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Noncardiac surgery

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https://www.readbyqxmd.com/read/28537983/comparison-of-the-mallampati-classification-in-sitting-and-supine-position-to-predict-difficult-tracheal-intubation-a-prospective-observational-cohort-study
#1
Jean-Luc Hanouz, Vincent Bonnet, Clément Buléon, Thérèse Simonet, Dorothée Radenac, Guillaume Zamparini, Marc Olivier Fischer, Jean-Louis Gérard
BACKGROUND: The Mallampati classification (MLPT) is normally evaluated in the sitting position. However, many patients cannot be evaluated in the sitting position for medical reasons. Thus, we compared the MLPT in sitting and supine positions in predicting difficult tracheal intubation (DTI). We hypothesized that the diagnostic accuracy of the MLPT performed in sitting and supine positions would differ. METHODS: We performed a single-center prospective observational study in adult patients who received general anesthesia and orotracheal intubation for noncardiac surgery...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28514242/risks-of-cardiovascular-adverse-events-and-death-in-patients-with-previous-stroke-undergoing-emergency-noncardiac-nonintracranial-surgery-the-importance-of-operative-timing
#2
Mia N Christiansen, Charlotte Andersson, Gunnar H Gislason, Christian Torp-Pedersen, Robert D Sanders, Per Føge Jensen, Mads E Jørgensen
BACKGROUND: The outcomes of emergent noncardiac, nonintracranial surgery in patients with previous stroke remain unknown. METHODS: All emergency surgeries performed in Denmark (2005 to 2011) were analyzed according to time elapsed between previous ischemic stroke and surgery. The risks of 30-day mortality and major adverse cardiovascular events were estimated as odds ratios (ORs) and 95% CIs using adjusted logistic regression models in a priori defined groups (reference was no previous stroke)...
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28486392/myocardial-injury-after-noncardiac-surgery-mins-in-vascular-surgical-patients-a-prospective-observational-cohort-study
#3
Bruce M Biccard, David Julian Ashbridge Scott, Matthew T V Chan, Andrew Archbold, Chew-Yin Wang, Alben Sigamani, Gerard Urrútia, Patricia Cruz, Sadeesh K Srinathan, David Szalay, John Harlock, Jacques G Tittley, Theodore Rapanos, Fadi Elias, Michael J Jacka, German Malaga, Valsa Abraham, Otavio Berwanger, Félix R Montes, Diane M Heels-Ansdell, Matthew T Hutcherson, Clara K Chow, Carisi A Polanczyk, Wojciech Szczeklik, Gareth L Ackland, Luc Dubois, Robert J Sapsford, Colin Williams, Olga L Cortés, Yannick Le Mananch, P J Devereaux
OBJECTIVE: To determine the prognostic relevance, clinical characteristics, and 30-day outcomes associated with myocardial injury after noncardiac surgery (MINS) in vascular surgical patients. BACKGROUND: MINS has been independently associated with 30-day mortality after noncardiac surgery. The characteristics and prognostic importance of MINS in vascular surgery patients are poorly described. METHODS: This was an international prospective cohort study of 15,102 noncardiac surgery patients 45 years or older, of whom 502 patients underwent vascular surgery...
May 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28469459/cardiac-evaluation-and-monitoring-of-patients-undergoing-noncardiac-surgery
#4
REVIEW
Arsalan Rafiq, Eduard Sklyar, Jonathan N Bella
Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Although such events are very small in number, they are associated with a high mortality rate making it essential for physicians to understand the importance of perioperative cardiovascular risk assessment and evaluation. Its involves a detailed process of history taking, patient's medical profile, medications being used, functional status of the patient, and knowledge about the surgical procedure and its inherent risks...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469453/evaluation-and-monitoring-of-patients-with-cardiovascular-implantable-electronic-devices-undergoing-noncardiac-surgery
#5
REVIEW
Eduard Sklyar, Jonathan N Bella
In this article, the reader will get some insights into managing patient with implantable cardiac devices while undergoing noncardiac surgery. We will review basic concepts regarding normal function of pacemakers and implantable cardioverter defibrillators, understanding how their function will be influenced during noncardiac surgeries. You will be guided through management steps from preoperative, intraoperative, and postoperative aspects. In an ever-changing world of medicine, it is important to keep up with progress as more and more patients get implantable cardiac devices...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28466755/perioperative-management-of-cardiac-transplant-recipients-undergoing-noncardiac-surgery-unique-challenges-created-by-advancements-in-care
#6
Paul T Jurgens, Christina L Aquilante, Robert L Page, Amrut V Ambardekar
Advancements in postcardiac transplant care have resulted in significant reductions in morbidity and increased life expectancy for cardiac transplant recipients. Consequently, many cardiac transplant recipients are living long enough to require subsequent noncardiac surgery. The perioperative care of heart transplant recipients presents a unique challenge as many of the common preoperative risk assessments do not apply to a transplanted heart, immunosuppressive medications have side effects and potential for drug-drug interactions, and the denervated heart results in an altered autonomic physiology and response to medications...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28463896/a-meta-analysis-of-the-impact-of-aspirin-clopidogrel-and-dual-antiplatelet-therapy-on-bleeding-complications-in-noncardiac-surgery
#7
Jesse A Columbo, Andrew J Lambour, Rebecca A Sundling, Nirali B Chauhan, Sarah Y Bessen, David L Linshaw, Ravinder Kang, Natalie B V Riblet, Philip P Goodney, David H Stone
OBJECTIVE: The aim of this study was to determine the bleeding risks associated with single (aspirin) and dual (aspirin + clopidogrel) antiplatelet therapy (DAPT) versus placebo or no treatment in adults undergoing noncardiac surgery. SUMMARY OF BACKGROUND DATA: The impact of antiplatelet therapy on bleeding during noncardiac surgery remains controversial. A meta-analysis was performed to examine the risk associated with single and DAPT. METHODS: A systematic review of antiplatelet therapy, noncardiac surgery, and perioperative bleeding was performed...
May 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28459734/a-systematic-review-and-meta-analysis-examining-the-impact-of-incident-postoperative-delirium-on-mortality
#8
Gavin M Hamilton, Kathleen Wheeler, Joseph Di Michele, Manoj M Lalu, Daniel I McIsaac
BACKGROUND: Delirium is an acute and reversible geriatric syndrome that represents a decompensation of cerebral function. Delirium is associated with adverse postoperative outcomes, but controversy exists regarding whether delirium is an independent predictor of mortality. Thus, we assessed the association between incident postoperative delirium and mortality in adult noncardiac surgery patients. METHODS: A systematic search was conducted using Cochrane, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, and Embase...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28459724/anesthetic-challenges-for-posterior-spine-surgery-in-patient-with-left-ventricular-assist-device-a-case-report
#9
J Pablo Kollmar, Douglas A Colquhoun, Julie L Huffmyer
With the growing rate of left ventricular assist device (LVAD) implantation, patients with end-stage heart failure and LVAD support are presenting for a variety of noncardiac surgeries. We describe a case of urgent posterior lumbar decompression for spinal stenosis in a 73-year-old man with HeartMateII LVAD, which presented significant anesthetic challenges in terms of positioning, blood loss, and coagulopathy.
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28457777/antifibrinolytic-agents-in-cardiac-and-noncardiac-surgery-a-comprehensive-overview-and-update
#10
REVIEW
Neal S Gerstein, Janet K Brierley, Jimmy Windsor, Pramod V Panikkath, Harish Ram, Kirill M Gelfenbeyn, Lindsay J Jinkins, Liem C Nguyen, Wendy H Gerstein
No abstract text is available yet for this article.
February 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28457342/outcome-after-coronary-bypass-grafting-for-coronary-complications-following-coronary-angiography
#11
Ingo Slottosch, Oliver Liakopoulos, Elmar Kuhn, Antje-Christin Deppe, Maximilian Scherner, Navid Mader, Yeong-Hoon Choi, Thorsten Wahlers
BACKGROUND: Coronary complications during coronary angiography or intervention (percutaneous coronary intervention [PCI]) are uncommon. However, PCI-related coronary artery perforation, dissection, or acute occlusion frequently result in myocardial ischemia followed by hemodynamic instability and need of urgent coronary artery bypass grafting (coronary artery bypass grafting [CABG]). This single-center study aimed to investigate clinical outcomes of patients undergoing urgent CABG after life-threatening PCI complications...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28457322/marriage-and-mortality-after-noncardiac-surgery
#12
Brian C Gulack, Betsy Hale, William D White, Richard E Moon, Elliott Bennett-Guerrero
BACKGROUND: Marriage is linked to substantial societal and economic benefits, and it has been associated with improved outcomes following acute illness. However, it is not known if being married confers benefit to patients undergoing noncardiac surgical procedures. MATERIALS AND METHODS: Patients undergoing any noncardiac surgical procedure were included over a period of 19 months. All-cause mortality at 2 years was determined by linking patient records to the National Death Index...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28445319/intraoperative-cardiac-arrest-a-10-year-study-of-patients-undergoing-tumorous-surgery-in-a-tertiary-referral-cancer-center-in-china
#13
Fei Han, Yufeng Wang, Yue Wang, Jiaxu Dong, Chaoran Nie, Meng Chen, Lina Hou
Intraoperative cardiac arrest (IOCA) is a lethal complication of noncardiac surgery. According to several reports, immediate survival after IOCA is approximately 50%. In this study, a retrospective case analysis was performed to determine the incidence of IOCA, the potential causes of cardiac arrest, and the risk factors of no resuscitation in patients undergoing tumorous surgery.The medical records of surgery patients who experienced cardiac arrest during the intraoperative period between 2005 and 2014 were reviewed...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444280/association-of-postoperative-high-sensitivity-troponin-levels-with-myocardial-injury-and-30-day-mortality-among-patients-undergoing-noncardiac-surgery
#14
P J Devereaux, Bruce M Biccard, Alben Sigamani, Denis Xavier, Matthew T V Chan, Sadeesh K Srinathan, Michael Walsh, Valsa Abraham, Rupert Pearse, C Y Wang, Daniel I Sessler, Andrea Kurz, Wojciech Szczeklik, Otavio Berwanger, Juan Carlos Villar, German Malaga, Amit X Garg, Clara K Chow, Gareth Ackland, Ameen Patel, Flavia Kessler Borges, Emilie P Belley-Cote, Emmanuelle Duceppe, Jessica Spence, Vikas Tandon, Colin Williams, Robert J Sapsford, Carisi A Polanczyk, Maria Tiboni, Pablo Alonso-Coello, Atiya Faruqui, Diane Heels-Ansdell, Andre Lamy, Richard Whitlock, Yannick LeManach, Pavel S Roshanov, Michael McGillion, Peter Kavsak, Matthew J McQueen, Lehana Thabane, Reitze N Rodseth, Giovanna A Lurati Buse, Mohit Bhandari, Ignacia Garutti, Michael J Jacka, Holger J Schünemann, Olga Lucía Cortes, Pierre Coriat, Nazari Dvirnik, Fernando Botto, Shirley Pettit, Allan S Jaffe, Gordon H Guyatt
Importance: Little is known about the relationship between perioperative high-sensitivity troponin T (hsTnT) measurements and 30-day mortality and myocardial injury after noncardiac surgery (MINS). Objective: To determine the association between perioperative hsTnT measurements and 30-day mortality and potential diagnostic criteria for MINS (ie, myocardial injury due to ischemia associated with 30-day mortality). Design, Setting, and Participants: Prospective cohort study of patients aged 45 years or older who underwent inpatient noncardiac surgery and had a postoperative hsTnT measurement...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#15
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28431420/generative-retrieval-improves-learning-and-retention-of-cardiac-anatomy-using-transesophageal-echocardiography
#16
Amanda M Kleiman, Katherine T Forkin, Allison J Bechtel, Stephen R Collins, Jennie Z Ma, Edward C Nemergut, Julie L Huffmyer
BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. METHODS: Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430682/attempted-development-of-a-tool-to-predict-anesthesia-preparation-time-from-patient-related-and-procedure-related-characteristics
#17
Kamal Maheshwari, Jing You, Kenneth C Cummings, Maged Argalious, Daniel I Sessler, Andrea Kurz, Jacek Cywinski
BACKGROUND: Operating room (OR) utilization generally ranges from 50% to 75%. Inefficiencies can arise from various factors, including prolonged anesthesia preparation time, defined as the period from induction of anesthesia until patients are considered ready for surgery. Our goal was to use patient-related and procedure-related factors to develop a model predicting anesthesia preparation time. METHODS: From the electronic medical records of adults who had noncardiac surgery at the Cleveland Clinic Main Campus, we developed a model that used a dozen preoperative factors to predict anesthesia preparation time...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28395291/undiagnosed-obstructive-sleep-apnea-and-postoperative-outcomes-a-prospective-observational-study
#18
Uma Devaraj, Srinivas Rajagopala, Ajay Kumar, Priya Ramachandran, Philip J Devereaux, George A D'Souza
BACKGROUND: The prevalence of undiagnosed obstructive sleep apnea (OSA) during preoperative evaluation and the best method to screen OSA and its association with postoperative complications remain unclear. OBJECTIVES: To determine the prevalence of undiagnosed OSA in preoperative Indian patients undergoing noncardiac surgery, to compare the diagnostic accuracy of the STOP-BANG questionnaire to a preoperative level III sleep study, and to assess the association of OSA with postoperative complications...
April 11, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28385315/use-of-antiplatelet-therapy-dapt-for%C3%A2-post-pci-patients-undergoing-noncardiac-surgery
#19
REVIEW
Subhash Banerjee, Dominick J Angiolillo, William E Boden, Joseph G Murphy, Houman Khalili, Ahmed A Hasan, Robert A Harrington, Sunil V Rao
Dual antiplatelet therapy (DAPT) is prescribed to millions of patients worldwide following coronary stenting. DAPT is indicated to lower the risk of ischemic events, such as myocardial infarction, including stent thrombosis, ischemic stroke, or death from cardiovascular causes. A significant number of these patients undergo noncardiac surgery and may require DAPT interruption. This poses a significant clinical dilemma because DAPT interruption exposes patients to the potential risk of stent thrombosis, perioperative myocardial infarction, or both...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#20
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
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