and hysterectomy. We reviewed maternal outcomes and risk factors for conversion to GA in a cohort of patients undergoing CD and hysterectomy under neuraxial anesthesia (NA). METHODS: We performed a single-center, retrospective cohort study of parturients undergoing nonemergent CD for placenta previa with suspected MAP from 1997 to 2015...
February 23, 2018: Anesthesia and Analgesia
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