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https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#1
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774938/-analysis-of-risk-factors-of-prolonged-postoperative-ileus-after-gastric-cancer-surgery
#2
Ning Wang, Lin Chen, Mingsen Li, Naizhong Jin, Bo Wei
OBJECTIVE: To investigate the risk factors of prolonged postoperative ileus (PPOI) after gastric cancer surgery. METHODS: Definition of PPOI was that gastrointestinal function did not return to normal within 96 hours after operation. Diagnostic criteria of PPOI were as follows: according with over 2 below conditions at postoperative 97-hour: (1) moderate to severe sick (mild: 1-3 points, moderate: 4-7 points, severe: 8-10 points) or vomiting occurred in past 12 hours...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#3
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#4
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#5
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29766943/brain-stem-hemangioblastomas-the-seemingly-innocuous-lesion-in-a-perilous-location
#6
Jeena Joseph, Sanjay Behari, Shruti Gupta, Kamlesh Singh Bhaisora, Anish Gandhi, Arun Srivastava, Awadhesh K Jaiswal
Introduction: Hemangioblastomas [75% sporadic, 25% with Von Hippel Lindau (VHL) disease] are highly vascular, benign lesions. The surgical nuances, management, and complication avoidance in brain-stem hemangioblastomas (BHs) have been studied. Material and Methods: Over 18 years, 27(mean age: 29 years; range 15-60 years) consecutive cases of BH underwent microsurgical excision. All patients were assessed clinico-radiologically for neurological deficits and screened for VHL disease...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29765440/prevalence-of-bacteria-and-fungi-in-samples-of-cornea-preservation-fluid
#7
Grażyna Broniek, Ewa Langwińska-Wośko, Małgorzata Sybilska, Jerzy Szaflik, Jacek P Szaflik, Marta Wróblewska
Introduction: Recipients of corneal transplants are at risk of healthcare-associated infections, which, apart from other causes of surgical site infections, may also occur as a result of the transfer of infected corneal tissue. In this study we assessed the risk of bacterial and fungal infections based on the results of routine microbiological testing of cornea preservation fluid samples. Material and methods: We examined a total of 725 samples of corneal preservation fluid, obtained during a period of 3 years (2011-2013)...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29758073/effects-of-computer-assisted-navigation-versus-conventional-total-knee-arthroplasty-on-the-levels-of-inflammation-markers-a-prospective-study
#8
Shu-Jui Kuo, Horng-Chaung Hsu, Ching-Jen Wang, Ka-Kit Siu, Ya-Hung Hsu, Jih-Yang Ko, Chih-Hsin Tang
Total knee arthroplasty (TKA) is a well-established modality for the treatment of advanced knee osteoarthritis (OA). However, the detrimental effects of intramedullary reaming used in conventional TKA for distal femur cutting are of concern. Avoiding intramedullary reaming with the use of computer-assisted navigation TKA can not only provide superior prosthetic alignment, but also mitigate perioperative blood loss and the dissipation of marrow emboli. We quantified local and systemic concentrations of inflammation markers for both techniques...
2018: PloS One
https://www.readbyqxmd.com/read/29756693/multi-parametric-functional-hemodynamic-optimization-improves-postsurgical-outcome-after-intermediate-risk-open-gastrointestinal-surgery-a-randomized-controlled-trial
#9
Pavel Szturz, Pavel Folwarczny, Roman Kula, Jan Neiser, Pavel Ševčík, Jan Benes
BACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopresors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi- parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29746218/effect-of-an-innovative-technology-active-warming-and-passive-warming-on-unplanned-hypothermia-during-perioperative-period-a-clinical-trial
#10
Ganime Esra Soysal, Arzu İlçe, Mehmet Hayri Erkol
Patients are at risk for unplanned hypothermia during the perioperative period due to many reasons, including anesthesia, low room temperature, cold intravenous fluid, and blood transfusion. This study was conducted to examine the effect of active and passive warming methods applied in patients during the perioperative period on unplanned hypothermia. This study is a case-control type study. The population of this study is composed of the patients hospitalized in surgical clinic and undergone abdominal region-related operations...
May 10, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29743101/individualized-perioperative-hemodynamic-goal-directed-therapy-in-major-abdominal-surgery-ipegasus-trial-study-protocol-for-a-randomized-controlled-trial
#11
Sandra Funcke, Bernd Saugel, Christian Koch, Dagmar Schulte, Thomas Zajonz, Michael Sander, Angelo Gratarola, Lorenzo Ball, Paolo Pelosi, Savino Spadaro, Riccardo Ragazzi, Carlo Alberto Volta, Thomas Mencke, Amelie Zitzmann, Benedikt Neukirch, Gonzalo Azparren, Marta Giné, Vicky Moral, Hans Otto Pinnschmidt, Oscar Díaz-Cambronero, Maria Jose Alberola Estelles, Marisol Echeverri Velez, Maria Vila Montañes, Javier Belda, Marina Soro, Jaume Puig, Daniel Arnulf Reuter, Sebastian Alois Haas
BACKGROUND: Postoperative morbidity and mortality in patients undergoing surgery is high, especially in patients who are at risk of complications and undergoing major surgery. We hypothesize that perioperative, algorithm-driven, hemodynamic therapy based on individualized fluid status and cardiac output optimization is able to reduce mortality and postoperative moderate and severe complications as a major determinant of the patients' postoperative quality of life, as well as health care costs...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29743022/predictors-of-major-complications-after-elective-abdominal-surgery-in-cancer-patients
#12
Claudia M Simões, Maria J C Carmona, Ludhmila A Hajjar, Jean-Louis Vincent, Giovanni Landoni, Alessandro Belletti, Joaquim E Vieira, Juliano P de Almeida, Elisangela P de Almeida, Ulysses Ribeiro, Ana L Kauling, Celso Tutyia, Lie Tamaoki, Julia T Fukushima, José O C Auler
BACKGROUND: Patients undergoing abdominal surgery for solid tumours frequently develop major postoperative complications, which negatively affect quality of life, costs of care and survival. Few studies have identified the determinants of perioperative complications in this group. METHODS: We performed a prospective observational study including all patients (age > 18) undergoing abdominal surgery for cancer at a single institution between June 2011 and August 2013...
May 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29736359/clinical-significance-of-candida-in-an-intraoperative-peritoneal-specimen-with-perforation-peritonitis-an-institutional-perspective
#13
Jagannath Pramod, Chellappa Vijayakumar, Krishnamachari Srinivasan, Nanda Kishore Maroju, Nagarajan Raj Kumar, Gopal Balasubramaniyan
Introduction Fungal infection of the peritoneum has become more common in recent years, the most common cause of which is Candida. Candida peritonitis is considered as a severe disease and is regarded as an independent risk factor for mortality in postoperative peritonitis. This study was planned to find out the clinical significance of Candida isolation on the outcome of the patients with peritonitis in terms of morbidity and mortality. Methods This prospective study included consecutive patients admitted and operated for secondary peritonitis over a two-year period in a tertiary care hospital in South India...
March 5, 2018: Curēus
https://www.readbyqxmd.com/read/29736280/the-effect-of-perioperative-fluid-management-on-intraocular-pressure-during-gynecologic-laparoscopic-pelvic-surgery
#14
Izakson Alexander, Sindawi Ahmad, Ben Shachar Inbar, Pikkel Joseph
Purpose: Visual loss is a devastating perioperative complication that can result from elevated intraocular pressure (IOP). The Trendelenburg position during surgery increases IOP. The purpose of this study was to quantify IOP changes in patients undergoing laparoscopic hysterectomy, at different time points and body positions throughout the procedure, and to compare fluctuations of IOP during the perioperative period according to two fluid management protocols. Methods: Thirty women scheduled to undergo elective gynecologic laparoscopic pelvic surgery were randomly allocated to receive a liberal or restrictive fluid management protocol...
2018: Journal of Ophthalmology
https://www.readbyqxmd.com/read/29732465/risk-factors-for-postoperative-ileus-following-elective-laparoscopic-right-colectomy-a-retrospective-multicentric-study
#15
Lise Courtot, Bertrand Le Roy, Ricardo Memeo, Thibault Voron, Nicolas de Angelis, Nicolas Tabchouri, Francesco Brunetti, Anne Berger, Didier Mutter, Johan Gagniere, Ephrem Salamé, Denis Pezet, Mehdi Ouaïssi
PURPOSE: Postoperative ileus (POI) is associated with an elevated risk of other complications and increases the economic impact on healthcare services. The aim of this study was to identify pre-, intra- and postoperative risk factors associated with the development of POI following elective laparoscopic right colectomy. METHODS: Between 2004 and 2016, 637 laparoscopic right colectomies were performed. Data were analysed retrospectively thanks to the CLIHMET database...
May 7, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29729082/a-case-series-of-perioperative-variables-in-relation-to-short-term-outcomes-in-pediatric-renal-transplant-recipients
#16
Celine Y Y Goh, Helen Hume-Smith, Nicos Kessaris, Stephen D Marks
Multiple perioperative variables have been shown in existing literature to influence long-term outcomes of pediatric RTx, such as allograft survival. Their impact on short-term outcomes is not as well-documented. This case series aims to investigate the effects of nine perioperative variables on two short-term outcomes in pRTR: 1-week post-operative eGFR and post-operative LOS. A total of 73 pRTR transplanted over 3 years from 2012 to 2014 at a single center were studied retrospectively and statistical analyses were performed...
May 5, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29726418/improving-fluid-management-in-critical-care-towards-the-icu-of-the-future
#17
Katharina Bergmoser, Lucas Pflanzl-Knizacek, Matthias Hafner, Gernot Schilcher, Christian Baumgartner
BACKGROUND: The calculation of daily fluid balances is essential in perioperative and postoperative fluid management in order to prevent severe hypervolemia or hypovolemia in critically ill patients. In this context, modern health information technology has the potential to reduce the workload for health care professionals by not only automating data collection but also providing appropriate decision support. OBJECTIVES: Within this work, current problems and barriers regarding fluid balancing in cardiac intensive care patients are outlined and improvement activities are specified...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29721547/evaluation-of-the-pharyngeal-airway-using-computational-fluid-dynamics-in-patients-with-acromegaly
#18
Keika Mukaihara, Maiko Hasegawa-Moriyama, Tomonori Iwasaki, Youichi Yamasaki, Yuichi Kanmura
Objectives: Perioperative airway management may be particularly challenging in patients with acromegaly undergoing trans-sphenoidal pituitary surgery (TSS). Management for airway obstruction is required prior to pituitary surgery to minimize perioperative hypoxia. The purpose of this retrospective study was to evaluate airway obstruction by simulation of computational fluid dynamics (CFD) using computed tomography (CT) images in patients who had undergone TSS. Methods: CT images of the nasopharyngeal airways of patients with acromegaly (n = 5) or nonfunctional pituitary adenoma (n = 6) undergoing TSS from April 2012 to January 2017 were used to construct these airways in three dimensions...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29719906/totally-laparoscopic-versus-open-gastrectomy-for-gastric-cancer-a-matched-pair-analysis
#19
Kaja Ludwig, Sylke Schneider-Koriath, Uwe Scharlau, Holger Steffen, Daniela Möller, Jörn Bernhardt
BACKGROUND: Laparoscopic gastrectomy has been established for treatment of early gastric cancer (EGC) especially in Eastern Asian countries. Currently, it still needs evaluation for advanced gastric cancer (AGC, T ≥ 2). Difficulty is how far Asian study data are valid for western conditions. METHODS: Out of 502 patients who underwent gastric cancer surgery between 2003 and 2016 at Klinikum Suedstadt Rostock 90 patients were selected for a retrospective study to compare totally laparoscopic D2-gastrectomy (LG, n = 45) with open D2-gastrectomy (OG, n = 45)...
April 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29713955/successful-hemostatic-management-of-major-surgery-for-cervical-spondylotic-myelopathy-in-a-patient-with-severe-factor-xi-deficiency
#20
Yoshiyuki Ogawa, Kunio Yanagisawa, Yuri Uchiyama, Naoki Akashi, Tokue Mieda, Haku Iizuka, Madoka Inoue, Reiko Shizuka, Masami Murakami, Naomichi Matsumoto, Hiroshi Handa
Factor XI deficiency (FXID) is a rare bleeding disorder caused by mutations in the F11 gene. Spontaneous bleeding in patients with factor XI deficiency is rare, but major bleeding may occur after surgery or trauma. The basic method for hemostatic treatment is replacement of the missing factor using FXI concentrate or fresh frozen plasma (FFP). We report the case of a 72-year-old male with severe FXID who underwent a laminoplasty under sufficient, but minimal, FFP transfusion. Through detailed monitoring of activated partial thromboplastin time (APTT) and FXI activity at the perioperative period, we succeeded in hemostatic management of major surgery without significant blood loss and fluid overload...
April 30, 2018: International Journal of Hematology
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