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https://www.readbyqxmd.com/read/29026677/bedside-ultrasound-in-the-diagnosis-and-treatment-of-children-with-respiratory-difficulty-following-cardiac-surgery
#1
REVIEW
Hussam Kanaan Hamadah, Mohamed Salim Kabbani
Many children frequently fail extubation or require a prolonged period of positive pressure ventilation support after cardiac surgery. Pediatric cardiac Intensive Care Unit (PCICU) ultrasound (US) stands as a simple, basic bedside tool that can be performed by trained intensivists for the diagnosis with immediate implication on therapeutic decisions in multiple scenarios that physicians may face in PCICU. Bedside US is widely available, convenient, and inexpensive. This educational article based mainly on our own experience is highlighting the role of US in detecting the most common causes of respiratory weaning difficulties and extubation failure in postoperative cardiac children through proposed illustration and algorithm...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/29016380/comparison-of-del-nido-cardioplegia-with-blood-cardioplegia-in-adult-combined-surgery
#2
Raphael Hamad, Anthony Nguyen, Éric Laliberté, Denis Bouchard, Yoan Lamarche, Ismail El-Hamamsy, Philippe Demers
OBJECTIVE: del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. METHODS: Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS...
October 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28994676/does-bilevel-positive-airway-pressure-improve-outcome-of-acute-respiratory-failure-after-open-heart-surgery
#3
Ahmed Said Elgebaly
BACKGROUND: Respiratory failure is of concern in the postoperative period after cardiac surgeries. Invasive ventilation (intermittent positive pressure ventilation [IPPV]) carries the risks and complications of intubation and mechanical ventilation (MV). AIMS: Noninvasive positive pressure ventilation (NIPPV) is an alternative method and as effective as IPPV in treating insufficiency of respiration with less complications and minimal effects on respiratory and hemodynamic parameters next to open-heart surgery...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28986001/a-bioprosthetic-total-artificial-heart-for-end-stage-heart-failure-results-from-a-pilot-study
#4
Christian Latrémouille, Alain Carpentier, Pascal Leprince, Jean-Christian Roussel, Bernard Cholley, Elodie Boissier, Eric Epailly, Antoine Capel, Piet Jansen, David M Smadja
BACKGROUND: The electro-hydraulically actuated Carmat total artificial heart (C-TAH) is designed to replace the heart in patients with end-stage heart failure, either as bridge to transplant or destination therapy. It provides pulsatile flow and contains bio-prosthetic blood contacting materials. A clinical feasibility study was conducted to evaluate the C-TAH safety and performance. METHODS: Hospitalized patients, at imminent risk of death from irreversible biventricular failure despite optimal medical management, and not eligible for transplant or eligible but on extracorporeal life support, were enrolled...
September 14, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28985703/escalation-of-extracorporeal-life-support-as-a-bridge-to-lung-transplantation-in-end-stage-lung-disease
#5
Prashant N Mohite, Alexander Rosenberg, Clara Hernández Caballero, Simona Soresi, Javid Fatullayev, Anna Reed, Aron-Frederik Popov, Anton Sabashnikov, André R Simon
Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplant (LTx) is not uncommon, but it is not commonplace yet. We present a case of a 45-year-old man with cystic fibrosis with recent deterioration in lung function who was initially supported with veno-venous (VV) ECMO. However, he subsequently required conversion to veno-veno-arterial (VVA) ECMO. After 21 days of support, he underwent double lung transplantation, with an uneventful postoperative course. This case shows that, in patients with end-stage respiratory failure awaiting lung transplantation, extracorporeal life support may require escalation to improve gas exchange and address circulatory requirements...
October 2017: Perfusion
https://www.readbyqxmd.com/read/28977203/noninvasive-ventilation-during-immediate-postoperative-period-in-cardiac-surgery-patients-systematic-review-and-meta-analysis
#6
Suzimara Monteiro Pieczkoski, Ane Glauce Freitas Margarites, Graciele Sbruzzi
OBJECTIVE: To verify the effectiveness of noninvasive ventilation compared to conventional physiotherapy or oxygen therapy in the mortality rate and prevention of pulmonary complications in patients during the immediate postoperative period of cardiac surgery. METHODS: Systematic review and meta-analysis recorded in the International Prospective Register of Ongoing Systematic Reviews (number CRD42016036441). The research included the following databases: MEDLINE, Cochrane Central, PEDro, LILACS and manual search of the references of studies published until March 2016...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28965456/adolescent-idiopathic-scoliosis-risk-factors-for-complications-and-the-effect-of-hospital-volume-on-outcomes
#7
Richard P Menger, Piyush Kalakoti, Andrew J Pugely, Anil Nanda, Anthony Sin
OBJECTIVE Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. Limited literature exists defining risk factors associated with outcomes during initial hospitalization in these patients. In this study, the authors investigated patient demographics, clinical and hospital characteristics impacting short-term outcomes, and costs in adolescent patients undergoing surgical deformity correction for idiopathic scoliosis. Additionally, the authors elucidate the impact of hospital surgical volume on outcomes for these patients...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965446/insertion-of-magnetically-controlled-growing-rods-in-a-patient-with-a-diaphragmatic-pacemaker-case-report
#8
Andrew C Vivas, Steven W Hwang, Joshua M Pahys
Phrenic stimulators offer an alternative to standard mechanical ventilation as well as the potential for ventilator independence in select patients with chronic respiratory failure. Young patients (< 10 years old) with high cervical spinal cord injuries often develop paralytic scoliosis due to loss of muscle tone caudal to their spinal cord lesion. Growing rod systems allow for stabilization of spinal deformity while permitting continued growth of the spine and thoracic cavity. Magnetically controlled growing rods (MCGRs) offer the advantage of noninvasive expansion, as opposed to the operative expansion required in traditional growing rod systems...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28963742/transfusion-acquired-hepatitis-e-infection-misdiagnosed-as-severe-critical-illness-polyneuromyopathy-in-a-heart-transplant-patient
#9
Julie Belliere, Florence Abravanel, Marie Béatrice Nogier, Salima Martinez, Pascal Cintas, Sébastien Lhomme, Laurence Lavayssière, Olivier Cointault, Stanislas Faguer, Jacques Izopet, Nassim Kamar
This is the case of a 56-year-old man who underwent heart transplantation. Within the first postoperative days, his respiratory and limb muscles weakened, which was attributed to critical illness polyneuromyopathy (CIPM). At day 70 post transplantation, he had increased liver enzyme levels and acute hepatitis E virus (HEV) infection was diagnosed. HEV RNA was found in the serum, stools, and cerebrospinal fluid. Results of further investigations suggested a possible HEV-related polyradiculoneuropathy. At transplantation, the patient was negative for immunoglobulin (Ig)G, IgM, and HEV RNA...
September 29, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28951155/low-mortality-rates-after-endovascular-aortic-repair-expand-use-to-high-risk-patients
#10
Shaunak S Adkar, Megan C Turner, Harold J Leraas, Brian F Gilmore, Uttara Nag, Ryan S Turley, Cynthia K Shortell, Leila Mureebe
OBJECTIVE: The 2010 endovascular aneurysm repair (EVAR) trial 2 (EVAR 2) reported that patients with comorbidity profiles rendering them unfit for open aneurysm repair who underwent EVAR did not experience a survival advantage compared with those who did not undergo intervention. These patients experienced a 30-day mortality of 7.3%, whereas reports from similar cohorts reported far lower mortality rates. The primary objective of our study was to compare the incidence of 30-day mortality in low- and high-risk patients undergoing EVAR in a contemporary data set, using patient risk stratification criteria from EVAR 2...
September 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28950377/preoperative-short-term-plus-postoperative-physical-therapy-versus-postoperative-physical-therapy-alone-for-patients-undergoing-lung-cancer-surgery-retrospective-analysis-of-a-nationwide-inpatient-database
#11
Kazuaki Uda, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
OBJECTIVES: The aim of this study is to determine whether physical therapy (PT) within 3 days before lung cancer surgery combined with postoperative PT reduces 30-day mortality and the incidence of postoperative pulmonary complications (PPCs) compared with postoperative PT alone. METHODS: This retrospective cohort study, using the Japanese Diagnosis Procedure Combination database, included patients aged ≥18 years who underwent non-small-cell lung cancer surgery and received PT on postoperative Day 1 or 2 between 2010 and 2015...
August 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#12
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935325/tracheal-compression-caused-by-a-hematoma-after-redo-aortic-root-replacement
#13
Tetsuro Uchida, Azumi Hamasaki, Atsushi Yamashita, Ken Nakamura, Jun Hayashi, Mitsuaki Sadahiro
Postoperative tracheal compression caused by hematoma is extremely rare in patients who have undergone cardiovascular operations. A 65-year-old man underwent elective redo aortic root replacement. Hemostasis was controlled with Surgicel packing (Ethicon, Somerville, NJ). After extubation, he had severe respiratory distress. The emergent computed tomographic scan showed severe obstruction of the tracheal bifurcation compressed by a hematoma around the packed Surgicel. During reexploration, a considerable hematoma was removed...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28930836/slide-tracheoplasty-in-81-children-improved-outcomes-with-modified-surgical-technique-and-optimal-surgical-age
#14
Hengyi Zhang, Shunmin Wang, Zhaohui Lu, Limin Zhu, Xinwei Du, Hao Wang, Zhiwei Xu
The aim of this study was to evaluate the surgical outcome of slide tracheoplasty.Eighty-one patients who underwent slide tracheoplasty were retrospectively reviewed. Before and after operation, all patients were examined by computed tomography (CT) and bronchoscopy regularly.There were 8 deaths and the mortality was 9.9%. They all died of respiratory failure associated with the formation of granulation tissue in the airway postoperatively. The mortality was 15.8% from 2009 to 2012 and decreased to 8.1% from 2013 to 2016...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28927912/steinmann-pins-for-c1-lateral-mass-screw-placement-during-atlantoaxial-stabilization
#15
Joshua E Meyers, Kunal Vakharia, Joseph M Kowalski, Vassilios G Dimopoulos, John Pollina
OBJECTIVE: The authors describe a modified technique for placement of the C1 lateral mass screw using a Steinmann pin as a guide. This technique minimizes dissection and provides atlantoaxial stabilization during arthrodesis. METHODS: In our technique, a non-threaded 1.6mm spade-tip Steinmann pin is placed into the lateral mass of C1 to serve as a guide over which a powered drill is used for screw insertion. Perioperative data were collected for consecutive patients who underwent a C1-2 arthrodesis that involved the modified technique between March 2010 and July 2016...
September 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#16
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28918753/neonatal-intestinal-obstruction-associated-with-situs-inversus-totalis-two-case-reports-and-a-review-of-the-literature
#17
Rahul Gupta, Varsha Soni, Prakash Devidas Valse, Ram Babu Goyal, Arun Kumar Gupta, Praveen Mathur
BACKGROUND: The association of neonatal intestinal obstruction with situs inversus totalis is extremely rare with only few cases reported in the literature to date. This association poses dilemmas in management. We present two such cases (of Indian origin), and briefly discuss the pertinent literature and measures to prevent unfavorable outcome. CASE PRESENTATION: Case 1: a 1-month-old preterm (1300 g) male neonate belonging to Hindu (Indian) ethnicity presented with recurrent bile-stained vomiting, non-passage of stools and epigastric fullness...
September 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28894056/-emergency-mitral-valvoplasty-for-papillary-muscle-rupture
#18
Keishi Ueyama, Motohiro Koyama, Kenji Otaki, Kae Ito
We experienced 2 emergency surgical cases of severe mitral valve regurgitation due to papillary muscle rupture. Case 1:a 69-year-old man presented with respiratory and cardiac failure due to mitral regurgitation. He had no history of myocardial infarction. Mitral valve repair with artificial cords was performed. The papillary muscle of the anterior leaflet was ruptured. The postoperative course was uneventful. Case 2:a 80-year-old man came to our hospital with cardiac arrest. Emergency coronary intervention was performed to the right coronary and intraaortic balloon pumping was inserted...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28891912/postoperative-complications-affecting-survival-after-cardiac-arrest-in-general-surgery-patients
#19
Minjae Kim, Guohua Li
BACKGROUND: Postoperative cardiac arrest is uncommon but associated with a high mortality risk in general surgery patients and is often preceded by postoperative complications. The relationships between previous complications and mortality after cardiac arrest in general surgery patients have not been completely evaluated. METHODS: retrospective, observational cohort of general surgery in patients with cardiac arrest occurring after postoperative day (POD) #0 (and up to POD #30) was obtained from the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28870932/clinical-significance-of-salvage-esophagectomy-for-patients-with-esophageal-cancer-and-factors-of-influencing-long-term-survival
#20
Makoto Sohda, Yuji Kumakura, Hideyuki Saito, Kengo Kuriyama, Tomonori Yoshida, Hiroaki Honjyo, Keigo Hara, Daigo Ozawa, Shigemasa Suzuki, Naritaka Tanaka, Makoto Sakai, Tatsuya Miyazaki, Minoru Fukuchi, Hiroyuki Kuwano
BACKGROUND/AIM: Definitive chemoradiotherapy (CRT) without planned surgery has been recently widely used as a therapeutic option for locally advanced esophageal cancer. Salvage esophagectomy can offer the chance of prolonged survival for patients who have locoregional failure after definitive CRT, but many clinicians oppose the use of surgery due to the associated excessive morbidity and mortality. The aim of this study was to identify patients who are good candidates for salvage surgery by investigating factors influencing long-term survival...
September 2017: Anticancer Research
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