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Tracheostomy cardiac surgery

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...
November 21, 2016: Pediatric Cardiology
Shinya Miura, Nao Hamamoto, Masaki Osaki, Satoshi Nakano, Chisato Miyakoshi
BACKGROUND: The purpose of this study was to explore the prevalence, etiology, and risk factors of extubation failure (EF) in post-cardiac surgery neonates. METHODS: Neonates (30 days old or younger) who underwent cardiac surgery and were admitted to the cardiac intensive care unit between September 2010 and February 2016 were included. The prevalence and etiology of EF, defined as reintubation within 48 hours, were reviewed. Demographic, operative, and perioperative data were retrospectively collected...
October 6, 2016: Annals of Thoracic Surgery
Rachel L Bounds, Joseph Kuebler, Jill M Cholette, George M Alfieris, Sitaram M Emani, Carol A Wittlieb-Weber
A 2-month-old male with dysmorphic facies, neonatal thrombocytopenia, left congenital cataract, and long bone abnormalities became hypotensive with ST depression on induction of anesthesia for congenital cataract repair. Echocardiogram demonstrated decreased left ventricular function (ejection fraction 46%), mild mitral valve regurgitation (MR), and regional wall motion abnormalities. The left coronary artery could not be visualized. Subsequent cardiac catheterization confirmed atresia of the left main coronary artery...
September 12, 2016: World Journal for Pediatric & Congenital Heart Surgery
Andreas Schaefer, Yvonne Schneeberger, Daniel Reichart, Alexander M Bernhardt, Mathias Kubik, Markus J Barten, Florian M Wagner, Stefan Kluge, Hermann Reichenspurner, Sebastian A Philipp
Over the last decade the number of heart transplantations declined and the number of implanted left ventricular assist devices (LVAD) markedly increased. Accordingly, common intensive care interventions rise and present their own challenges, especially due to the necessary anticoagulation regimen. One of these procedures is percutaneous dilatation tracheostomy (PDT). We herein report our experience with 34 patients with LVAD and established phrenprocoumon therapy (INR 2.1 ± 0.9, PTT 68.9 ± 19.0 sec...
August 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jennifer C DeMichele, Nikhil Vajaria, Hongyue Wang, Dawn M Sweeney, Karen S Powers, Jill M Cholette
STUDY OBJECTIVE: To determine the incidence of postoperative airway complications in infants <5kg in weight undergoing cardiac surgery intubated with Microcuff (Kimberley-Clark, Roswell, GA) endotracheal tubes (ETTs). DESIGN: Retrospective review of infants weighing <5.0 kg with congenital heart disease (CHD) presenting for cardiac surgery. SETTING: Single-center, tertiary pediatric cardiac critical care unit at a university hospital...
September 2016: Journal of Clinical Anesthesia
Esther Cheng, Eric Thorpe
OBJECTIVE: To describe a technique for tracheostomy in heterotopic ossification that has not yet been described in the literature. METHODS: We report a case of difficult tracheostomy while using conventional techniques in a 68-year-old patient who underwent mitral valve replacement requiring warfarin therapy three months prior. Imaging revealed heterotopic ossification overlying the trachea. A literature review was performed to identify similar cases or techniques...
November 2016: Annals of Otology, Rhinology, and Laryngology
Andrea Conforti, Chiara Iacusso, Laura Valfrè, Marilena Trozzi, Sergio Bottero, Pietro Bagolan
AIM: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) consist of a spectrum of rare congenital abnormalities. Although EA surgical treatment is well established, the outcome of EA with proximal fistula (type B and D EA) or isolated H-type fistula (type E EA) is poorly explored. These forms of EA shared a common surgical step: the need of a cervical approach to close the fistula. Therefore, the aim of present study is to evaluate postoperative outcomes of patients treated for Gross type B-D and E EA, on regards of their cervical surgery...
October 2016: Journal of Pediatric Surgery
Eeva Haapio, Ilpo Kinnunen, Juhani K E Airaksinen, Heikki Irjala, Tuomas Kiviniemi
BACKGROUND: The purpose of this retrospective study was to present our assessment of modifiable perioperative factors for major cardiac and cerebrovascular events (MACCE). METHODS: This study included an unselected cohort of patients with head and neck cancer (n = 456) treated in Turku University Hospital between 1999 and 2008. RESULTS: Perioperative and postoperative univariate predictors of MACCE at 30-day follow-up were: total amount of fluids (during 24 hours) over 4000 mL, any red blood cell (RBC) infusion, treatment in the intensive care unit (ICU), tracheostomy, and microvascular reconstruction surgery...
June 14, 2016: Head & Neck
Christopher W Mastropietro, Brian D Benneyworth, Mark Turrentine, Amelia S Wallace, Christoph P Hornik, Jeffrey P Jacobs, Marshall L Jacobs
BACKGROUND: Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. METHODS: The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy...
June 2016: Annals of Thoracic Surgery
Joel D Cooper
Prior to the 20(th) century, the need for surgical procedures on the airway was infrequent and consisted mainly of tracheostomy to relieve airway obstruction or repair of tracheal injuries such as lacerations. Even the ability of tracheal suture lines to heal primarily was viewed with concern due to the rigidity of the tracheal wall, its precarious blood supply and uncertainty as to whether the cartilage components could heal without complications. In the 20(th) century the evolution of tracheal procedures on major airways evolved to meet the challenges provided by the expanding fields of thoracic surgery and advent of mechanical respiratory support with its associated complications...
March 2016: Journal of Thoracic Disease
Wilfredo Puentes, Angela Jerath, George Djaiani, Rosa Cabrerizo Sanchez, Marcin Wąsowicz
BACKGROUND: Benefits of tracheostomy have been well established. Most of the literature, refers these benefits to general intensive care population, excluding cardiac surgery or including only small number of these patients. On the other hand, there is no clear definition describing the proper time to perform the procedure and defining what are potential benefits of early compared to late tracheostomy. This retrospective cohort aims to assess the potential benefits of early tracheostomy on post-operative outcomes, length of stay and post-tracheostomy complications within cardiac surgical population...
2016: Anaesthesiology Intensive Therapy
Matthew J Hartley, Nicholas P M Smith, Bruce Jaffray
AIM OF STUDY: We examined variables associated with survival for oesophageal atresia between 1996 and 2014. METHODS: Possible explanatory variables: birth weight, gestation, cardiac anomalies (any or major), renal anomalies (any or severe), primary anastomosis, leak, secondary oesophageal surgery, tracheomalacia, aortopexy, tracheostomy, gastrostomy, fundoplication, karyotype, neurological status. Variables were assessed with logistic regression and a new model assessed with Kaplan-Meier graphs...
July 2016: Journal of Pediatric Surgery
Zirka H Anastasian, Minjae Kim, Eric J Heyer, Shuang Wang, Mitchell F Berman
BACKGROUND: Factors including ASA physical status, blood loss, and case length have been described as correlating with the decision to delay tracheal extubation after specific surgical procedures. In this retrospective study, we investigated whether handoffs by anesthesia attendings were associated with delayed extubation after general anesthesia for a broad range of surgical procedures. METHODS: We reviewed the records of 37,824 patients who underwent general anesthesia with an endotracheal tube for surgery (excluding tracheostomy surgery, cardiac surgeries, and liver and lung transplant surgeries) from 2008 to 2013 at Columbia University Medical Center...
March 2016: Anesthesia and Analgesia
Feridoun Sabzi, Aghighe Heidari, Reza Faraji
The concomitant presence of abnormal connection from three aortic valsalva sinuses to cardiac chambers is a rare complication of native aortic Brucella endocarditis. This case report presents a 37-year-old Iranian female patient who had native aortic valve Brucella endocarditis complicated by periannular abscess formation and subsequent perforation to multi-cardiac chambers associated with congestive heart failure and left bundle branch block. Multiple aorto-cavitary fistulas to right atrium, main pulmonary artery, and formation of a pocket over left atrial roof were detected by transthoracic echocardiogram (TTE)...
2015: GMS Hygiene and Infection Control
Emma Daly, Anna Miles, Samantha Scott, Michael Gillham
PURPOSE: This retrospective audit set out to identify referral rates, swallowing characteristics, and risk factors for dysphagia and silent aspiration in at-risk patients after cardiac surgery. Dysphagia and silent aspiration are associated with poorer outcomes post cardiac surgery. METHODS: One hundred ninety patients who survived cardiac surgery and received more than 48 hours of intubation were included. Preoperative, perioperative, and postoperative information was collected...
February 2016: Journal of Critical Care
Trent Sims, Linda Gratny, Charisse Lachica, Ortmann Laura
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Lachmandath Tewarie, Rachad Zayat, Helga Haefner, Jan Spillner, Andreas Goetzenich, Rüdiger Autschbach, Ajay Moza
BACKGROUND: The impact of percutaneous dilatational tracheostomy (PDT) on the development of post-median sternotomy wound infection (SWI) and mediastinitis is still controversial. We aimed to investigate the frequency of cross-infection and incidence of SWI after PDT. METHODS: In a retrospective design, out of a total of 4100 procedures, all patients who had undergone median sternotomy and postoperative PDT were included from January 2010 to May 2013. For comparison of the pathogens isolated from SWIs, data from all patients who developed an SWI without a PDT during the aforementioned period were also analyzed...
2015: Journal of Cardiothoracic Surgery
Molly Dreher, Andrew C Glatz, Andrea Kennedy, Tami Rosenthal, J William Gaynor
Cardiac surgery with the use of cardiopulmonary bypass (CPB) is known to induce an inflammatory response in patients. This response may be even more pronounced in pediatric patients given their small body size compared to adults. Several interventions have been instituted in an effort to attenuate this response, including the use of corticosteroids in the pump prime. However, the clinical effectiveness and potential harmful effects of steroid use have been the source of recent debate. Therefore, our institution made the decision to evaluate the use of methylprednisolone in our CPB prime...
September 2015: Journal of Extra-corporeal Technology
Yumiko Kohno, Keiko Koishi, Tomoki Nishiyama
Malignant hyperthermia occurred 10 hours after surgery in a 72-year-old man who had received emergency laparoscopic cholecystectomy for severe acute cholecystitis with cholelethiasis. He had a high fever (39.4 degrees C) with liver damage before surgery. Anesthesia was induced with propofol and fentanyl and maintained with sevoflurane and epidural block using ropivacaine. Rocuronium was used as a muscle relaxant During surgery, body temperature decreased by cooling the body surface, but tachycardia continued...
June 2015: Masui. the Japanese Journal of Anesthesiology
Koji Hoshino, Rui Kato, Sayaka Nagasawa, Masahito Kozu, Yuji Morimoto
A 58-year-old man with no history of cardiac disease was scheduled for a cerebral aneurysm clipping surgery. Anesthesia was administered with propofol, rocuronium, fentanyl, and remifentanil. At the end of the surgery, extubation was performed 3 min after the administration of 200 mg sugammadex, along with a simultaneous blood-pressure decrease with ST elevation on lead II. Cardiopulmonary resuscitation was per- formed owing to the occurrence of lethal arrhythmia, and the patient was successfully resuscitated...
June 2015: Masui. the Japanese Journal of Anesthesiology
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