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Perioperative volume management

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https://www.readbyqxmd.com/read/29139021/perioperative-complications-and-mortality-in-patients-with-urothelial-carcinoma-and-end-stage-renal-disease-undergoing-one-stage-complete-urinary-tract-extirpation
#1
Yun-Ching Huang, Ying-Hsu Chang, Alan W Shindel, Yin-Lun Chang, Jian-Hui Lin, Dong-Ru Ho, Chih-Shou Chen
BACKGROUND: Complete urinary tract extirpation (CUTE) is a complex procedure with substantial risk for perioperative complications. The association between clinical characteristics and the risk of major postoperative complications has not been systematically investigated. OBJECTIVE: The aim of this study was to analyze the incidence and risks for major perioperative complications after CUTE. METHODS: Respective chart review of 81 patients with urothelial carcinoma (UC) who were treated with one-stage CUTE between January 2004 and December 2015...
November 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29137011/a-prospective-observational-study-evaluating-the-efficacy-of-prophylactic-internal-iliac-artery-balloon-catheterization-in-the-management-of-placenta-previa-accreta-a-strobe-compliant-article
#2
Yao Fan, Xun Gong, Nan Wang, Ketao Mu, Ling Feng, Fuyuan Qiao, Suhua Chen, Wanjiang Zeng, Haiyi Liu, Yuanyuan Wu, Qiong Zhou, Yuan Tian, Qiang Li, Meitao Yang, Fanfan Li, Mengzhou He, Rajluxmee Beejadhursing, Dongrui Deng
We studied the efficacy of prophylactic internal iliac artery balloon catheterization for managing severe hemorrhage caused by pernicious placenta previa.This prospective observational study was conducted in Tongji Hospital, Wuhan, China. One hundred sixty-three women past 32-week's gestation with placenta previa-accreta were recruited and managed. Women in the balloon group accepted prophylactic internal iliac artery balloon catheterization before scheduled caesarean delivery and controls had a conventional caesarean delivery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29124870/defining-a-hba1c-value-that-predicts-increased-risk-of-penile-implant-infection
#3
Mohamad Habous, Raanan Tal, Tarek Soliman, Alaa Tealab, Mohammed Nassar, Zenhom Mekawi, Saad Mahmoud, Osama Abdelwahab, Mohamed Elkhouly, Hatem Kamr, Abdallah Remeah, Saleh Binsaleh, David Ralph, John Mulhall
OBJECTIVES: To explore the association between HbA1C level and penile implant infection rates and to define a cut-off value that predicted implant infection. PATIENTS AND METHODS: A multi center prospective study included all patients undergoing penile implant surgery between 2009-15. Preoperative, perioperative and postoperative management were identical for the entire cohort. Univariate analysis was performed to define predictors of implant infection. HbA1c levels were analyzed as a continuous variable and sequential analysis was conducted utilizing 0...
November 10, 2017: BJU International
https://www.readbyqxmd.com/read/29123436/development-and-retrospective-clinical-assessment-of-a-patient-specific-closed-form-integro-differential-equation-model-of-plasma-dilution
#4
Glen Atlas, John K-J Li, Shawn Amin, Robert G Hahn
A closed-form integro-differential equation (IDE) model of plasma dilution (PD) has been derived which represents both the intravenous (IV) infusion of crystalloid and the postinfusion period. Specifically, PD is mathematically represented using a combination of constant ratio, differential, and integral components. Furthermore, this model has successfully been applied to preexisting data, from a prior human study, in which crystalloid was infused for a period of 30 minutes at the beginning of thyroid surgery...
2017: Biomedical Engineering and Computational Biology
https://www.readbyqxmd.com/read/29112544/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-day-surgery-and-fast-track-surgery
#5
Linas Venclauskas, Juan V Llau, Jean-Yves Jenny, Per Kjaersgaard-Andersen, Øivind Jans
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#6
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29082529/patient-blood-management-knowledge-and-practice-among-clinicians-from-seven-european-university-hospitals-a%C3%A2-multicentre-survey
#7
P M Manzini, A M Dall'Omo, S D'Antico, A Valfrè, K Pendry, A Wikman, D Fischer, D Borg-Aquilina, S Laspina, E C M van Pampus, M van Kraaij, M T Bruun, J Georgsen, J Grant-Casey, P S Babra, M F Murphy, G Folléa, K Aranko
BACKGROUND AND OBJECTIVES: The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. MATERIALS AND METHODS: A web-based questionnaire was sent to 4952 clinicians working in medical, surgery and anaesthesiology disciplines. The responses were analysed, and the overall results as well as a comparison between hospitals are presented...
October 29, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29073613/impact-of-the-flotrac-vigileotm-monitoring-on-intraoperative-fluid-management-and-outcome-after-liver-resection
#8
Enrico Giustiniano, Fabio Procopio, Nadia Ruggieri, Stefania Grimaldi, Guido Torzilli, Ferdinando Raimondi
BACKGROUNDS: Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. METHODS: We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs...
October 26, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29064875/perioperative-patient-blood-management-to-improve-outcomes
#9
Neel Desai, Nick Schofield, Toby Richards
Anemia is common in elective surgery and is an independent risk factor for morbidity and mortality. Historical management of anemia has focused on the use of allogeneic blood transfusion but this in itself is not without risk. It too has been independently associated with morbidity and mortality, let alone the costs and relative shortage of this resource. In recognition of this, patient blood management (PBM) shifts the focus from the product to the patient and views the patient's own blood as a resource that should be conserved and managed appropriately as a standard of care...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29050713/is-preoperative-fibrinogen-testing-associated-with-total-blood-loss-in-adolescent-idiopathic-scoliosis-correction
#10
Matthew J Geck, Devender Singh, Holly Gunn, John K Stokes, Eeric Truumees
STUDY DESIGN: Retrospective analysis. OBJECTIVE: This study sought to investigate the potential association between preoperative fibrinogen, bleeding, and transfusion requirements in adolescent idiopathic scoliosis (AIS) corrections. SUMMARY OF BACKGROUND DATA: Blood loss after major spinal reconstruction increases the risks and costs of surgery. Preoperative fibrinogen levels may predict intra- and postoperative blood loss. METHODS: Data were collected from clinic charts and hospital medical records of all 110 of a single surgeon's consecutive AIS patients undergoing greater than three-level deformity correction surgeries from January 2011 to December 2013...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29041921/perioperative-management-of-paraganglioma-and-catecholamine-induced-cardiomyopathy-in-child-a-case-report-and-review-of-the-literature
#11
Xixi Jia, Xiangyang Guo, Qing Zheng
BACKGROUND: Paragangliomas are catecholamine-secreting tumors of the paraganglia. Perioperative mortality of children with paraganglioma is high, but preoperative therapy and anesthetic management of paraganglioma resection are controversial in children. The literatures on catecholamine-induced cardiomyopathy are limited to several case reports,with few reports of studies on children. CASE PRESENTATION: Here we report the anesthetic management of a child with paraganglioma and catecholamine-induced cardiomyopathy, and the possible perioperative anesthesia problems of the paraganglioma resection are discussed...
October 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29026937/-minimally-invasive-and-robotic-assisted-surgical-management-of-upper-gastrointestinal-cancer
#12
REVIEW
P P Grimminger, H F Fuchs
Total minimally invasive upper gastrointestinal resections are currently mainly performed in centers. The advantages include reduction of operative trauma, magnified enlargement of the operation field and the resulting improvement in operative precision. Robotic-assisted minimally invasive esophagectomy (RAMIE) and laparoscopic/thoracoscopic minimally invasive esophagectomy (MIE) are currently the most commonly performed strategies for esophageal cancer. Laparoscopic (MIG) and robotic-assisted gastrectomy (RAG) are the equivalent procedures for gastric cancer...
October 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28985843/total-parenteral-nutrition-in-patients-following-pancreaticoduodenectomy-lessons-from-1184-patients
#13
Cullen E Worsh, Talar Tatarian, Awinder Singh, Michael J Pucci, Jordan M Winter, Charles J Yeo, Harish Lavu
BACKGROUND: Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD). Herein, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center. MATERIALS AND METHODS: We retrospectively queried our institution's pancreatic surgery database for patients who received TPN after PD from 2006 through 2015. RESULTS: Of 1184 patients who underwent PD, 232 (19...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28976345/-impact-of-a-goal-directed-therapy-in-the-implementation-of-an-eras-enhanced-recovery-after-surgery-protocol-in-laparoscopic-radical-cystectomy
#14
Rafael Uña Orejón, Ivan Huercio Martinez, Estrella Mateo Torres, Cristina Jofré Escudero, Juan Gomez Rivas, Jesús Diez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVES: The intraoperative goaldirected fluid therapy (GDT) has become the base of perioperative management in the fast-track protocols. This program using technology to estimate cardiac output, with the aim of minimizing splanchnic hypoperfusion. However, there is insufficient evidence to confirm its application in radical laparoscopic cystectomy. METHODS: In a retrospective study, we have included 52 patients that were scheduled for radical cystectomy. In group A (n=32) patients were treated following GDT...
October 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28964423/perioperative-lung-function-monitoring-for-anatomic-lung-resections
#15
Gregor J Kocher, Konstantinos P Gioutsos, Markus Ahler, Manuela Funke-Chambour, Sebastian R Ott, Patrick Dorn, Jon Lutz, Ralph A Schmid
BACKGROUND: The aim of this study was to prospectively investigate the correlation between postoperative spirometry values and pulmonary complications after anatomic lung resections. In addition, we compared postoperative pulmonary function changes between open and minimally invasive approaches. METHODS: Three hundred eighty-four patients who underwent an anatomic lung resection at our institution between June 2013 and June 2016 were enrolled in this prospective observational trial...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28964417/continued-successful-evolution-of-extended-criteria-donor-lungs-for-transplantation
#16
Sakhee Kotecha, Jamie Hobson, Jeremy Fuller, Eldho Paul, Bronwyn J Levvey, Helen Whitford, Miranda Paraskeva, David McGiffin, Gregory I Snell, Glen P Westall
BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second)...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28950348/report-from-the-european-society-of-thoracic-surgeons-database-2017-patterns-of-care-and-perioperative-outcomes-of-surgery-for-malignant-lung-neoplasm
#17
Michele Salati, Alessandro Brunelli, Herbert Decaluwe, Zalan Szanto, Marcel Dahan, Gonzalo Varela, Pierre-Emmanuel Falcoz
OBJECTIVES: The European Society of Thoracic Surgeons (ESTS) registry was created 10 years ago and represents an international database collecting thoracic surgery procedures from European contributors. The purpose of the present report was to offer an overview of baseline and surgical characteristics and outcomes of patients submitted to lung resections for malignant lung disease as derived from the ESTS registry. METHODS: We retrieved data about all lung resections from 2007 to 2016 performed for primary and metastatic (secondary) lung cancer...
July 31, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#18
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28922884/a-single-institution-experience-with-pineal-region-tumors-50-tumors-over-1-decade
#19
Isaac Josh Abecassis, Brian Hanak, Jason Barber, Martin Mortazavi, Richard G Ellenbogen
BACKGROUND: Pineal region tumors are rare intracranial tumors that are more common in children than adults. Surgical management of tumors in this region using a tailored approach is a strategy that enhances extent of resection and neurological outcome. OBJECTIVE: To review our institutional experience with pineal region tumors in children and adults over the past 10 years. METHODS: Our institutional pathology database and patient records were retrospectively reviewed for details regarding clinical and radiological presentation, surgical management, extent of resection, morbidity, and neurological outcome...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28890555/perioperative-fluid-management-from-physiology-to-improving-clinical-outcomes
#20
REVIEW
Victoria A Bennett, Maurizio Cecconi
Perioperative fluid management is a key component in the care of the surgical patient. It is an area that has seen significant changes and developments, however there remains a wide disparity in practice between clinicians. Historically, patients received large volumes of intravenous fluids perioperatively. The concept of goal directed therapy was then introduced, with the early studies showing significant improvements in morbidity and mortality. The current focus is on fluid therapy guided by an individual patient's physiology...
August 2017: Indian Journal of Anaesthesia
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