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Postoperative respiratory failure

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https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#1
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29104127/incidence-risk-factors-and-prognostic-impact-of-re-exploration-for-bleeding-after-cardiac-surgery-a-retrospective-cohort-study
#2
Lucas B Ohmes, Antonino Di Franco, T Sloane Guy, Christopher Lau, Monica Munjal, William Debois, Zhongyi Li, Karl H Krieger, Alexandra N Schwann, Jeremy R Leonard, Leonard N Girardi, Mario Gaudino
BACKGROUND: Postoperative re-exploration for bleeding (RB) is a frequent complication following cardiac surgery. We aim to assess incidence, risk factors, and prognostic significance of RB in a large cohort of cardiac patients. MATERIALS AND METHODS: We reviewed prospectively collected data for all patients who underwent cardiac surgery at our institution from 2007 to 2015. Logistic regression analysis was used to identify independent predictors of RB and specific outcomes...
November 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29076482/-palliative-surgical-correction-of-respiratory-insufficiency-in-diffusive-pulmonary-emphysema
#3
S D Gorbunkov, V V Varlamov, S M Cherny, O V Lukina, L D Kiryukhina, A I Romanikhin, A V Zinchenko, A L Akopov
AIM: To analyze early postoperative period in patients with diffuse pulmonary emphysema after palliative surgical correction of respiratory failure. MATERIAL AND METHODS: The study included 196 patients who underwent bullectomy (n=111) and surgical reduction of pulmonary volume (n=85). RESULTS AND DISCUSSION: Overall morbidity and mortality were 40.8% and 12.2% respectively. Among patients older than 60 years these values were significantly higher (58...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29075982/pterygomandibular-suspension-suture-a-simple-modification-of-uvulopalatopharyngoplasty-for-severe-obstructive-sleep-apnea
#4
Yen-Ting Lu, Shyh-Kuan Tai, Tsung-Lun Lee
BACKGROUNDS: The aim of this study is to introduce pterygomandibular suspension suture as a simple modification of uvulopalatopharyngoplasty for severe obstructive sleep apnea in dealing with lateral pharyngeal wall and retropalatal space collapse. METHODS: This retrospective study was conducted at Taipei Veterans General Hospital, Taiwan. Ten adult patients underwent modified uvulopalatopharyngoplasty with pterygomandibular suspension suture according to following inclusion criteria: severe obstructive sleep apnea (apnea-hypopnea index [AHI] > 30 events/h), type I Fujita with lateral pharyngeal wall collapse, and failure for continuous positive airway pressure (CPAP) therapy...
October 26, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29059665/-dyspnea-in-a-patient-after-open-reduction-of-fracture-of-the-femur
#5
Jan Lesiński, Tadeusz M Zielonka, Anna Zel, Katarzyna Życińska
Acute dyspnoea in the postoperative period requires quick consideration of all possible causes and implementation of the proper treatment. During the differential diagnostic process, other than the most common cardio-pneumological and otolaryngological reasons, we should consider a whole array of rare causes such as neuromuscular illnesses, renal failure, and gastrointestinal diseases. This case is an example of sudden onset of dyspnoea presenting in a 67 year old woman with COPD. The dyspnoea occurred in first postoperative day after open reduction of fracture of the femur...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29049817/long-term-patency-of-on-and-off-pump-coronary-artery-bypass-grafting-with-bilateral-internal-thoracic-arteries-the-significance-of-late-string-sign-development-in-the-off-pump-technique
#6
Yasunari Hayashi, Atsuo Maekawa, Sadanari Sawaki, Masayoshi Tokoro, Junji Yanagisawa, Takahiro Ozeki, Akihiko Usui, Toshiaki Ito
OBJECTIVES: This study aimed to examine the effect of off-pump coronary artery bypass grafting (CABG) in patients who underwent revascularization with bilateral internal thoracic arteries (ITAs). METHODS: Between January 2000 and December 2014, 499 patients underwent isolated CABG with bilateral ITAs for complete revascularization of the left coronary system at our institution. On-pump CABG was performed in 137 patients, and off-pump CABG was performed in 362 patients...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29038412/-effects-of-high-frequency-jet-ventilation-on-respiratory-failure-after-total-arch-replacement-due-to-acute-aortic-dissection-with-morbid-obesity-report-of-a-case
#7
Motoyuki Kumagai, Junichiro Nishizawa, Kazuhiro Takatoku, Takashi Ohba
A 55-year-old morbidly obese woman [body mass index (BMI) 51.2] developed acute type A aortic dissection, and she also presented with significant hypoxemia and hypercapnia. She underwent a successful emergency total arch replacement, but severe hypoxemia persisted and Pao2/Fio2 lowered to 71.9 mmHg. We therefore applied high frequency jet ventilation (HFJV), which soon improved the hypoxemia without hemodynamic compromise. HFJV was discontinued three days later, when her Pao2/Fio2 improved to 170.0 mmHg. Weaning from the respirator was initiated on postoperative day 13...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29033358/predictive-factors-of-early-postoperative-respiratory-complications-after-tonsillectomy-in-children-with-unidentified-risks-for-this-complication
#8
Florence Julien-Marsollier, Pierre Salis, Rachida Abdat, Thierno Diallo, Thierry van Den Abbelle, Souhayl Dahmani
INTRODUCTION: Tonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy. MATERIAL AND METHODS: This is a retrospective single centre observational study including patients with unanticipated postoperative respiratory failure...
October 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29032064/laparoscopic-and-robotic-assisted-hysterectomy-for-uterine-leiomyomas-a-comparison-of-complications-and-costs
#9
Tin Yan Tina Ngan, Andrew Zakhari, Nicholas Czuzoj-Shulman, Togas Tulandi, Haim Arie Abenhaim
OBJECTIVE: Robotic surgery is increasingly being used for treatment of malignant and benign gynaecologic diseases. The purpose of our study is to compare patient perioperative complications and costs of laparoscopic versus robotic-assisted hysterectomy for uterine leiomyomas. METHODS: A retrospective cohort study using the Nationwide Inpatient Sample database from the United States was conducted, comparing patients who underwent robotic-assisted hysterectomy and laparoscopic hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for uterine fibroids between 2008 and 2012...
October 11, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29026677/bedside-ultrasound-in-the-diagnosis-and-treatment-of-children-with-respiratory-difficulty-following-cardiac-surgery
#10
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
#11
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...
September 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
#12
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
#13
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
#14
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
#15
REVIEW
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
#16
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
#17
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
#18
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
#19
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
#20
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
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