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Tracheostomy cardiac surgery

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https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#1
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29062558/bilateral-diaphragmatic-paralysis-following-paediatric-cardiac-surgery-experience-of-four-cases-at-the-royal-hospital-muscat-oman
#2
Said A M Al-Hanshi, Mohammed H R Al-Ghafri
Bilateral diaphragmatic paralysis (BDP) is a rare complication of paediatric cardiac surgery. We report four children who developed BDP following cardiac surgery who were managed at the Royal Hospital, Muscat, Oman, between 2009 and 2014. All four children suffered severe respiratory distress soon after extubation and required re-intubation within two hours. In addition, all of the children underwent a tracheostomy as an interim method for ventilation. The four children were successfully weaned from positive pressure ventilation following the functional recovery of at least one side of the diaphragm...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28958272/inclusion-of-the-acute-care-surgeon-in-the-difficult-airway-protocol-a-nine-year-experience
#3
Seong K Lee, Andrew A Rosenthal, Dafney L Davare, Chauniqua Kiffin, Rafael Sanchez, Michael Hurtado, Eddy H Carrillo
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28903938/atrial-fibrillation-in-acute-obstructive-sleep-apnea-autonomic-nervous-mechanism-and-modulation
#4
Lilei Yu, Xuefei Li, Bing Huang, Xiaoya Zhou, Menglong Wang, Liping Zhou, Guannan Meng, Yuhong Wang, Zhenya Wang, Jielin Deng, Hong Jiang
BACKGROUND: The mechanisms of atrial fibrillation (AF) induced by obstructive sleep apnea (OSA) are not completely understood. This study investigated the roles of the intrinsic and extrinsic cardiac autonomic nervous system in OSA-induced AF and provided noninvasive autonomic nervous modulation for the suppression of OSA-induced AF by using low-level transcutaneous electrical stimulation (LL-TS) of the auricular branch of the vagus nerve at the tragus. METHODS AND RESULTS: Eighteen dogs received tracheostomy under general anesthesia and were randomly divided into 3 groups: the OSA group (OSA was simulated via clamping of the endotracheal tube at end expiration for 1...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28899526/association-between-severity-of-untreated-sleep-apnoea-and-postoperative-complications-following-major-cardiac-surgery-a-prospective-observational-cohort-study
#5
Martina Mason, Jules Hernández Sánchez, Alain Vuylsteke, Ian Smith
OBJECTIVE: To examine whether untreated sleep apnoea is associated with prolonged Intensive Care Unit (ICU) stay and increased frequency of postoperative ICU complications, in patients undergoing major cardiac surgery. PATIENTS/METHODS: Adult patients, undergoing elective coronary artery bypass grafting with or without cardiac valve surgery, between March 2013 and July 2014, were considered. We excluded patients participating in other interventional studies, those who had a tracheostomy before surgery, required emergency surgery or were due to be admitted on the day of surgery...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28822388/outcomes-following-noncardiac-surgery-in-patients-with-ventricular-assist-devices-a-single-center-experience
#6
Shawna M Kettyle, Nikhil L Chervu, Appajosula Sarada Rao, Salaam Sadi, David Majure, Jack A Sava, Laura S Johnson
the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28698424/-aortic-valve-replacement-via-a-partial-sternotomy-in-an-ankylosing-skeletal-hyperostosis-patient-after-prophylactic-tracheostomy-report-of-a-case
#7
Shogo Saito, Yoshio Misawa, Soki Kurumisawa, Kei Aizawa, Koji Kawahito
A 77-year-old man presented with exertional dyspnea. The patient had a history of ankylosing skeletal hyperostosis and sleep apnea syndrome. Echocardiographic examination revealed severe aortic valve regurgitation. The patient underwent a prophylactic tracheostomy 2 weeks before cardiac surgery to decrease his risk of perioperative respiratory failure. He successfully underwent aortic valve replacement through a lower partial sternotomy. His postoperative course was uneventful, and the tracheostoma was closed 6 months after the cardiac surgery...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28691936/national-variation-in-the-use-of-tracheostomy-in-patients-with-congenital-heart-disease
#8
Joyce T Johnson, Bradley S Marino, Darren Klugman, Pirouz Shamszad
OBJECTIVES: The postsurgical care of children with congenital heart disease may be complicated by the need for cardiorespiratory support, including tracheostomy. The variation of the use of tracheostomy across multiple pediatric cardiac surgical centers has not been defined. We describe multicenter variation in the use of tracheostomy in children undergoing congenital heart surgery. DESIGN: We retrospectively analyzed a multicenter cohort. SETTING: Pediatric Health Information Systems database retrospective cohort...
October 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#9
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28508288/repetitive-postoperative-extubation-failure-and-cardiac-arrest-due-to-laryngomalacia-after-general-anesthesia-in-an-elderly-patient-a-case-report
#10
Jun Takeshita, Kei Nishiyama, Masashi Fujii, Hiroyuki Tanaka, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
The authors report a case involving an elderly patient who experienced repetitive perioperative cardiac arrest caused by laryngomalacia. The patient underwent surgery under general anesthesia; however, 2 h after initial extubation, he experienced cardiopulmonary arrest. Return of spontaneous circulation was achieved by immediate resuscitation. Four hours later, a second extubation was performed without any neurological complications. However, 2 h later, he experienced cardiopulmonary arrest again. Immediately after the third extubation, 12 h after the second cardiopulmonary arrest, fiberoptic laryngoscopy revealed laryngomalacia...
October 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#11
COMPARATIVE STUDY
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28419746/factors-for-postoperative-complications-following-pressure-ulcer-operation-stepwise-multiple-logistic-regression-analysis
#12
Hyun Ho Han, Jun Gul Ko, Jong Won Rhie
Patients with pressure ulcers are generally older, have a long hospital stay and often have a variety of comorbidities. The decision to perform surgery for pressure ulcer management can be difficult because of concerns about the risk of postoperative complications. The aim of this study was to analyse the relationship between comorbid conditions and surgical outcomes in order to guide patient selection for pressure ulcer surgery. In 57 patients, data on age, defect size, operating time, hospital stay, body mass index, surgical site, mobility state, cardiac ischaemic history, diabetes, renal failure, ventilator dependency, tracheostomy state, use of haemodilution therapy and cancer were evaluated using stepwise multiple logistic regression analysis to determine the relationships between variables...
April 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28366715/twenty-years-of-anesthetic-and-perioperative-management-of-patients-with-tetralogy-of-fallot-with-absent-pulmonary-valve
#13
John D Jochman, Douglas B Atkinson, Luis G Quinonez, Morgan L Brown
OBJECTIVE: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve. DESIGN: Retrospective chart review. SETTING: Large academic children's hospital. PARTICIPANTS: Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period. INTERVENTIONS: None...
June 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28237062/tracheostomy-after-cardiac-surgery-what-have-we-learned
#14
EDITORIAL
Steven Milman, Thomas Ng
No abstract text is available yet for this article.
February 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28066609/association-between-post-sternotomy-tracheostomy-and-deep-sternal-wound-infection-a-retrospective-analysis
#15
Yi-Chin Tsai, Kevin Phan, Andrie Stroebel, Livia Williams, Lisa Nicotra, Lesley Drake, Elizabeth Ryan, James McGree, Peter Tesar, Kiran Shekar
BACKGROUND: Tracheostomy has traditionally been used as a means of facilitated mechanical ventilation in patients requiring respiratory management following cardiac surgery. However in the clinical setting, the advantages of tracheostomy has been questioned by concerns surrounding evidence of its association with increased risk of deep sternal wound infections (DSWI). The present study sought to evaluate retrospectively our experience with post-sternotomy tracheostomy among cardiac surgery patients and association with DSWI...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#16
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
May 2017: Surgery
https://www.readbyqxmd.com/read/27964980/incidence-of-sternal-wound-infection-after-tracheostomy-in-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis
#17
Hadi Toeg, Daniel French, Sebastien Gilbert, Fraser Rubens
PURPOSE: This systematic review and meta-analysis was performed to determine whether timing or type of tracheostomy was associated with superficial or deep sternal wound infections after cardiac surgery. METHODS: All studies reporting the incidence of sternal wound infection after tracheostomy in patients undergoing cardiac surgery were collected and analyzed. Subgroup analyses determined a priori included timing of tracheostomy and type of procedure (open vs percutaneous)...
June 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27939498/elective-primary-aortic-root-replacement-with-and-without-hemiarch-repair-in-patients-with-no-previous-cardiac-surgery
#18
Ourania Preventza, Joseph S Coselli, Matt D Price, Katherine H Simpson, Ouyang Yafei, Kim de la Cruz, Qianzi Zhang, Susan Green
OBJECTIVE: Excellent outcomes have been established for elective aortic root replacement (ARR). It is less clear whether extending the repair into the proximal aortic arch with hypothermic circulatory arrest increases risk. We examined the early outcomes of elective, primary ARR, with and without hemiarch replacement, in patients without previous cardiac surgery. METHODS: Over a 4-year period, 140 non-redo patients (median age, 54 years) underwent elective, primary ARR for root aneurysms; 119 patients (85%) had hemiarch replacement, and 21 (15%) had only ascending aortic replacement...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#19
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27872994/outcomes-of-tracheostomy-in-children-requiring-surgery-for-congenital-heart-disease
#20
Laura A Ortmann, Winston M Manimtim, Charisse I Lachica
Outcomes after discharge in children requiring tracheostomy after cardiac surgery have not been fully described. A retrospective, single-center study was performed on all children <18 years of age requiring both tracheostomy and surgery for congenital heart disease from January 2002 to May 2015. Forty-six tracheostomies were placed after surgery and four before. Single-ventricle anatomy was present in 12 (33%) patients. Incidence of tracheostomy after heart surgery increased from 0.8% the first half of the study period to 2% the second half...
February 2017: Pediatric Cardiology
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