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Postoperative respiratory failure

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https://www.readbyqxmd.com/read/29342051/does-hospital-volume-affect-outcomes-in-patients-undergoing-vestibular-schwannoma-surgery
#1
Jonathan L Hatch, Michael J Bauschard, Shaun A Nguyen, Paul R Lambert, Ted A Meyer, Theodore R McRackan
OBJECTIVE: To determine the effect of hospital surgical case volume on the outcomes of vestibular schwannoma surgery. STUDY DESIGN: Retrospective case review. SETTING: University HealthSystem Consortium member hospitals (includes nearly every US academic medical center). PATIENTS: Three thousand six hundred ninety-seven patients who underwent vestibular schwannoma resection over a 3-year timespan (2012-2015) grouped by race, age, comorbidities, payer, and sex...
January 16, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29339545/perioperative-implementation-of-noninvasive-positive-airway-pressure-therapies
#2
REVIEW
David R Hillman, Carla R Jungquist, Dennis Auckley
Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea...
January 16, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29325524/posterior-decompression-and-occipitocervical-fixation-followed-by-intraoperative-vertebroplasty-for-metastatic-involvement-of-the-axis
#3
Xinjie Wu, Mingsheng Tan, Yingna Qi, Ping Yi, Feng Yang, Xiangsheng Tang, Qingying Hao
BACKGROUND: Metastases to the upper cervical spine were rarely reported in the literature. However, metastases to this area may cause spinal instability and cord compression, which in turn can result in respiratory failure and neurological dysfunction. The present study investigated the efficacy and safety of posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for this disease. METHODS: This was a retrospective study that included 10 patients with metastatic involvement of the axis from March 2002 to May 2014...
January 11, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29324497/complications-associated-with-mortality-in-the-national-surgical-quality-improvement-program-database
#4
Robert E Freundlich, Michael D Maile, Joseph J Sferra, Elizabeth S Jewell, Sachin Kheterpal, Milo Engoren
BACKGROUND: Attributing causes of postoperative mortality is challenging, as death may be multifactorial. A better understanding of complications that occur in patients who die is important, as it allows clinicians to focus on the most impactful complications. We sought to determine the postoperative complications with the strongest independent association with 30-day mortality. METHODS: Data were obtained from the 2012-2013 National Surgical Quality Improvement Program Participant Use Data Files...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29317806/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-elderly-current-perspectives
#5
REVIEW
Michele Carron, Francesco Bertoncello, Giovanna Ieppariello
The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29312713/outcomes-of-perioperative-extracorporeal-membrane-oxygenation-use-in-patients-undergoing-lung-transplantation
#6
Joo Han Song, Ji Eun Park, Jin Gu Lee, Chang Young Lee, Kyung Sik Nam, Jee Won Suh, Anes Kim, Seung Hyun Lee, Hyun Chel Joo, Young Nam Youn, Song Yee Kim, Moo Suk Park, Hyo Chae Paik
Background: The aim of this single-center study is to review the transplant outcomes of patients receiving lung transplantation (LTx) using intraoperative extracorporeal membrane oxygenation (ECMO) according to the perioperative use of ECMO. Methods: We retrospectively reviewed the transplant outcomes of 107 consecutive patients who underwent LTx using intraoperative ECMO between March 2013 and August 2016 at Severance Hospital of Yonsei University (Seoul, Korea)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29289956/outcomes-and-predictors-of-mortality-after-mitral-valve-surgery-in-high-risk-elderly-patients-the-heidelberg-experience
#7
Sabreen Mkalaluh, Marcin Szczechowicz, Bashar Dib, Gabor Szabo, Matthias Karck, Alexander Weymann
BACKGROUND Overall, life expectancy at the age of 80 has significantly increased in the industrialized world and the proportion of this age class undergoing cardiac surgery has also grown. In this context, we have analyzed a contemporary series of octogenarians undergoing mitral valve surgery at our institution. MATERIAL AND METHODS We performed a retrospective analysis of 138 consecutive octogenarians receiving mitral valve surgery between January 2006 and April 2017. Preoperative comorbidities, early mortality, postoperative clinical course, and predictors of mortality were examined...
December 31, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29289366/comparison-of-endoaortic-and-transthoracic-aortic-clamping-in-less-invasive-mitral-valve-surgery
#8
Cristina Barbero, Ralph Krakor, Mohamed Bentala, Filip Casselman, Pascal Candolfi, Jacques Goldstein, Mauro Rinaldi
BACKGROUND: Less-invasive mitral valve surgery has become a widespread procedure in recent years, although mode of perfusion and aortic clamping are still debated questions. The aim of this study was to compare the results between transthoracic aortic clamping (TTC) and endoaortic clamping (EAC) in a multicenter, retrospective study. METHODS: Data from 3 centers experienced in both TTC and EAC were retrospectively analyzed. Five hundred consecutive patients undergoing less-invasive mitral valve surgery received either TTC (n = 250) or EAC (n = 250)...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29288311/antireflux-surgery-in-the-usa-influence-of-surgical-volume-on-perioperative-outcomes-and-costs-time-for-centralization
#9
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Few studies have analyzed the relationship between surgical volume and outcomes after antireflux procedures. The aim of this study was to determine the effect of surgical volume on postoperative results and costs for patients undergoing surgery for gastroesophageal reflux disease. METHODS: We analyzed the National Inpatient Sample (period 2000-2013). Adult patients (≥18 years old) with gastroesophageal reflux disease who underwent fundoplication were included...
December 30, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29287820/health-related-quality-of-life-scores-underestimate-the-impact-of-major-complications-in-lumbar-degenerative-scoliosis-surgery
#10
Steven D Glassman, Keith H Bridwell, Christopher I Shaffrey, Charles C Edwards, Jon D Lurie, Christine R Baldus, Leah Y Carreon
STUDY DESIGN: Retrospective cohort. OBJECTIVE: To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. SUMMARY OF BACKGROUND DATA: HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. METHODS: We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59...
January 2018: Spine Deformity
https://www.readbyqxmd.com/read/29284849/comparison-of-the-efficacy-and-safety-of-morphine-and-fentanyl-as-adjuvants-to-bupivacaine-in-providing-operative-anesthesia-and-postoperative-analgesia-in-subumblical-surgeries-using-combined-spinal-epidural-technique
#11
Owais Mushtaq Shah, Kharat Mohammad Bhat
Introduction: The combined spinal epidural (CSE) technique involves intentional subarachnoid blockade and epidural catheter placement during the same procedure to combine their individual best features, to reduce the total drug dosage and avoid their respective disadvantages. The addition of opioids to local anesthetics (bupivacaine) for CSE anesthesia (CSEA) is increasingly common to enhance the block. Neuraxial fentanyl is more potent and has shorter duration of action than morphine which provides prolonged anesthesia and analgesia, however at the cost of increased incidence of adverse effects like delayed respiratory depression...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29280899/surgical-correction-of-severe-kyphoscoliosis-associated-with-crouzon-syndrome-with-serious-postoperative-respiratory-problems-a-case-report
#12
Taro Umezu, Nobuyuki Fujita, Mitsuru Yagi, Osahiko Tsuji, Narihito Nagoshi, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
CASE: A 12-year-old girl with Crouzon syndrome presented to our hospital with scoliosis (114°) and kyphosis from T8 to T12 (138°). After she had been in halo-gravity traction for 2 weeks, we performed posterior correction and fusion surgery from T3 to L3, with a posterior vertebral column resection of T10. She experienced postoperative respiratory failure and remained on a ventilator for 4 weeks. With rehabilitation, the respiratory function had recovered by postoperative week 8. At the 2-year follow-up, there was no loss of correction or any other complication...
December 27, 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29249784/-surgical-embolectomy-for-acute-massive-pulmonary-thromboembolism-requiring-percutaneous-cardiopulmonary-support-after-thoracoabdominal-aorta-replacement
#13
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Yukihiro Hayatsu, Kyohei Ueno, Masaaki Naganuma, Naoya Terao
A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29229347/post-operative-stridor-and-acute-respiratory-failure-after-parkinson-s-disease-deep-brain-stimulator-placement-a-case-report-and-review-of-literature
#14
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson's disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech.. Acute upper airway obstruction is a very rare finding in PD, especially in the perioperative settings...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29212280/influence-of-body-mass-index-on-postoperative-complications-after-thymectomy-in-myasthenia-gravis-patients
#15
Xu-Dong Liu, Ming-Rui Shao, Lei Sun, Lin Zhang, Xin-Shan Jia, Wen-Ya Li
Objectives: It is not clear whether being overweight or obese influences postoperative complications in myasthenia gravis (MG) patients. We retrospectively investigated an association between body mass index (BMI) and postoperative complications in MG. Materials and Methods: Fifty-nine MG patients who had undergone transsternal thymectomy were classified as low or high BMI based on the criteria for Asian-Pacific populations. An association between BMI and complications was analyzed...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#16
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29203299/evaluation-of-cardiac-index-and-extravascular-lung-water-after-single-lung-transplantation-using-the-transpulmonary-thermodilution-technique-by-the-picco2-device
#17
Alexy Tran-Dinh, Pascal Augustin, Guillaume Dufour, Sigismond Lasocki, Nicolas Allou, Gabriel Thabut, Yves Castier, Philippe Montravers, Mathieu Desmard
OBJECTIVES: First evaluation of the transpulmonary thermodilution technique by the PiCCO2 device to assess cardiac index and pulmonary edema during the postoperative course after single-lung transplantation. DESIGN: Prospective observational study. SETTINGS: Intensive care unit, university hospital (single center). PARTICIPANTS: Single-lung transplant patients. INTERVENTIONS: The authors compared cardiac index measured by PiCCO2 and pulmonary artery catheter and assessed pulmonary edema using extravascular lung water index and pulmonary vascular permeability index measured by PiCCO2...
December 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29197407/low-tidal-volume-mechanical-ventilation-against-no-ventilation-during-cardiopulmonary-bypass-heart-surgery-mecano-study-protocol-for-a-randomized-controlled-trial
#18
Lee S Nguyen, Messaouda Merzoug, Philippe Estagnasie, Alain Brusset, Jean-Dominique Law Koune, Stephane Aubert, Thierry Waldmann, Jean-Michel Grinda, Hadrien Gibert, Pierre Squara
BACKGROUND: Postoperative pulmonary complications are a leading cause of morbidity and mortality after cardiac surgery. There are no recommendations on mechanical ventilation associated with cardiopulmonary bypass (CPB) during surgery and anesthesiologists perform either no ventilation (noV) at all during CPB or maintain low tidal volume (LTV) ventilation. Indirect evidence points towards better pulmonary outcomes when LTV is performed but no large-scale prospective trial has yet been published in cardiac surgery...
December 2, 2017: Trials
https://www.readbyqxmd.com/read/29191359/evaluation-of-esophageal-anastomotic-integrity-with-serial-pleural-amylase-levels
#19
Daniel L Miller, Gerald A Helms, William R Mayfield
BACKGROUND: An anastomotic leak is the most devastating and potentially fatal complication after esophagectomy. Current detection methods can be inaccurate and place patients at risk of other complications. Analysis of pleural fluid for amylase may be more accurate and place patients at less of a risk for evaluating the integrity of an esophageal anastomosis. METHODS: We retrospectively reviewed prospective data of 45 consecutive patients who underwent an Ivor Lewis esophagectomy over an 18-month period and evaluated their anastomotic integrity with serial pleural amylase levels (PAL)...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29191187/clinical-value-of-a-prophylactic-minitracheostomy-after-esophagectomy-analysis-in-patients-at-high-risk-for-postoperative-pulmonary-complications
#20
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Keita Itatsu, Masato Nagino
BACKGROUND: The aim of this study is to evaluate the clinical value of a prophylactic minitracheostomy (PMT) in patients undergoing an esophagectomy for esophageal cancer and to clarify the indications for a PMT. METHODS: Ninety-four patients who underwent right transthoracic esophagectomy for esophageal cancer between January 2009 and December 2013 were studied. Short surgical outcomes were retrospectively compared between 30 patients at high risk for postoperative pulmonary complications who underwent a PMT (PMT group) and 64 patients at standard risk without a PMT (non-PMT group)...
December 1, 2017: BMC Surgery
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