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Perioperative volume management

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https://www.readbyqxmd.com/read/29337771/outcomes-of-closed-versus-open-defects-after-local-excision-of-rectal-neoplasms-a-multi-institutional-matched-analysis
#1
Lawrence Lee, Ashley Althoff, Kimberley Edwards, Matthew R Albert, Sam B Atallah, Iain A Hunter, James Hill, John R T Monson
BACKGROUND: The management of the rectal wall defect after local excision of rectal neoplasms remains controversial, and the existing data are equivocal. OBJECTIVE: This study aimed to determine the effect of open versus closed defects on postoperative outcomes after local excision of rectal neoplasms. DESIGN: Data from 3 institutions were analyzed. Propensity score matching was performed in one-to-one fashion to create a balanced cohort comparing open and closed defects...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#2
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29317965/perioperative-anesthetic-management-of-a-case-of-rare-ectopic-pheochromocytoma
#3
Aihua Jiang, Haiqiao Zhang, Xiaofei Liu, Huishan Zhao
We report an unusual case of pheochromacytoma and investigate the perioperative anesthetic management methods for giant abdominal aortic pheochromocytoma. We analyzed and summarized the recent clinical anesthetic management and experience in the hospital for a giant abdominal aortic pheochromocytoma, with the size of 20 × 14 × 5 cm. Under general anesthesia combined with TAPB, the resection of the giant abdominal aorta pheochromocytoma was successfully completed, and the patient was cured and discharged. Well planned and careful management resulted in patient with stable blood pressure, blood volume and cardiac functions, free from complications...
December 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29316474/spinal-versus-general-anesthesia-for-lumbar-spine-surgery-in-high-risk-patients-perioperative-hemodynamic-stability-complications-and-costs
#4
Michael Finsterwald, Marco Muster, Mazda Farshad, Andrea Saporito, Muriel Brada, José A Aguirre
OBJECTIVE: More stable perioperative hemodynamic conditions, lower costs and a lower perioperative complication rate were reported in young healthy patients undergoing lumbar spine surgery in spinal anesthesia (SA) compared to general anesthesia (GA). However, the benefits of SA in high risk patients (ASA≥II suffering from cardiovascular and/or pulmonary pathologies) undergoing this surgery are unclear. Our objective was to analyze whether SA leads to an improved perioperative hemodynamic stability and to a more cost-effective management compared to GA in high risk patients undergoing this surgery...
January 6, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29304919/cranial-tumor-surgical-outcomes-at-a-high-volume-academic-referral-center
#5
Desmond A Brown, Benjamin T Himes, Brittny T Major, Benjamin F Mundell, Ravi Kumar, Bruce Kall, Fredric B Meyer, Michael J Link, Bruce E Pollock, John D Atkinson, Jamie J Van Gompel, W Richard Marsh, Giuseppe Lanzino, Mohamad Bydon, Ian F Parney
OBJECTIVE: To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. PATIENTS AND METHODS: All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#6
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29299352/a-semi-automated-assessment-of-sarcopenia-using-psoas-area-and-density-predicts-outcomes-after-pancreaticoduodenectomy-for-pancreatic-malignancy
#7
Jukes P Namm, Kiran H Thakrar, Chi-Hsiung Wang, Susan J Stocker, Malini D Sur, Jonathan Berlin, William Dale, Mark S Talamonti, Kevin K Roggin
Background: Sarcopenia has been associated with increased adverse outcomes after major abdominal surgery. Sarcopenia defined as decreased muscle volume or increased fatty infiltration may be a proxy for frailty. In conjunction with other preoperative clinical risk factors, radiographic measures of sarcopenia using both muscle size and density may enhance prediction of outcomes after pancreaticoduodenectomy (PD) for malignancy. Methods: Preoperative computed tomography (CT) scans of patients undergoing PD for malignancy were analyzed from a prospective pancreatic surgery database...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29262474/-clinical-application-of-electrical-velocimetry-in-monitoring-pediatric-blood-volume-after-cardiopulmonary-bypass
#8
J R Xue, B Li
Objective: To investigate the clinical applicability of electrical velocimetry (EV) in monitoring pediatric blood volume after cardiopulmonary bypass. Method: Between July 2016 and November 2016, 60 children with congenital heart disease were divided into EV group and traditional central venous pressure (CVP) group randomly. For EV group, the volume of fluid and vascular active medicine was adjusted according to the monitoring stroke volume variation (SVV) hemodynamic parameters. Whereas for CVP group empirical volume of fluid infusion was managed by the monitoring traditional hemodynamic parameters such as CVP, blood pressure, heart rate, urine volume and blood gas analysis...
December 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29244167/tracheal-surgery-in-children-outcome-of-a-12-year-survey
#9
Luigi Arcieri, Vitali Pak, Vincenzo Poli, Roberto Baggi, Paola Serio, Nadia Assanta, Riccardo Moschetti, Bruno Noccioli, Salvatore De Masi, Lorenzo Mirabile, Bruno Murzi
OBJECTIVES: Despite the fact that team management has improved the results in recent years, perioperative deaths and complications remain high in paediatric tracheal surgery. We reviewed our institutional experience by comparing our results with those in the literature. METHODS: Between 2005 and 2017, 30 children underwent surgery for tracheal disease. Fifteen were boys and fifteen were girls (50% vs 50%). The median age at operation was 7 months (15 days-9...
December 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29242033/the-evidence-and-rationale-for-the-perioperative-use-of-loop-diuretics-during-kidney-transplantation-a-comprehensive-review
#10
REVIEW
Shaifali Sandal, Pannya Bansal, Marcelo Cantarovich
PURPOSE: Loop diuretics (LD) attenuate ischemic injury in nephrons. They are thought to decrease delayed graft function (DGF) during kidney transplantation (KT). This review aimed to summarize the current evidence for the perioperative use of LD during KT. METHODS: We performed an analysis of all articles that were published since the inception of Medline and Embase: 26 studies were selected for inclusion. Scope was LD use during the perioperative phase of KT only...
November 23, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/29234998/reduction-of-cardiopulmonary-renal-complications-with-serum-bnp-guided-volume-status-management-in-posthepatectomy-patients
#11
Sameer H Patel, Bradford J Kim, Ching-Wei D Tzeng, Yun Shin Chun, Claudius Conrad, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND: After hepatectomy, over- and under-resuscitations induce cardiopulmonary complications and acute kidney injury, respectively, leading to significant perioperative morbidity and mortality. Unlike serum chemistries or urine output, serum brain natriuretic peptide (BNP) levels have been shown to accurately reflect current intravascular fluid balance without influence from alterations of hormonal axes. Based on these data, this study was designed to measure the impact of a serum BNP-guided hepatobiliary fluid protocol on the incidence of posthepatectomy cardiopulmonary/renal complications...
October 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29234539/transurethral-bipolar-plasmakinetic-vapo-enucleation-of-the-prostate-is-it-safe-for-patients-on-chronic-oral-anticoagulants-and-or-platelet-aggregation-inhibitors
#12
Waleed El-Shaer, Ahmed Abou-Taleb, Wael Kandeel
Objectives: To assess the safety and efficacy of bipolar plasmakinetic enucleation and resection of the prostate (PKERP) for the management of benign prostatic hyperplasia (BPH) in patients on oral anticoagulant (OAC) therapy and/or platelet aggregation inhibitors (PAIs). Patients and methods: In all, 91 patients were recruited and underwent PKERP whilst they were receiving PAIs (aspirin, 56 patients; clopidogrel, three; aspirin and clopidogrel, 11). In all, 15 patients were receiving an OAC drug perioperatively, whilst another six patients were on dual PAIs and OACs...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29234537/day-care-bipolar-transurethral-resection-vs-photoselective-vaporisation-under-sedoanalgesia-a-prospective-randomised-study-of-the-management-of-benign-prostatic-hyperplasia
#13
Rajeev Sood, T Manasa, Hemant Goel, Ritesh Kumar Singh, Rajpal Singh, Nikhil Khattar, Praveen Pandey
Objective: To conduct a prospective randomised study comparing the safety, effectiveness and treatment outcomes in patients undergoing bipolar transurethral resection of the prostate (bTURP) and photoselective vaporisation of the prostate (PVP) under sedoanalgesia, as sedoanalgesia is a safe and effective technique suitable for minimally invasive endourological procedures and although studies have confirmed that both TURP and PVP are feasible under sedoanalgesia there are none comparing the two...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29210790/management-of-1-lung-ventilation-variation-and-trends-in-clinical-practice-a-report-from-the-multicenter-perioperative-outcomes-group
#14
Douglas A Colquhoun, Bhiken I Naik, Marcel E Durieux, Amy M Shanks, Sachin Kheterpal, S Patrick Bender, Randal S Blank
BACKGROUND: Lung-protective ventilation (LPV) has been demonstrated to improve clinical outcomes in surgical patients. There are very limited data on the current use of LPV for patients undergoing 1-lung ventilation (1LV) despite evidence that 1LV may be a particularly important setting for its use. In this multicenter study, we report trends in ventilation practice for patients undergoing 1LV. METHODS: The Multicenter Perioperative Outcomes Group database was used to identify patients undergoing 1LV...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29200059/a-perioperative-medicine-model-for-population-health-an-integrated-approach-for-an-evolving-clinical-science
#15
Solomon Aronson, Julie Westover, Nicole Guinn, Tracy Setji, Paul Wischmeyer, Padma Gulur, Thomas Hopkins, Thorsten M Seyler, Sandhya Lagoo-Deendayalan, Mitchell T Heflin, Annemarie Thompson, Madhav Swaminathan, Ellen Flanagan
Health care delivery in the United States continues to balance on the tight rope that connects its transition from volume to value. Value in economic terms can be defined as the amount something exceeds its commodity price and is determined by extraordinary reputation, quality, and/or service, whereas its destruction can be a consequence of poor management, unfavorable policy, decreased demand, and/or increased competition. Going forward, payment for health care delivery will increasingly be based on services that contribute to improvements in individual and/or population health value, and funds to pay for health care delivery will become increasingly vulnerable to competitive market forces...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29198625/transversus-abdominis-plane-block-improves-perioperative-outcome-after-esophagectomy-versus-epidural
#16
Gal Levy, Mark A Cordes, Alexander S Farivar, Ralph W Aye, Brian E Louie
BACKGROUND: Pain control is challenging during esophagectomy. An epidural is commonly used, but the sympathetic blockade can have unintended consequences such as hypotension or delayed return of bowel function. A transversus abdominis plane (TAP) block has the potential to control upper abdominal pain without these adverse consequences. We aimed to compare bilateral TAP blocks with patient-controlled analgesia (PCA) for immediate management after esophagectomy with a cohort using a thoracic (T5 to T8) epidural...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29189276/perioperative-noninvasive-blood-pressure-monitoring
#17
Kai Kuck, Philip D Baker
The most commonly monitored variable for perioperative hemodynamic management is blood pressure. Several indirect noninvasive blood pressure monitoring techniques have been developed over the last century, including intermittent techniques such as auscultation (Riva-Rocci and Korotkoff) and oscillometry (Marey) and continuous techniques. With the introduction of automated noninvasive blood pressure devices in the 1970s, the oscillometric technique quickly became and remains the standard for automated, intermittent blood pressure measurement...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29176373/obstructive-sleep-apnea-and-bariatric-surgical-guidelines-summary-and-update
#18
Christel A L de Raaff, Nico de Vries, Bart A van Wagensveld
PURPOSE OF REVIEW: Increasing numbers of bariatric surgical procedures and the high prevalence of obstructive sleep apnea (OSA) in this population have resulted in a growing interest in the perioperative management of OSA in bariatric surgery. This review provides a summary of the first consensus guideline on this topic as well as an update of the newest literature available. RECENT FINDINGS: All bariatric patients should be screened for OSA and obesity hypoventilation syndrome (OHS) to reduce the risk of perioperative complications...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29174123/intraoperative-anesthetic-management-of-lung-transplantation-center-specific-practices-and-geographic-and-centers-size-differences
#19
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29169337/minimally-invasive-pancreaticoduodenectomy-for-periampullary-disease-a-comprehensive-review-of-literature-and-meta-analysis-of-outcomes-compared-with-open-surgery
#20
Ke Chen, Yu Pan, Xiao-Long Liu, Guang-Yi Jiang, Di Wu, Hendi Maher, Xiu-Jun Cai
BACKGROUND: Minimally invasive pancreatoduodenectomy (MIPD) has been gradually attempted. However, whether MIPD is superior, equal or inferior to its conventional open pancreatoduodenectomy (OPD) is not clear. METHODS: Studies published up to May 2017 were searched in PubMed, Embase, Cochrane Library, and Web of Science. Main outcomes were comprehensively reviewed and measured including conversion to open approach, operation time (OP), estimated blood loss (EBL), transfusion, length of hospital stay (LOS), overall complications, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), post-pancreatectomy hemorrhage (PPH), readmission, reoperation and reasons of preoperative death, number of retrieved lymph nodes (RLN), surgical margins, recurrence, and survival...
November 23, 2017: BMC Gastroenterology
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