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Intraoperative fluids

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https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#1
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28210022/csf-related-complications-after-intradural-spinal-tumor-surgery-utility-of-an-autologous-fat-graft
#2
Kenan I Arnautovic, Marko Kovacevic
OBJECT: The incidence of cerebrospinal fluid (CSF)-related complications after intradural spinal tumor (IST) surgery is high and reported in up to 18% of patients. However, no efficient way to prevent those complications has been reported so far. Treating these complications may require prolonged bed rest, re-exploration, external lumbar drain, use of antibiotics, and possible precipitation of other complications. To alleviate the risk of CSF-related complications, we prospectively adopted the intraoperative use of autologous fat grafting after IST surgery...
December 2016: Medical Archives
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#3
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#4
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#5
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28191620/clinical-application-of-scalp-markers-and-three-dimensional-sliced-computer-tomography-reconstructions-of-the-skull-transverse-sigmoid-sinus-groove-in-the-retrosigmoid-approach
#6
Chao Wang, Han Guoqiang, Chao You, Chuangxi Liu
AIM: To explore the clinical value of bone flap creation and the sinus protection in the approach of retrosigmoid keyhole craniotomy with the guidance of three-dimensional (3D) sliced computer tomography (CT) reconstruction of the skull transverse sinus and sigmoid sinus groove. MATERIAL AND METHODS: The scalp tracings of the transverse sinus and sigmoid sinus groove of 108 posterior fossa lesion patients were delineated by gentian violet, which relies on the relationship between its 3D reconstruction location and scalp marker...
January 17, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28186470/image-guidance-based-on-mri-for-spinal-interstitial-laser-thermotherapy-technical-aspects-and-accuracy
#7
Claudio E Tatsui, Clarissa N G Nascimento, Dima Suki, Behrang Amini, Jing Li, Amol J Ghia, Jonathan G Thomas, R Jason Stafford, Laurence D Rhines, Juan P Cata, Ashok J Kumar, Ganesh Rao
OBJECTIVE Image guidance for spinal procedures is based on 3D-fluoroscopy or CT, which provide poor visualization of soft tissues, including the spinal cord. To overcome this limitation, the authors developed a method to register intraoperative MRI (iMRI) of the spine into a neuronavigation system, allowing excellent visualization of the spinal cord. This novel technique improved the accuracy in the deployment of laser interstitial thermal therapy probes for the treatment of metastatic spinal cord compression...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28183081/management-of-abdominal-drainage-after-hepatic-resection
#8
Yoshihiro Inoue, Yoshiro Imai, Nao Kawaguchi, Fumitoshi Hirokawa, Michihiro Hayashi, Kazuhisa Uchiyama
BACKGROUND: Routine drainage after partial hepatic resection has long been controversial. METHODS: Three hundred and twenty-eight patients who underwent hepatic resections for liver tumors without biliary-enteric and gastrointestinal anastomoses were analyzed using propensity score matching analysis with respect to if and when a prophylactic drain was used and for how long. The criteria for drain placement were established and validated. RESULTS: Our criteria for drain placement were chosen according to postoperative percutaneous abdominal drainage risk factors, organ/space surgical site infections (SSIs), hepatic resection method, intraoperative bile leakage and operative time (≥300 min)...
February 10, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#9
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28176510/methylene-blue-dye-for-identification-of-processus-vaginalis-during-hydrocele-repair-experience-in-a-teaching-hospital
#10
Salvatore Arena, Tiziana Russo, Pietro Impellizzeri, Pietro Antonuccio, Patrizia Perrone, Carmelo Romeo
BACKGROUND: To investigate the use of methylene blue in perioperative identification of the patent processus vaginalis in a group of boys presenting with congenital or recurrent hydrocele where surgery was performed by junior surgeons in training. METHODS: We retrospectively reviewed the notes of 22 boys with hydrocele, of which two recurrences, who were operated on via a standard inguinal approach, by trainees. Methylene blue 0.3-0.5 ml was injected into the hydrocele fluid through the scrotal wall...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28162161/-effect-of-dexmedetomidine-alone-for-postoperative-analgesia-after-laparoscopic-cholecystectomy
#11
X H Chen, Z J Wang, Q M Xiang, J W Zheng
Objective: To investigate the effect of dexmedetomidine alone for postoperative analgesia after laparoscopic cholecystectomy. Methods: Forty patients scheduled for elective laparoscopic cholecystectomy in First Hospital of Ninghai County, American Society of Anesthesiologists (ASA) gradeⅠor Ⅱ, were randomly divided into dexmedetomidine group (Group D, n=20) and fentanyl group (Group F, n=20). The patient controlled analgesia (PCA) pumps were used after the operation. In the group D, the intravenous PCA protocol was dexmedetomidine 0...
January 24, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28156134/absorption-of-irrigation-fluid-during-thulium-laser-vaporization-of-the-prostate
#12
Gautier Simon Müllhaupt, Dominik Abt, Livio Mordasini, Olivia Köhle, Daniel Engeler, Andreas Lüthi, Rafael Sauter, Hans-Peter Schmid, Christoph Schwab
To assess prevalence and extent of irrigation fluid absorption during thulium laser vaporization of the prostate. Material and Methods Fifty-four patients undergoing thulium laser vaporization of the prostate were prospectively included into the trial at a tertiary referral center. Isotonic saline containing 1% ethanol was used for intraoperative irrigation. Absorption of irrigation fluid was measured periodically during the operation using the expired breath ethanol technique. Amongst others, intra- and postoperative changes in biochemical and hematological laboratory findings were assessed...
February 3, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28152199/investigation-of-perioperative-and-anesthetic-variables-affecting-short-term-survival-of-horses-with-small-intestinal-strangulating-lesions
#13
Pablo Espinosa, Sarah S Le Jeune, Alessia Cenani, Philip H Kass, Robert J Brosnan
OBJECTIVE: To determine if preoperative and intraoperative physiologic variables, and surgical factors correlate with survival to anesthetic recovery or hospital discharge, repeat celiotomy, and postoperative nasogastric intubation (NGT) in horses undergoing exploratory celiotomy for small intestinal (SI) strangulating lesions. STUDY DESIGN: Retrospective case series. ANIMALS: Horses that had surgical correction of SI strangulating lesions (n = 258)...
February 2, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28151903/mechanical-intestinal-obstruction-secondary-to-appendiceal-mucinous-cystadenoma-a-case-report-and-brief-review
#14
Zheng-Shui Xu, Wei Xu, Jia-Qi Ying, Hua Cheng
BACKGROUND: Appendiceal mucinous cystadenoma can present in various ways, and it is most commonly encountered incidentally during appendectomy, but mechanical intestinal obstruction secondary to an appendiceal mucocele has been rarely reported. METHODS: We report a case of mechanical intestinal obstruction secondary to appendiceal mucinous cystadenoma. After nasogastric decompression and initial aggressive intravenous fluid resuscitation, an emergency operation was performed under the diagnosis of acute mechanical intestinal obstruction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151822/clinical-significance-of-portal-hypertension-diagnosed-with-bedside-ultrasound-after-cardiac-surgery
#15
André Y Denault, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Roberto Eljaiek, Ismail El-Hamamsy, Yoan Lamarche, Alexandra Chronopoulos, Jean Lambert, Josée Bouchard, Georges Desjardins
BACKGROUND: Portal venous flow pulsatility detected by Doppler ultrasound is a sign of congestive heart failure in noncritically ill patients. The assessment of portal and splenic venous flows has never been reported in patients undergoing cardiac surgery. METHODS: This is a case series performed in patients undergoing cardiac surgery between February 2014 and February 2015 in which portal and/or splenic venous flows were assessed by the attending anesthesiologist during surgery or by the intensivist after surgery using transthoracic echography in 9 patients or transesophageal echocardiography in 5 patients...
February 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#16
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28134637/experiences-in-performing-posterior-calvarial-distraction
#17
Kevin McMillan, Mark Lloyd, Martin Evans, Nicholas White, Hiroshi Nishikawa, Desiderio Rodrigues, Melanie Sharp, Pete Noons, Guirish Solanki, Stephen Dover
The use of posterior calvarial distraction (PCD) for the management of craniosynostosis is well recognized. The advantages of using this technique include increased cranial volume, decreased intracranial pressure, relief of posterior fossa crowding, improved cerebrospinal fluid (CSF) circulation at the cranio-cervical junction with cessation, and possible resolution of syrinx.The authors retrospectively review their first 50 patients who have undergone PCD under the senior author's care in our unit.The demographics, diagnoses, intraoperative approach with techniques in distractor placement and outcomes of each patient were obtained through an electronic craniofacial database and written patient records...
January 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28130030/biomarker-changes-in-anterior-cruciate-ligament-deficient-knees-compared-with-healthy-controls
#18
Daniel J Kaplan, Vanessa G Cuellar, Laith M Jazrawi, Eric J Strauss
PURPOSE: To establish how synovial fluid biomarker concentrations change in patients after anterior cruciate ligament (ACL) tears, with and without associated cartilage injury, with comparisons made to healthy controls. METHODS: Patients were prospectively enrolled between January 2013 and December 2014. Inclusion criteria included any patient undergoing knee arthroscopy. Patients with a confirmed ACL tear were allocated to either the ACL tear with cartilage injury group or the ACL tear without cartilage injury group based on intraoperative assessment...
January 24, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28129264/management-of-pericardial-fluid-in-blunt-trauma-variability-in-practice-and-predictors-of-operative-outcome-in-patients-with-computed-tomography-evidence-of-pericardial-fluid
#19
Cordelie E Witt, Ken F Linnau, Ronald V Maier, Frederick P Rivara, Monica S Vavilala, Eileen M Bulger, Saman Arbabi
BACKGROUND: The objectives of this study were to assess current variability in management preferences for blunt trauma patients with pericardial fluid, and to identify characteristics associated with operative intervention for patients with pericardial fluid on admission computed tomography (CT) scan. METHODS: This was a mixed-methods study of blunt trauma patients with pericardial fluid. The first portion was a research survey of members of the Eastern Association for the Surgery of Trauma conducted in 2016, in which surgeons were presented with four clinical scenarios of blunt trauma patients with pericardial fluid...
January 26, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#20
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
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