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https://www.readbyqxmd.com/read/28743152/-prevention-of-perioperative-hypothermia-guidelines-for-daily-clinical-practice
#1
Timo Iden, Jan Höcker
Inadvertent perioperative hypothermia (body core temperature < 36 °C) is a serious complication leading to increased rates of wound infection, higher blood loss associated with increased transfusion requirements as well as patient dissatisfaction among others. Body core temperature is a vital parameter and needs constant monitoring just like heart rate, blood pressure and arterial oxygen saturation. Patient-, anesthesia-, surgery- and environment-related risk factors were identified for occurring perioperative hypothermia...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743150/-anesthesiology-and-outcome-impact-of-the-perioperative-process
#2
Jörg Zieger, Helene A Häberle
In recent years, the role of the anesthesiologist has turned tremendously from the "anaesthesia doctor" into a perioperative physician and risk specialist. Patients are older, multimorbid, and are called up for more and more extensive surgery and interventions. Socioeconomic aspects have grown in importance. The anesthesiologist, paving the way for a good outcome, is involved in nearly all perioperative processes: preoperative evaluation, definition and optimization of preoperative and intraoperative conditions, management of modern intraoperative anesthesia as well as postoperative medically indicated, effective and efficient treatment of partially highly complex patients...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743149/-the-influence-of-anesthesia-on-perioperative-outcome-in-children-institutional-and-individual-factors
#3
Frank Fideler, Christian Grasshoff
The perioperative care of children is challenging for health care providers. Since anesthetists cannot affect the nature of the disease and have hardly an impact on the decision for surgery we summarized in this review individual and institutional factors for improving perioperative outcome by anesthetists. Individual factors include the level of education and the professional experience of the anesthetist as well as an anesthetic management that is focused on the maintenance of an adequate cerebral perfusion...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743148/-impact-of-cardiac-anaesthesia-on-patient-outcome
#4
Martina Nowak-Machen
The perioperative management of complex patients in a highly technical and subspecialized environment is the domain of the cardiac anesthesiologist. Evidence suggests that hemodynamic management using goal directed hemodynamic therapy (GDHT) improves patient outcome. Organ protection remains a main concern during cardiac surgery using extracorporeal circulation. Mortality can be decreased when remote ischemic preconditioning techniques (RIPC) are being used. Neurological outcomes can be improved with near-infrared-spectometry (NIRS), volatile anesthetics increase myocardial protection through preconditioning and perioperative echocardiography increases overall patient survival...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743147/-development-of-anaesthesia-related-mortality-and-impact-on-perioperative-outcome
#5
Peter Rosenberger, Berthold Drexler
Achievements in anaesthesiology form the basis for the tremendous development of surgical therapy. Reliable monitoring technology, which is scrutinized on a regular basis using checklists, is allowing anaesthesia at the borders of physiology. During the last decades, anaesthesia-related mortality has been decreasing considerably. Well-trained anaesthesiology staff, who considers patient- and procedure-specific risks in anaesthetic management, is of major importance. Furthermore, postoperative care in specialised units and intensive care wards is a key factor of improved patient outcome after surgery...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742786/proper-distal-placement-of-tibial-nail-improves-rate-of-malalignment-for-distal-tibia-fractures
#6
Konstantinos Triantafillou, Eric Barcak, Arturo Villarreal, Cory Collinge, Edward Perez
OBJECTIVES: We hypothesize that the anatomic center of the distal tibia is just lateral and anterior to the center of the distal tibia articular surface in the coronal and sagittal planes respectively, and that placement of the nail along this axis results in improved rates of malalignment when treating distal tibia fractures. DESIGN: Retrospective study SETTING:: One level I and one level II trauma center PATIENTS/PARTICIPANTS:: 203 distal tibia fractures treated with IMN (primary cohort) whose main fracture line extended within 5 cm of the plafond to evaluate the rate of malalignment with distal nail placement...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28742778/quality-and-safety-in-anesthesia-and-perioperative-care
#7
Nicholas J Morey, Timothy E Morey
No abstract text is available yet for this article.
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742777/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-persistent-opioid-use-among-patients-undergoing-shoulder-arthroplasty-evidence-from-the-marketscan-database
#8
Kathryn G Mueller, Stavros G Memtsoudis, Edward R Mariano, Laurence C Baker, Sean Mackey, Eric C Sun
BACKGROUND: Persistent opioid use following surgery has received increasing attention from policymakers, researchers, and clinicians. Perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. We examined whether nerve blockade was associated with a decreased risk of persistent opioid use among patients undergoing shoulder arthroplasty, a procedure with high rates of persistent postoperative pain. METHODS: Using health care claims data, we constructed a sample of 6695 patients undergoing shoulder arthroplasty between 2002 and 2012 and used billing data to identify the utilization of nerve blockade...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742771/perioperative-amino-acid-infusion-for-preventing-hypothermia-and-improving-clinical-outcomes-during-surgery-under-general-anesthesia-a-systematic-review-and-meta-analysis
#9
Yoshitaka Aoki, Yukie Aoshima, Kazuyuki Atsumi, Ryo Kaminaka, Rintaro Nakau, Kyoko Yanagita, Makiko Kora, Shunsuke Fujii, Junichiro Yokoyama
Amino acid (AA) infusion is sometimes selected to avoid hypothermia during general anesthesia. However, the widespread clinical use of AA infusion therapy has not been established. This study aimed to clarify the evidence that AA infusion can increase patient body temperature and improve clinical outcomes using the Grading of Recommendations Assessment, Development, and Evaluation system. We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Japana Centra Revuo Medicina) in November 2015...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#10
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742760/a-randomized-trial-comparing-clinical-outcomes-between-zero-profile-and-traditional-multi-level-anterior-cervical-discectomy-and-fusion-surgery-for-cervical-myelopathy
#11
Shenghua He, Hualong Feng, Zhiming Lan, Lai Juyi, Zhitao Sun, Yeguang Wang, Jian Wang, Zhiqiang Ren, Feiqiang Huang, Fuguang Xu
STUDY DESIGN: Prospective randomized study from a single center OBJECTIVE.: The purpose of this study was to compare outcomes between a zero-profile (ZP) anterior cervical discectomy and fusion (ACDF) construct to a traditional ACDF with anterior plate (ACP) in the treatment of multilevel cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA: Multi-level cervical spondylotic myelopathy can be treated by a variety of techniques, most commonly with corpectomy, ACDF, posterior cervical fusion or a combination of the three...
July 24, 2017: Spine
https://www.readbyqxmd.com/read/28742736/comparative-analysis-of-perioperative-outcomes-using-nationally-derived-hospital-discharge-data-relative-to-a-prospective-multicenter-surgical-database-of-adult-spinal-deformity-surgery
#12
Gregory W Poorman, Peter G Passias, Aaron J Buckland, Cyrus M Jalai, Michael Kelly, Daniel M Sciubba, Brian J Neuman, D Kojo Hamilton, Amit Jain, Bassel Diebo, Virginie Lafage, Shay Bess, Eric O Klineberg
STUDY DESIGN: Retrospective analysis of three prospectively collected databases. OBJECTIVE: To compare perioperative outcomes in Adult Spinal Deformity (ASD) surgeries in a surgeon-run (SR-ASD) and two national databases: the Nationwide Inpatient Sample (NIS) and the National Surgical Quality Improvement Program (NSQIP). SUMMARY OF BACKGROUND DATA: Much has been learned on the treatment of ASD in the last decade with prospective multicenter collaborative research focusing on this specific condition...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#13
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742713/does-prolonged-enteral-feeding-with-supplemental-omega-3-fatty-acids-impact-on-recovery-post-esophagectomy-results-of-a-randomized-double-blind-trial
#14
Laura A Healy, Aoife Ryan, Suzanne L Doyle, Éadaoin Bríd Ní Bhuachalla, Samantha Cushen, Ricardo Segurado, Thomas Murphy, Narayanasamy Ravi, Claire L Donohoe, John V Reynolds
OBJECTIVE: This randomized controlled trial (RCT) hypothesized that prolonged enteral nutrition (EN) with supplemental eicosapentanoic acid (EPA), an omega-3 fatty acid with immune and anabolic properties, may impact on clinical and nutritional outcomes. BACKGROUND: Esophagectomy is associated with significant weight loss and catabolism, and negatively impacts quality of life (QL). Strategies to counter sustained catabolism have therapeutic rationale. METHODS: This multicenter, double-blind, placebo-controlled RCT was powered on a 5% difference in lean body mass (LBM) at 1 month...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742697/are-thoracotomy-and-or-intrathoracic-anastomosis-still-predictors-of-postoperative-mortality-after-esophageal-cancer-surgery-a-nationwide-study
#15
Sébastien Degisors, Arnaud Pasquer, Florence Renaud, Hélène Béhal, Flora Hec, Anne Gandon, Marguerite Vanderbeken, Gilbert Caranhac, Alain Duhamel, Guillaume Piessen, Christophe Mariette
BACKGROUND: Intrathoracic (vs cervical) anastomosis and a thoracotomy (vs absence) have previously been associated with increasing postoperative mortality (POM). Recent improvements in surgical practices and perioperative management may have changed these dogmas. OBJECTIVES: The aim of this study was to evaluate the impact of performing intrathoracic anastomosis and/or thoracotomy on POM after esophageal cancer surgery in recent years. METHODS: All consecutive patients who underwent esophageal cancer surgery with reconstruction between 2010 and 2012 in France were included (n = 3286)...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742442/analysis-of-variability-in-intraoperative-fluid-administration-for-colorectal-surgery-an-argument-for-goal-directed-fluid-therapy
#16
Timothy D Quinn, Ethan Y Brovman, Richard D Urman
BACKGROUND: Fluid therapy in the perioperative period varies greatly between anesthesia providers and may have a negative impact on surgical outcomes. METHODS: We conducted a retrospective analysis of 705 elective colorectal cases consisting of colectomies, ileocolic resections, and low anterior resections at an academic institution from January 1, 2010 to May 29, 2015, collected by our electronic medical record before implementation of Enhanced Recovery After Surgery (ERAS(®)) pathways...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#17
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28741839/feasibility-of-spacers-to-facilitate-postoperative-radiotherapy-for-retroperitoneal-sarcomas
#18
Jessica Reid, Richard Smith, Martin Borg, Christopher Dobbins, Raghu Gowda, Steve Chryssidis, Matthew Borg, Susan Neuhaus
INTRODUCTION: The role and timing of postoperative radiotherapy (PORT) in the management of retroperitoneal sarcoma (RPS) remains controversial. METHOD: This is a retrospective cohort review of patients undergoing curative resection for RPS at a single institution between January 2011 and July 2016. Patient selection was through the South Australian Soft Tissue Tumour Multidisciplinary Group (MDT) based at Royal Adelaide Hospital. An individualised approach, including assessment of resectability, histopathological grade and subtype, and radiotherapy considerations, was taken for each patient...
July 25, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28741745/venous-thromboembolism-prophylaxis-in-urology-a-review
#19
REVIEW
Manmeet Saluja, Peter Gilling
Venous thromboembolism is potentially a lethal problem, and is associated with chronic morbidity. Venous thromboembolism is frequently diagnosed after urological surgery, yet the role of perioperative venous thromboembolism prophylaxis is not clearly defined. Any current recommendations are largely based on evidence derived from other surgical specialties. Even within different guidelines, there remains significant variation, suggesting a consensus is required. The present review aims to define the problem of venous thromboembolism within the urological population, and identifies patients at risk...
July 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28741744/thermal-suit-in-preventing-unintentional-intraoperative-hypothermia-during-general-anaesthesia-a-randomized-controlled-trial
#20
S-L Lauronen, M-L Kalliomäki, A J Aho, J Kalliovalkama, J M Riikonen, M-T Mäkinen, H M Leppikangas, A M Yli-Hankala
BACKGROUND: Unintentional perioperative hypothermia causes serious adverse effects to surgical patients. Thermal suit (T-Balance(®) ) is an option for passive warming perioperatively. We hypothesized that the thermal suit will not maintain normothermia more efficiently than conventional cotton clothes when also other preventive procedures against unintentional hypothermia are used. METHODS: One hundred patients were recruited to this prospective, randomized trial...
July 25, 2017: Acta Anaesthesiologica Scandinavica
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