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Perioperative fluids

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https://www.readbyqxmd.com/read/29156484/-perioperative-intravenous-fluid-therapy-in-children
#1
Robert Sümpelmann
The objective of this consensus-based S1 Guideline for perioperative fluid therapy in children is to maintain or re-establish the child's homeostasis. Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. For the intraoperative background infusion a physiologically composed balanced isotonic electrolyte solution (BS) with 1 - 2.5% glucose is recommended to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29152476/early-recovery-pathway-for-hepatectomy-data-driven-liver-resection-care-and-recovery
#2
REVIEW
Susanne G Warner, Zeljka Jutric, Liana Nisimova, Yuman Fong
In recent years, great progress has been made toward safer hepatobiliary surgical interventions. This has resulted in more widely available treatments for patients who in the past were ineligible for curative resection of primary liver tumors, liver metastases, and advanced biliary tumors. However, the rise in procedures has seen increasingly heterogeneous perioperative management, yielding strikingly disparate outcomes. A number of groups have attempted to standardize perioperative care in an effort to create enhanced recovery pathways (ERPs) and provide clinicians with a dependable roadmap to success following hepatectomy...
October 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#3
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29135586/increased-hyperalgesia-and-proinflammatory-cytokines-in-the-spinal-cord-and-dorsal-root-ganglion-after-surgery-and-or-fentanyl-administration-in-rats
#4
Lu Chang, Fang Ye, Quehua Luo, Yuanxiang Tao, Haihua Shu
BACKGROUND: Perioperative fentanyl has been reported to induce hyperalgesia and increase postoperative pain. In this study, we tried to investigate behavioral hyperalgesia, the expression of proinflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and the activation of microglia in the spinal cord and dorsal root ganglion (DRG) in a rat model of surgical plantar incision with or without perioperative fentanyl. METHODS: Four groups of rats (n = 32 for each group) were subcutaneously injected with fentanyl at 60 μg/kg or normal saline for 4 times with 15-minute intervals...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29135526/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#5
Boris D Heifets, Erin Crawford, Ethan Jackson, Jessica Brodt, Richard A Jaffe, Mark A Burbridge
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29123436/development-and-retrospective-clinical-assessment-of-a-patient-specific-closed-form-integro-differential-equation-model-of-plasma-dilution
#6
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/29123077/effect-and-outcome-of-intraoperative-fluid-restriction-in-living-liver-donor-hepatectomy
#7
Chih-Hsien Wang, Kwok-Wai Cheng, Chao-Long Chen, Shao-Chun Wu, Tsung-Hsiao Shih, Sheng-Chun Yang, Ying-En Lee, Bruno Jawan, Chiu-En Huang, Sin-Ei Juang, Chia-Jung Huang
BACKGROUND The purpose of this study was to evaluate the effect and outcome of intraoperative fluid restriction in living liver donor hepatectomy, regarding changes in intraoperative CVP levels, blood loss, and postoperative renal function. MATERIAL AND METHODS The charts of 167 patients were reviewed and analyzed retrospectively. Intraoperative central venous pressure levels, blood loss, fluids infused, and urine output per hour, before and after the liver allograft procurement, were calculated. Perioperative renal functions were also analyzed...
November 10, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29122527/implementation-of-enhanced-recovery-programs-for-bariatric-surgery-results-from-the-francophone-large-scale-database
#8
Anissa Deneuvy, Karem Slim, Maxime Sodji, Pierre Blanc, Denis Gallet, Marie-Cécile Blanchet
BACKGROUND: The feasibility, safety, and efficacy of programs for enhanced recovery after bariatric surgery (ERABS) are now well established. However, data concerning their large-scale implementation remain insufficient. OBJECTIVES: The objective of the present study was to review the multicenter implementation of ERABS SETTING: This retrospective analysis of a prospective database was conducted in 15 Groupe francophone de Rehabilitation Améliorée après ChirurgiE centers from data from March 2014 to January 2017...
October 4, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29122209/choice-of-fluids-in-the-perioperative-period-of-kidney-transplantation
#9
Alejandro Gonzalez-Castro, María Ortiz-Lasa, Yhivian Peñasco, Camilo González, Carmen Blanco, Juan Carlos Rodriguez-Borregan
Normal saline has traditionally been the resuscitation fluid of choice in the perioperative period of kidney transplantation over balanced potassium solutions. However, the problems arising from hyperchloraemia triggered by the infusion of normal saline have led to studies being conducted that compare this solution with balanced solutions. From this narrative review it can be concluded that the use of balanced crystalloids containing potassium in the perioperative period of kidney transplantation can be considered safe...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#10
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/29108091/effects-of-low-dose-epinephrine-on-perioperative-hemostasis-and-inflammatory-reaction-in-major-surgeries-a%C3%A2-randomized%C3%A2-clinical-trial
#11
J L Liu, W N Zeng, F Y Wang, C Chen, X Y Gong, H Yang, Z J Tan, X L Jia, L Yang
BACKGROUND: Haemostasis, thrombosis, and surgical stress-induced immune reaction are important for perioperative morbidity and recovery in major surgeries. OBJECTIVES: This study aimed to evaluate the effects of combined administration of low-dose epinephrine (LDEPI) plus tranexamic acid (TXA) on perioperative blood loss, thromboembolic complications, and inflammatory response in total hip arthroplasty (THA). PATIENTS /METHODS: Patients scheduled for THA (n = 195) were randomized into 3 interventions: intravenous (IV) LDEPI plus TXA (Group IV); topical (TP) diluted-epinephrine plus TXA (Group TP); and TXA alone as control (CT) (Group CT)...
November 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29104182/lipid-peroxidation-in-cardiac-surgery-towards-consensus-on-biomonitoring-diagnostic-tools-and-therapeutic-implementation
#12
Rosalba Romano, Simona M Cristescu, Terence H Risby, Nandor Marczin
This review focuses on oxidative stress and more specifically lipid peroxidation in cardiac surgery, one of the fundamental theories of perioperative complications. We present the molecular pathways leading to lipid peroxidation and integrate analytical methods that allow detection of lipid peroxidation markers in the fluid phase with those focusing on volatile compounds in exhaled breath. In order to explore the accumulated data in the literature, we present a systematic review of quantitative analysis of malondialdehyde (MDA), a widely used lipid peroxidation product at various stages of cardiac surgery...
November 6, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/29094066/surgical-repair-of-spontaneous-cerebrospinal-fluid-csf-leaks-a-systematic-review
#13
REVIEW
Brian C Lobo, Maraya M Baumanis, Rick F Nelson
Objectives: To review the safety and efficacy of surgical management for spontaneous cerebrospinal fluid (CSF) leaks of the anterior and lateral skull base. Data Sources: A systematic review of English articles using MEDLINE. Review Methods: Search terms included spontaneous, CSF, cerebrospinal fluid, endoscopic, middle fossa, transmastoid, leak, rhinorrhea. Independent extraction of articles by 3 authors. Results: Patients with spontaneous CSF leaks are often obese (average BMI of 38 kg/m(2)) and female (72%)...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29073613/impact-of-the-flotrac-vigileotm-monitoring-on-intraoperative-fluid-management-and-outcome-after-liver-resection
#14
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/29071091/the-use-of-the-renalguard-system-in-cardiac-surgery-with-cardiopulmonary-bypass-a-first-in-man-prospective-observational-feasibility-pilot-study
#15
Heyman Luckraz, Ramesh Giri, Benmjamin Wrigley, Anne-Marie Hennessy, Johann Nicholas, Alan Nevill
OBJECTIVES: As proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system. BACKGROUND: Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored...
2017: Open Heart
https://www.readbyqxmd.com/read/29067620/what-is-enhanced-recovery-and-how-can-i-do-it
#16
Bradford J Kim, Thomas A Aloia
BACKGROUND: Enhanced recovery (ER) and fast-track protocols were initially implemented in the perioperative management of the surgical patient over 20 years ago. These standardized protocols are now broadly implemented across most surgical specialties for its many benefits. ER is well known for its positive effects on decreasing length of stay and complications. However, patient-centric outcomes for adequate pain control, functional recovery, costs, and overall patient experience are less considered...
October 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29066231/antibiotic-prophylaxis-and-infection-prevention-for-endoscopic-endonasal-skull-base-surgery-our-protocol-results-and-review-of-the-literature
#17
Stephen J Johans, Daniel J Burkett, Kevin N Swong, Chirag R Patel, Anand V Germanwala
Endoscopic endonasal approaches to the skull base provide minimally invasive corridors to intracranial lesions; however, enthusiasm for this new approach is always tempered by the recognition that this route requires passage through a nonsterile sinonasal corridor. Despite an increasing number of patients undergoing these surgeries, there remains no consensus on the use of perioperative antibiotics. A retrospective review of consecutive patients undergoing endoscopic endonasal skull base surgery (EESBS) at Loyola University Medical Center by the same neurosurgeon and otolaryngologist team between February 2015 and October 2016 was performed...
October 21, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29062560/use-of-a-minimally-invasive-cardiac-output-monitor-to-optimise-haemodynamics-in-a-patient-with-mitral-valve-disease-undergoing-cerebrovascular-surgery
#18
Ali M Al-Mashani, Niranjan D Waje, Neeraj Salhotra, Samaresh Das, Neelam Suri, Rashid A Al-Sheheimi, Nilay Chatterjee
Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29058286/treatment-of-retrogastric-pancreatic-pseudocysts-by-laparoscopic-transgastric-cystogastrostomy
#19
Tian-Ming Wu, Zhong-Kui Jin, Qiang He, Xin Zhao, Jian-Tao Kou, Hua Fan
This paper discusses variations of laparoscopic transgastric cystogastrostomy in management of retrogastric pancreatic pseudocysts for 8 patients with symptom or pseudocysts (larger than 6 cm) companied with clinical manifestations. Using a Harmonic scalpel, two 3-5-cm incisions were made in the anterior and posterior gastric wall respectively. In the last step, the anterior gastrotomy was closed with an Endo-GIA stapler. All cases were successfully treated without large blood loss and without conversion to open surgery...
October 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/29052006/risk-factors-for-and-the-prevention-of-acute-kidney-injury-after-abdominal-surgery
#20
REVIEW
Yongbo An, Kai Shen, Yingjiang Ye
Postoperative acute kidney injury in patients undergoing abdominal surgery is not rare and often results in bad outcomes for patients. The incidence of postoperative acute kidney injury is hard to evaluate reliably due to its non-unified definitions in different studies. Risk factors for acute kidney injury specific to abdominal surgery include preoperative renal insufficiency, intraabdominal hypertension, blood transfusion, bowel preparation, perioperative dehydration, contrast agent and nephrotoxic drug use...
October 19, 2017: Surgery Today
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