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Intraoperative fluids

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https://www.readbyqxmd.com/read/28545764/implementation-of-an-enhanced-recovery-protocol-in-pediatric-colorectal-surgery
#1
Heather L Short, Kurt F Heiss, Katelyn Burch, Curtis Travers, John Edney, Claudia Venable, Mehul V Raval
PURPOSE: Enhanced recovery protocols (ERPs) have been shown to improve outcomes in adult surgical populations. Our purpose was to compare outcomes before and after implementation of an ERP in children undergoing elective colorectal surgery. METHODS: A pediatric-specific colorectal ERP was developed and implemented at a single center starting in January 2015. A retrospective review was performed including 43 patients in the pre-ERP period (2012-2014) and 36 patients in the post-ERP period (2015-2016)...
May 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28530080/-cataract-surgery-complications-in-males-treated-with-alpha-1-antagonists-for-benign-prostatic-hyperplasia
#2
REVIEW
Tamar Pedut Kloizman, Raneen Shehadeh Mashour
Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell in 2005. The characteristics of this syndrome include: 1. Floppy iris that billows in reaction to intraocular fluid currents during standard phacoemulsification procedure; 2. Flaccid iris stroma that tends to prolapse through well-constructed surgical incisions; 3. Insufficient pupillary mydriasis despite proper pharmacologic preparation and progressive pupillary constriction during the operation. Surgical procedures with IFIS have since been noted to have an exceptionally high rate of complications, some of which can be vision threatening...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#3
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#4
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28526144/pulmonary-vasodilators-and-anesthesia-considerations
#5
REVIEW
Jeremy B Green, Brendon Hart, Elyse M Cornett, Alan D Kaye, Ali Salehi, Charles J Fox
Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28516158/a-management-algorithm-for-mitomycin-c-induced-cystitis
#6
Amy N Luckenbaugh, Rory M Marks, David C Miller, Alon Z Weizer, John T Stoffel, Jeffrey S Montgomery
Background/Objective: A post-bladder tumor resection dose of MMC can reduce non-invasive papillary (pTa) bladder cancer recurrences by up to 40%; this treatment is recommended in both the AUA and EUA non-muscle-invasive bladder cancer guidelines. A common complication of this treatment is eosinophilic cystitis. Symptoms range from mild urinary frequency and urgency to debilitating pain and dysuria. Currently, there is no established treatment algorithm for MMC-induced cystitis. Methods: Members of the Urologic Surgery Quality Collaborative (USQC), a group composed of over 160 private and academic urologists, met to discuss the management of patients with cystitis following MMC therapy...
April 27, 2017: Bladder Cancer
https://www.readbyqxmd.com/read/28514320/preoperative-warming-versus-no-preoperative-warming-for-maintenance-of-normothermia-in-women-receiving-intrathecal-morphine-for-cesarean-delivery-a-single-blinded-randomized-controlled-trial
#7
Judy Munday, Sonya Osborne, Patsy Yates, David Sturgess, Lee Jones, Edward Gosden
BACKGROUND: Rates of hypothermia for women undergoing spinal anesthesia for cesarean delivery are high and prevention is desirable. This trial compared the effectiveness of preoperative warming versus usual care among women receiving intrathecal morphine, which is thought to exacerbate perioperative heat loss. METHODS: A prospective, single-blinded, randomized controlled trial compared 20 minutes of forced air warming (plus intravenous fluid warming) versus no active preoperative warming (plus intravenous fluid warming) in 50 healthy American Society of Anesthesiologists graded II women receiving intrathecal morphine as part of spinal anesthesia for elective cesarean delivery...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28511699/does-intraoperative-closed-suction-drainage-influence-the-rate-of-pancreatic-fistula-after-pancreaticoduodenectomy
#8
Ophélie Aumont, Aurélien Dupré, Adeline Abjean, Bruno Pereira, Julie Veziant, Bertrand Le Roy, Denis Pezet, Emmanuel Buc, Johan Gagnière
BACKGROUND: Although drainage of pancreatic anastomoses after pancreaticoduodenectomy (PD) is still debated, it remains recommended, especially in patients with a high risk of post-operative pancreatic fistula (POPF). Modalities of drainage of pancreatic anastomoses, especially the use of passive (PAD) or closed-suction (CSD) drains, and their impact on surgical outcomes, have been poorly studied. The aim was to compare CSD versus PAD on surgical outcomes after PD. METHODS: Retrospective analysis of 197 consecutive patients who underwent a standardized PD at two tertiary centers between March 2012 and April 2015...
May 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#9
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28497021/understanding-rare-adverse-sequelae-of-breast-implants-anaplastic-large-cell-lymphoma-late-seromas-and-double-capsules
#10
REVIEW
Mark W Clemens, Maurizio Bruno Nava, Nicola Rocco, Roberto N Miranda
Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) is a distinct type of T-cell lymphoma arising around breast implants. The United States FDA recently updated the 2011 safety communication, warning that women with breast implants may have a very low risk of developing ALCL adjacent to a breast implant. According to the World Health Organization, BI-LCL is not a breast cancer or cancer of the breast tissue; it is a lymphoma, a cancer of immune cells. BI-ALCL is highly curable in the majority of patients...
April 2017: Gland Surgery
https://www.readbyqxmd.com/read/28495088/fluorescence-guided-resection-with-5-aminolevulinic-acid-of-a-pilomyxoid-astrocytoma-of-the-third-ventricle
#11
Luis Miguel Bernal García, Jose Manuel Cabezudo Artero, Rafael García Moreno, Maria Bella Marcelo Zamorano, Carlos Mayoral Guisado
Fluorescence-guided resection with 5-aminolevulinic acid has been shown to be useful in the resection of certain brain tumors other than high grade gliomas, facilitating the intraoperative differentiation of neoplastic tissue. The technique enables the surgeon to ensure that no tumor fragments remain, thereby achieving higher rates of complete resection. Tihan first described pilomyxoid astrocytomas in 1999. They are currently classified as grade II astrocytoma according to the WHO classification system and, because of their tendency to recur and their dissemination through the cerebrospinal fluid pathways, they are considered to be more aggressive than pilocytic astrocytoma...
May 8, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28492124/predicting-postoperative-haemoglobin-changes-after-burn-surgery
#12
Petrus Slabber, Zane Farina, Nikki Allorto, Reitze Nils Rodseth
BACKGROUND: Burn surgery is associated with significant blood loss and fluid shifts that cause rapid haemoglobin (Hb) changes during and after surgery. Understanding the relationship between intraoperative and postoperative (day 1) Hb changes may assist in avoiding postoperative anaemia and unnecessary peri-operative blood transfusion. OBJECTIVE: To describe the Hb changes into the first day after burn surgery and to identify factors predictive of Hb changes that would guide blood transfusion decisions...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28490407/the-application-of-a-free-nasal-floor-mucoperiosteal-graft-in-endoscopic-sinus-surgery
#13
Anali Dadgostar, Christopher Okpaleke, Fahad Al-Asousi, Amin Javer
BACKGROUND: Numerous reconstructive techniques and materials have been reported for repair of skull base defects, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone, including pedicled vascularized flaps and free mucosal grafts. OBJECTIVE: This study described our technique of harvesting and transferring a free nasal floor mucoperiosteal graft and discussed our experience with the application of this technique. METHODS: A retrospective review of 19 patients (mean age, 53...
May 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28490156/multiloculated-hydrocephalus-open-craniotomy-or-endoscopy
#14
REVIEW
Yun Ho Lee, Young Sub Kwon, Kook Hee Yang
Multiloculated hydrocephalus (MLH) is a condition in which patients have multiple, separate abnormal cerebrospinal fluid collections with no communication between them. Despite technical advancements in pediatric neurosurgery, neurological outcomes are poor in these patients and the approach to this pathology remains problematic especially given individual anatomic complexity and cerebrospinal fluid (CSF) hydrodynamics. A uniform surgical strategy has not yet been developed. Current treatment options for MLH are microsurgical fenestration of separate compartments by open craniotomy or endoscopy, shunt surgery in which multiple catheters are placed in the compartments, and combinations of these modalities...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28489805/first-experience-of-ndasek-with-heads-up-surgery-a-case-report
#15
Yasser Helmy Mohamed, Masafumi Uematsu, Daisuke Inoue, Takashi Kitaoka
PURPOSE: To report a case of non-Descemet Stripping Automated Endothelial Keratoplasty (nDSAEK) using heads-up surgery. CASE/INTERVENTION: The case was a 72-years-old man who had history of left eye blunt trauma since childhood. One year ago, the patient was diagnosed to have left posttraumatic bullous keratopathy. The patient underwent lt nDSAEK by using the heads-up three-dimensional (3D) system last July. The surgery was performed with a Rescan 700 surgical microscope (Carl Zeiss), which is integrated with intraoperative optical coherence tomography (iOCT) system...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28484814/contemporary-approaches-to-perioperative-iv-fluid-therapy
#16
REVIEW
Paul S Myles, Sam Andrews, Jonathan Nicholson, Dileep N Lobo, Monty Mythen
BACKGROUND: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management. METHOD: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. RESULTS: Of 275 retrieved articles, we identified 25 articles to inform this review...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28484565/multiple-spinal-extradural-arachnoidal-cysts-an-uncommon-cause-of-thoracic-cord-compression
#17
Raghavendra Nayak, Anupkumar Chaudhuri, Shahid Sadique, Sanjeev Attry
Spinal extradural arachnoid cysts are one of the rare causes of symptomatic spinal cord compression. Among them, occurrence of multiple cysts at the same spinal segment is rarely described in the literature. They appear to be extradural outpouchings of arachnoid that communicate with the intraspinal sub-arachnoid space through a small defect in the dura, filled by cerebrospinal fluid. Pathogenesis of these lesions is still unclear. Surgical excision is considered as the gold standard treatment. We present a 7-year-old female child who presented with spastic paraparesis...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28479059/comparison-of-pre-revision-magnetic-resonance-imaging-and-operative-findings-in-mechanically-assisted-crevice-corrosion-in-symptomatic-metal-on-polyethylene-total-hip-arthroplasties
#18
Pavel P Morozov, Munib Sana, Brian J McGrory, Steven W Farraher, Tod G Abrahams
BACKGROUND: Failed total hip arthroplasty (THA) caused by mechanically assisted crevice corrosion (MACC) has serious consequences-notably, adverse local tissue reactions. Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) has been used to evaluate failed THA for other reasons but has not been assessed for the analysis of cases of MACC in the setting of metal-on-polyethylene arthroplasties. METHODS: We examined the correlation between preoperative MARS MRI and surgical findings in a cohort of 20 consecutive patients undergoing revision THA for symptomatic MACC without other associated orthopedic diagnoses...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28479056/utility-of-synovial-white-blood-cell-count-and-differential-before-reimplantation-surgery
#19
Benjamin M Zmistowski, Corey T Clyde, Elie S Ghanem, James R Gotoff, Carl A Deirmengian, Javad Parvizi
BACKGROUND: Determining optimal timing of reimplantation during 2-stage exchange for periprosthetic joint infection (PJI) remains elusive. Joint aspiration for synovial white blood cell (WBC) count and neutrophil percentage (PMN%) before reimplantation is widely performed; yet, the implications are rarely understood. Therefore, this study investigates (1) the diagnostic yield of synovial WBC count and differential analysis and (2) the calculated thresholds for persistent infection. METHODS: Institutional PJI databases identified 129 patients undergoing 2-stage exchange arthroplasty who had joint aspiration before reimplantation between February 2005 and May 2014...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28475547/prediction-of-intraoperative-csf-gusher-and-postoperative-facial-nerve-stimulation-in-patients-with-cochleovestibular-malformations-undergoing-cochlear-implantation-surgery
#20
Teru Kamogashira, Shinichi Iwasaki, Akinori Kashio, Akinobu Kakigi, Shotaro Karino, Yu Matsumoto, Tatsuya Yamasoba
OBJECTIVE: To determine parameters in computed tomography (CT) of the temporal bone that would be useful for prediction of cerebrospinal fluid (CSF) gusher during cochlear implantation (CI) surgery and postoperative facial nerve stimulation (FNS) in patients with inner ear malformations. STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center. PATIENTS: Three hundred seventy-five cases who had undergone CI surgery including 54 inner ear malformation cases were analyzed...
May 4, 2017: Otology & Neurotology
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