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Postoperative delirium

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https://www.readbyqxmd.com/read/29429053/program-of-gastrointestinal-rehabilitation-and-early-postoperative-enteral-nutrition-a-prospective-study
#1
Frank Daniel Martos-Benítez, Anarelys Gutiérrez-Noyola, Andrés Soto-García, Iraida González-Martínez, Ilionanys Betancourt-Plaza
Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January-2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit...
February 10, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29427259/intraoperative-cerebral-oximetry-based-management-for-optimizing-perioperative-outcomes-a-meta-analysis-of-randomized-controlled-trials
#2
Andres Zorrilla-Vaca, Ryan Healy, Michael C Grant, Brijen Joshi, Lucia Rivera-Lara, Charles Brown, Marek A Mirski
PURPOSE: Although evidence from observational studies in a variety of clinical settings supports the utility of cerebral oximetry as a predictor of outcomes, prospective clinical trials thus far have reported conflicting results. This systematic review and meta-analysis was designed to evaluate the influence of management associated with intraoperative cerebral oximetry on postoperative outcomes. The primary outcome was postoperative cognitive dysfunction (POCD), with secondary outcomes that included postoperative delirium, length of intensive care unit (ICU) stay, and hospital length of stay (LOS)...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29423780/do-risk-prediction-models-for-postoperative-delirium-consider-patients-preoperative-medication-use
#3
REVIEW
Gizat M Kassie, Tuan A Nguyen, Lisa M Kalisch Ellett, Nicole L Pratt, Elizabeth E Roughead
BACKGROUND: Medicines are potentially modifiable risk factors for postoperative delirium. However, the extent to which preoperative medicines are included in risk prediction models (RPMs) is unknown. OBJECTIVE: This systematic review aimed to assess the extent of inclusion of preoperative medications in RPMs for postoperative delirium. METHODS: Articles were systematically searched from MEDLINE, EMBASE and CINAHL using Medical Subject Headings (MeSH) where possible and keywords for postoperative delirium and prediction model...
February 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29415580/a-non-interventional-comparative-study-of-the-20-1-combination-of-cafedrine-theodrenaline-versus-ephedrine-for-the-treatment-of-intraoperative-arterial-hypotension-the-hypotens-study-design-and-rationale
#4
Leopold Eberhart, Götz Geldner, Susanne Huljic, Kerstin Marggraf, Thomas Keller, Tilo Koch, Peter Kranke
OBJECTIVE: To compare the effectiveness of 20:1 cafedrine/theodrenaline approved for use in Germany to ephedrine in the restoration of arterial blood pressure and on postoperative outcomes in patients with intraoperative arterial hypotension of any origin under standard clinical practice conditions. METHODS AND RESULTS: 'HYPOTENS' is a national, multicenter, prospective, open-label, two-armed, non-interventional study. Effectiveness and post-operative outcome following cafedrine/theodrenaline or ephedrine therapy will be evaluated in two cohorts of hypotensive patients...
February 7, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29412440/precipitants-of-delirium-in-older-inpatients-admitted-in-surgery-for-post-fall-hip-fracture-an-observational-study
#5
E Levinoff, A Try, J Chabot, L Lee, D Zukor, O Beauchet
BACKGROUND: Hip fractures precipitate several acute adverse outcomes in elderly people, thus leading to chronic adverse outcomes. OBJECTIVES: The objective of our study was to examine the clinical characteristics associated with incident delirium in community dwelling elderly individuals who have a hip fracture. DESIGN: Retrospective observational cohort study. SETTING: Data was collected from an academic tertiary hospital affiliated with McGill University...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29404892/cerebral-oximetry-during-preoperative-resuscitation-in-elderly-patients-with-hip-fracture-a-prospective-observational-study
#6
C G Clemmesen, L M Pedersen, S Hougaard, M L Andersson, V Rosenkvist, H B Nielsen, H Palm, N B Foss
This study explores the association between postadmission and intraoperative cerebral oxygenation (ScO2), reflecting systemic perfusion, and postoperative mortality and delirium. Forty elderly (age > 65 years) patients with hip fractures were included in this prospective observational study. The ScO2 was determined using near-infrared spectroscopy at initial resuscitation after patients were admitted to the hospital and during surgery. Postoperative delirium was assessed up to seven days after surgery using the memorial delirium assessment scale and the confusion assessment method...
February 5, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29402715/does-parkinson-disease-increase-the-risk-of-perioperative-complications-after-total-hip-arthroplasty-a-nationwide-database-study
#7
Jared M Newman, Nipun Sodhi, Sarah E Dalton, Anton Khlopas, Richard P Newman, Carlos A Higuera, Michael A Mont
BACKGROUND: Parkinson disease (PD) is the second most common neurodegenerative disorder in the United States, affecting over 1 million people. As part of the disease process, PD can cause poor bone quality and other musculoskeletal problems that can affect a patient's quality of life. With advances in treatment, PD patients can be more active and may be candidates for total hip arthroplasty (THA). However, there is a paucity of literature on the outcomes of THA in PD patients. Therefore, the purpose of this study was to evaluate the perioperative outcomes of PD patients who underwent THA...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29401106/csf-beta-amyloid-1-42-concentration-predicts-delirium-following-elective-arthroplasty-surgery-in-an-observational-cohort-study
#8
Emma L Cunningham, Bernadette McGuinness, Daniel F McAuley, Jamie Toombs, Tim Mawhinney, Seamus O'Brien, David Beverland, Jonathan M Schott, Michael P Lunn, Henrik Zetterberg, Anthony P Passmore
OBJECTIVE: To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium. BACKGROUND: Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium. METHODS: This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty...
February 2, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29397119/the-hip-fracture-surgery-in-elderly-patients-hipeld-study-to-evaluate-xenon-anaesthesia-for-the-prevention-of-postoperative-delirium-a-multicentre-randomized-clinical-trial
#9
M Coburn, R D Sanders, M Maze, M-L Nguyên-Pascal, S Rex, B Garrigues, J A Carbonell, M L Garcia-Perez, A Stevanovic, P Kienbaum, M Neukirchen, M S Schaefer, B Borghi, H van Oven, A Tognù, L Al Tmimi, L Eyrolle, O Langeron, X Capdevila, G M Arnold, M Schaller, R Rossaint
BACKGROUND: Postoperative delirium occurs frequently in elderly hip fracture surgery patients and is associated with poorer overall outcomes. Because xenon anaesthesia has neuroprotective properties, we evaluated its effect on the incidence of delirium and other outcomes after hip fracture surgery. METHODS: This was a phase II, multicentre, randomized, double-blind, parallel-group, controlled clinical trial conducted in hospitals in six European countries (September 2010 to October 2014)...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29385235/comprehensive-geriatric-assessment-for-older-people-admitted-to-a-surgical-service
#10
REVIEW
Gilgamesh Eamer, Amir Taheri, Sidian S Chen, Quinn Daviduck, Thane Chambers, Xinzhe Shi, Rachel G Khadaroo
BACKGROUND: Aging populations are at increased risk of postoperative complications. New methods to provide care for older people recovering from surgery may reduce surgery-related complications. Comprehensive geriatric assessment (CGA) has been shown to improve some outcomes for medical patients, such as enabling them to continue living at home, and has been proposed to have positive impacts for surgical patients. CGA is a coordinated, multidisciplinary collaboration that assesses the medical, psychosocial and functional capabilities and limitations of an older person, with the goal of establishing a treatment plan and long-term follow-up...
January 31, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29379311/postoperative-discomfort-and-emergence-delirium-in-children-undergoing-dental-rehabilitation-under-general-anesthesia-comparison-of-nasal-tracheal-intubation-and-laryngeal-mask-airway
#11
Sultan Keles, Ozlem Kocaturk
Background: Several studies have identified side effects of general anesthesia with endotracheal intubation, such as laryngeal pain, dysphonia, and postoperative nausea and vomiting (PONV). The laryngeal mask airway (LMAw) is believed to decrease these side effects. The aim of this trial was to compare postoperative discomfort, emergence delirium, and recovery time of patients who received either an LMAw or nasotracheal intubation (NTI). Patients and methods: A total of 70 children were randomly assigned to the LMAw group (n=35) or the NTI group (n=35)...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29377404/sedation-for-magnetic-resonance-imaging-using-propofol-with-or-without-ketamine-at-induction-in-pediatrics-a-prospective-randomized-double-blinded-study
#12
Achim Schmitz, Markus Weiss, Christian Kellenberger, Ruth O Gorman Tuura, Richard Klaghofer, Ianina Scheer, Malek Makki, Carola Sabandal, Philipp Karl Buehler
INTRODUCTION: Deep sedation using propofol has become a standard technique in children. This double-blinded randomized clinical trial aims to compare the clinical effects of propofol-mono-sedation vs a combination of propofol and ketamine at induction and a reduced propofol infusion rate for maintenance in children undergoing diagnostic magnetic resonance imaging. METHODS: Children aged from 3 months to 10 years scheduled as outpatients for elective magnetic resonance imaging with deep sedation were included...
January 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29374667/epidurals-in-pancreatic-resection-outcomes-e-pro-study-protocol-for-a-randomised-controlled-trial
#13
Linda Ma Pak, Simon Haroutounian, William G Hawkins, Lori Worley, Monika Kurtz, Karen Frey, Menelaos Karanikolas, Robert A Swarm, Michael M Bottros
INTRODUCTION: Epidural analgesia provides an important synergistic method of pain control. In addition to reducing perioperative opioid consumption, the deliverance of analgesia into the epidural space, effectively creating a sympathetic blockade, has a multitude of additional potential benefits, from decreasing the incidence of postoperative delirium to reducing the development of persistent postsurgical pain (PPSP). Prior studies have also identified a correlation between the use of epidural analgesia and improved oncological outcomes and survival...
January 26, 2018: BMJ Open
https://www.readbyqxmd.com/read/29374358/identifying-older-adults-at-risk-of-delirium-following-elective-surgery-a-systematic-review-and-meta-analysis
#14
Jennifer Watt, Andrea C Tricco, Catherine Talbot-Hamon, Ba' Pham, Patricia Rios, Agnes Grudniewicz, Camilla Wong, Douglas Sinclair, Sharon E Straus
BACKGROUND: Postoperative delirium is a common preventable complication experienced by older adults undergoing elective surgery. In this systematic review and meta-analysis, we identified prognostic factors associated with the risk of postoperative delirium among older adults undergoing elective surgery. METHODS: Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and AgeLine were searched for articles published between inception and April 21, 2016...
January 26, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29368313/the-use-of-point-of-care-ultrasound-to-diagnose-patent-foramen-ovale-in-elective-hip-and-knee-arthroplasty-patients-and-its-association-with-postoperative-delirium
#15
Nan Gai, Ronit Lavi, Philip M Jones, Hwa Lee, Douglas Naudie, Daniel Bainbridge
PURPOSE: Hip and knee arthroplasty surgeries are associated with embolism of materials such as air, cement, and fat. Patent foramen ovale (PFO) is a common congenital cardiac condition that has been reported to lead to paradoxical embolism. This observational study aimed to investigate if the presence of a PFO was associated with an increased risk of postoperative delirium in patients undergoing primary elective hip or knee arthroplasties. METHOD: This was a prospective cohort study at a tertiary teaching hospital...
January 24, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29361457/postoperative-delirium-in-cardiac-surgery-patients
#16
Kati Järvelä, Helena Porkkala, Sari Karlsson, Tero Martikainen, Tuomas Selander, Stepani Bendel
OBJECTIVE: The authors studied the incidence of postoperative delirium among cardiac surgery patients using the Intensive Care Delirium Screening Checklist (ICDSC). DESIGN: Prospective screening. SETTING: Two university hospitals. PARTICIPANTS: A total of 1,036 consecutive patients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were prospectively screened from day 1 to day 10 after surgery or until hospital discharge...
December 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29355811/preoperative-hemoglobin-level-is-associated-with-increased-healthcare-utilization-after-elective-spinal-fusion-%C3%A2-3-levels-in-elderly-male-spine-deformity-patients
#17
Aladine A Elsamadicy, Owoicho Adogwa, Michael Ongele, Amanda R Sergesketter, Aaron Tarnasky, David E T Lubkin, Nicolas Drysdale, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Measures of healthcare utilization such as length of hospital stay (LOS) are used as proxies for quality of care after spine surgery. Accordingly, hospitals and health systems are investing considerable resources into the pre-operative identification of patients at risk for prolonged LOS. This study aims to investigate the impact of preoperative hemoglobin on outcomes and LOS after spinal fusion. METHODS: The medical records of 204 elderly (≥60 years) male patients undergoing elective spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed...
January 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29353441/pre-and-postoperative-management-of-risk-factors-for-postoperative-delirium-who-is-in-charge-and-what-is-its-essence
#18
Bruno Neuner, Daniel Hadzidiakos, Gabriella Bettelli
Postoperative delirium (POD) is an adverse clinical outcome characterized by cognitive, affective and behavioral symptoms with typically an acute onset and a fluctuating course. POD is attributed to certain patients' predisposing factors as well as to treatment-related precipitating factors. While there are several single-component interventions for the prevention of POD, evolving evidence suggests the importance of a system approach in the prevention of POD. This involves strategies by multidisciplinary teams with additional geriatric consultation services to identify risk factors for POD and to modify their impact on the perioperative course...
January 20, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29349349/a-retrospective-analysis-of-outpatient-anesthesia-management-for-dental-treatment-of-patients-with-severe-alzheimer-s-disease
#19
Eunsun So, Hyun Jeong Kim, Myong-Hwan Karm, Kwang-Suk Seo, Juhea Chang, Joo Hyung Lee
Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#20
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
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