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Perioperative fluids

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https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#1
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#2
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#3
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28086855/postoperative-fluid-overload-is-a-risk-factor-for-adverse-surgical-outcome-in-patients-undergoing-esophagectomy-for-esophageal-cancer-a-retrospective-study-in-335-patients
#4
Torben Glatz, Birte Kulemann, Goran Marjanovic, Svenja Bregenzer, Frank Makowiec, Jens Hoeppner
BACKGROUND: Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome. METHODS: We retrospectively examined 335 patients who had undergone esophagectomy for esophageal cancer at the University Hospital Freiburg between 1996 and 2014 to investigate the relation between intra- and postoperative fluid management and postoperative morbidity after esophagectomy...
January 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28078858/use-of-lactated-ringer%C3%A2-s-solution-does-not-eliminate-the-risk-of-strong-ion-difference-related-metabolic-acidosis-following-on-pump-cardiac-surgery
#5
T Jovaisa, V Vicka, G Linkaitė, J Guseinovaitė, D Ringaitienė, I Norkienė
There is a growing interest in the effects of plasma sodium levels on postoperative outcomes. A trend of using balanced crystalloid solutions is based on the extensive data on chloride and the strong ion difference-related acidosis. However, effects of sodium are often overlooked in this context. The aim of the study was to establish the effects of the routine use of Lactated Ringer’s Solution (RL) on postoperative changes in sodium concentrations and whether these changes result in metabolic acidosis. We performed database analysis of 358 consecutive elective on-pump cardiac surgery cases in a tertiary referral university hospital...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28077531/sodium-bicarbonate-does-not-prevent-postoperative-acute-kidney-injury-after-off-pump-coronary-revascularization-a-double-blinded-randomized-controlled-trial
#6
S Soh, J W Song, J K Shim, J H Kim, Y L Kwak
BACKGROUND: Acute kidney injury (AKI) is a common morbidity after off-pump coronary revascularization. We investigated whether perioperative administration of sodium bicarbonate, which might reduce renal injury by alleviating oxidative stress in renal tubules, prevents postoperative AKI in off-pump coronary revascularization patients having renal risk factors. METHODS: Patients (n=162) having at least one of the following AKI risk factors were enrolled: (i) age >70 yr; (ii) diabetes mellitus; (iii) chronic renal disease; (iv) congestive heart failure or left ventricular ejection fraction <35%; and (v) reoperation or emergency...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077530/impact-of-balanced-tetrastarch-raw-material-on-perioperative-blood-loss-a-randomized-double-blind-controlled-trial
#7
A Joosten, R Tircoveanu, S Arend, P Wauthy, P Gottignies, P Van der Linden
BACKGROUND: As 6% hydroxyethyl starch (HES) 130/0.40 or 130/0.42 can originate from different vegetable sources, they might have different clinical effects. The purpose of this prospective, randomized, double-blind controlled trial was to compare two balanced tetrastarch solutions, one maize-derived and one potato-derived, on perioperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS: We randomly assigned 118 patients undergoing elective cardiac surgery into two groups, to receive either a maize- or a potato-derived HES solution...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077526/patient-safety-and-the-risk-of-i-v-fluid-therapy-in-perioperative-medicine-importance-of-host-susceptibility-and-exposure-dose
#8
A D Shaw, M D McEvoy
No abstract text is available yet for this article.
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28075168/transurethral-resection-of-prostate-and-bleeding-a-prospective-randomized-double-blind-placebo-controlled-trial-to-see-efficacy-of-short-term-use-of-finasteride-and-dutasteride-on-operative-blood-loss-and-prostatic-micro-vessel-density
#9
Ankur Bansal, Aditi Arora
OBJECTIVE: To evaluate the effects of short term use of finasteride and dutasteride on the amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in the patients with benign prostatic hyperplasia (BPH) prior to transurethral resection of prostate (TURP). METHODS: The study involved 450 male patients who planned to have TURP and were prospectively randomized into 3 groups (150 patients each). Group 1 received placebo, group 2 received finasteride 5 mg/day and group 3 received dutasteride 0...
January 11, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28072601/risk-factors-and-clinical-outcomes-associated-with-perioperative-transfusion-associated-circulatory-overload
#10
Leanne Clifford, Qing Jia, Arun Subramanian, Hemang Yadav, Darrell R Schroeder, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. METHODS: In this case-control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications...
January 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28063958/prevention-of-chronic-post-thoracotomy-pain-in-rats-by-intrathecal-resolvin-d1-and-d2-effectiveness-of-perioperative-and-delayed-drug-delivery
#11
Jeffery Chi-Fei Wang, Gary R Strichartz
: Thoracotomy results in a high frequency of chronic post-operative pain. Resolvins are endogenous molecules, synthesized and released by activated immune cells, effective against inflammatory and neuropathic pain. Different resolvins have differential actions on selective neuronal and glial receptors and enzymes. This paper examines the ability of intrathecal Resolvin D1 (RvD1) and Resolvin D2 (RvD2) to reduce chronic post-thoracotomy pain in rats. Thoracotomy, involving intercostal incision and rib retraction, resulted in a decrease in the mechanical force threshold to induce nocifensive behavior, an enlargement of the pain-sensitive area, and an increase in the fraction of rats showing nocifensive behavior, all for at least 5 weeks...
January 4, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28062325/a-system-based-nursing-approach-to-improve-outcomes-in-the-postoperative-esophagectomy-patient
#12
REVIEW
Susan Collazo, Nicole L Graf
OBJECTIVE: To review essential nursing implications in the care of postoperative esophagectomy patients. DATA SOURCES: Peer-reviewed literature, institutional experience, journal articles. CONCLUSION: Utilizing a system-based approach to assess the post-esophagectomy patient will assist the nurse in ensuring safe and comprehensive care. IMPLICATIONS FOR NURSING PRACTICE: Nursing care measures to reduce perioperative esophagectomy morbidity includes aggressive fluid management, pain management, use of epidural analgesia, and early ambulation...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28054177/factors-associated-with-a-low-initial-cerebral-oxygen-saturation-value-in-patients-undergoing-cardiac-surgery
#13
Kensuke Kobayashi, Tadashi Kitamura, Satoshi Kohira, Shinzo Torii, Tetsuya Horai, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Yusuke Irisawa, Takuya Matsushiro, Hidenori Hayashi, Yurie Miyata, Yuta Tsuchida, Naoki Ohtomo, Kagami Miyaji
Regional cerebral oximetry using near-infrared spectroscopy device, an INVOS 5100 C (Medtronic, Minneapolis, MN, USA), during cardiac surgery aims to avoid perioperative neurological impairment, especially during cardiopulmonary bypass. However, it is not uncommon to encounter critically low initial cerebral regional oxygen saturation or a low value unresponsive to intervention. Therefore, it is important to identify factors associated with low saturation value other than true cerebral hypoxia. We investigated the relationship between preoperative regional cerebral oxygen saturation and clinical variables during cardiac surgery...
January 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28054107/-evidence-based-supportive-measures-to-secure-pancreatic-anastomoses
#14
O Belyaev, W Uhl
BACKGROUND: Pancreatic anastomosis is the Achilles heel of pancreatic surgery. Despite substantial progress in surgical techniques the rate of postoperative pancreatic fistulas remains very high. For this reason various supportive measures to secure pancreatic anastomoses are of continuing interest. OBJECTIVE: This review presents the newest evidence-based data on supportive measures designed to secure a pancreatic anastomosis. MATERIAL AND METHODS: The most recent meta-analyses, randomized controlled trials and the largest retrospective studies on the role of pancreatic duct stenting, double loop reconstruction, autologous patches and drainage in pancreaticoduodenectomy were taken into account...
January 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28040303/evaluation-of-the-prevalence-of-residual-sialolith-fragments-after-transoral-approach-of-wharton-s-duct
#15
M Gerni, J M Foletti, C Collet, C Chossegros
Transoral submandibular duct sialolith removal is a simple technique with very few complications. Nevertheless, following this procedure, we have observed long-term calculus recurrence in a number of patients. We therefore elected to evaluate these cases. This was a monocentric prospective study performed between November 2013 and June 2014. All patients received surgery for submandibular gland lithiasis by intraoral removal of submandibular duct calculi. Between the day following the procedure and 3 months postsurgery, these patients systematically underwent an ultrasound examination of the submandibular gland...
April 15, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28038759/-medication-errors-in-anesthesia-unacceptable-or-unavoidable
#16
Ira Dhawan, Anurag Tewari, Sankalp Sehgal, Ashish Chandra Sinha
Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated...
December 27, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28029449/perioperative-fluid-status-and-surgical-outcomes-in-patients-undergoing-cytoreductive-surgery-for-advanced-epithelial-ovarian-cancer
#17
M G Desale, E J Tanner, A K Sinno, A Africano Angarita, A N Fader, R L Stone, K L Levinson, R E Bristow, K Long Roche
OBJECTIVE: The objective of this study is to investigate the impact of fluid status on perioperative outcomes of patients undergoing cytoreductive surgery (CRS) for advanced epithelial ovarian cancer (EOC). METHODS: Patients undergoing CRS for stage III or IV EOC at a comprehensive cancer center from 12/2010 to 05/2015 were identified. Those who underwent upper abdominal procedures or colon resections were included. Demographic, perioperative, and 30-day complication data were collected...
October 28, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#18
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28008629/lower-airway-disease-and-pituitary-surgery-is-there-an-association-with-postoperative-cerebrospinal-fluid-leak
#19
Curtis Hanba, Peter F Svider, Jeffrey T Jacob, Murali Guthikonda, James K Liu, Jean Anderson Eloy, Adam J Folbe
OBJECTIVES/HYPOTHESIS: To explore the relationship between lower airway disease and postoperative cerebrospinal fluid (CSF) rhinorrhea among patients undergoing pituitary surgery STUDY DESIGN: Retrospective review. METHODS: A retrospective review of the Healthcare Cost and Utilization Project's 2013 National Inpatient Sample was conducted to characterize the hospital stay and surgical outcomes of patients undergoing pituitary surgery. Patients with lower airway disease (including chronic obstructive pulmonary disease and asthma) were compared to a disease-free population identifying demographics and complications over-represented in the lower airway group...
December 23, 2016: Laryngoscope
https://www.readbyqxmd.com/read/28005739/minimally-invasive-strip-craniectomy-simplifies-anesthesia-practice-in-patients-with-isolated-sagittal-synostosis
#20
Daan P F van Nunen, Bart M Stubenitsky, Peter A Woerdeman, Kuo Sen Han, Corstiaan C Breugem, Aebele B Mink van der Molen, Jurgen C de Graaff
BACKGROUND: Traditional open corrective surgery for isolated sagittal synostosis entails significant blood loss, transfusion rates, morbidity, and a lengthy hospitalization. Minimally invasive strip craniectomy (MISC) was introduced to avoid the disadvantages of open techniques. OBJECTIVES: The aim of the study was, first, to compare the anesthesia practice in MISC and open extended strip craniectomy (OESC), and, second, to evaluate the incidence of perioperative complications in both surgical procedures...
November 2016: Journal of Craniofacial Surgery
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