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Noncardiac surgery

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https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#1
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28089600/perioperative-aspirin-in-cardiac-and-noncardiac-surgery
#2
REVIEW
Jordan E Goldhammer, Corey R Herman, Jian-Zhong Sun
No abstract text is available yet for this article.
October 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28089598/impact-of-focused-intraoperative-transthoracic-echocardiography-by-anesthesiologists-on-management-in-hemodynamically-unstable-high-risk-noncardiac-surgery-patients
#3
Thomas Kratz, Thorsten Steinfeldt, Maik Exner, Marco Campo Dell Orto, Nina Timmesfeld, Caroline Kratz, Martin Skrodzki, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Focused transthoracic echocardiography (TTE) is used perioperatively for surgical patients. Intraoperative application of TTE is feasible, but its benefits remain unclear. The intention of this study was to investigate the effect of intraoperative TTE on the management of high-risk noncardiac surgery patients. DESIGN: A prospective interventional study. SETTING: Single-center university hospital. PARTICIPANTS: Fifty consecutive hemodynamically unstable high-risk patients anesthetized for noncardiac surgery...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28073987/neutrophil-lymphocyte-ratio-and-risk-of-atrial-fibrillation-after-thoracic-surgery
#4
Kevin J Walsh, Kay See Tan, Hao Zhang, David Amar
OBJECTIVES: Postoperative atrial fibrillation (POAF) occurs frequently in patients after noncardiac thoracic surgery and has been associated with increased morbidity and risk of stroke. Recent studies have shown conflicting results on the role of neutrophil-lymphocyte ratio (NLR) and its association with the development of POAF after cardiac surgery. Our goal was to determine whether an association exists between NLR and the incidence of POAF after non-cardiac thoracic surgery. METHODS: Using a database of 259 consecutive patients age 60 or older who had anatomic lung resection or oesophagectomy for oncologic resection, we compared preoperative, postanaesthesia care unit and postoperative day 1 NLR between patients who did and did not develop POAF during their hospitalization using Fisher's exact test or logistic regression...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073770/impact-of-beta-blocker-initiation-timing-on-mortality-risk-in-patients-with-diabetes-mellitus-undergoing-noncardiac-surgery-a-nationwide-population-based-cohort-study
#5
Ray-Jade Chen, Hsi Chu, Lung-Wen Tsai
BACKGROUND: Relevant clinical studies have been small and have not convincingly demonstrated whether the perioperative initiation of beta-blockers should be considered in patients with diabetes mellitus undergoing noncardiac surgery. METHODS AND RESULTS: In this nationwide propensity score-matched study, we included patients with diabetes mellitus undergoing noncardiac surgery between 2000 and 2011 from Taiwan's National Health Insurance Research Database. Patients were classified as beta-blocker and non-beta-blocker cohorts...
January 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28072601/risk-factors-and-clinical-outcomes-associated-with-perioperative-transfusion-associated-circulatory-overload
#6
Leanne Clifford, Qing Jia, Arun Subramanian, Hemang Yadav, Darrell R Schroeder, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. METHODS: In this case-control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications...
January 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#7
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28043688/neonatal-surgery-for-noncardiac-congenital-anomalies-neonates-at-risk-of-brain-injury
#8
Lisanne J Stolwijk, Kristin Keunen, Linda S de Vries, Floris Groenendaal, David C van der Zee, Maud Y A van Herwaarden, Petra M A Lemmers, Manon J N L Benders
OBJECTIVE: To evaluate the incidence of brain injury after neonatal surgery for noncardiac congenital anomalies using magnetic resonance imaging (MRI). STUDY DESIGN: An MRI was obtained in 101 infants at 7 days [range: 1-115] after neonatal surgery for major noncardiac congenital anomalies. Brain injury was assessed using T1, T2, diffusion weighted imaging, and susceptibility-weighted imaging. RESULTS: Thirty-two preterm infants (<37 weeks of gestation) and 69 full-term infants were included...
December 30, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28032851/is-perioperative-beta-blockade-effective-and-safe-in-patients-undergoing-noncardiac-surgery
#9
Andrés Armstrong, Gabriel Rada, Fernando Altermatt
Beta-blockade in patients undergoing noncardiac surgery has been widely recommended as a way to reduce cardiovascular adverse events during the perioperative period. However, studies have shown contradictory results. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified 22 systematic reviews comprising 131 studies addressing the question of this article, including 112 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
December 27, 2016: Medwave
https://www.readbyqxmd.com/read/28030663/perioperative-major-adverse-cardiovascular-and-cerebrovascular-events-associated-with-noncardiac-surgery
#10
Nathaniel R Smilowitz, Navdeep Gupta, Harish Ramakrishna, Yu Guo, Jeffrey S Berger, Sripal Bangalore
Importance: Major adverse cardiovascular and cerebrovascular events (MACCE) are a significant source of perioperative morbidity and mortality following noncardiac surgery. Objective: To evaluate national trends in perioperative cardiovascular outcomes and mortality after major noncardiac surgery and to identify surgical subtypes associated with cardiovascular events using a large administrative database of United States hospital admissions. Design, Setting, Participants: Patients who underwent major noncardiac surgery from January 2004 to December 2013 were identified using the National Inpatient Sample...
December 28, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/28027208/reply-to-association-of-increased-n-terminal-b-type-natriuretic-propeptide-levels-with-short-term-adverse-outcomes-after-noncardiac-surgery
#11
Carlos Álvarez Zurro, Antonio Planas Roca, Enrique Alday Muñoz, Rosa Méndez Hernández
No abstract text is available yet for this article.
February 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28027207/association-of-increased-n-terminal-b-type-natriuretic-propeptide-levels-with-short-term-adverse-outcomes-after-noncardiac-surgery
#12
Gui-Zhen Yang, Fu-Shan Xue, Gao-Pu Liu, Chao Sun
No abstract text is available yet for this article.
February 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28002165/improving-prediction-of-postoperative-myocardial-infarction-with-high-sensitivity-cardiac-troponin-t-and-nt-probnp
#13
Michael Kopec, Andreas Duma, Mohammad A Helwani, Jamie Brown, Frank Brown, Brian F Gage, David W Gibson, J Philip Miller, Eric Novak, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: This study sought to determine whether preoperatively measured high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) improve cardiac risk prediction in patients undergoing major noncardiac surgery compared with the standard risk indices. METHODS: In this ancillary study to the Vitamins in Nitrous Oxide trial, patients were included who had preoperative hs-cTnT and NT-proBNP measured (n = 572). Study outcome was the incidence of postoperative myocardial infarction (MI) within the first 3 postoperative days...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27994379/preoperative-red-cell-distribution-width-not-a-useful-prognostic-indicator-for-30-day-mortality-in-patients-who-undergo-major-or-ultra-major-noncardiac-surgery
#14
Yik-Nang Cheung, Hoi-Ping Shum, King-Chung Chan, Wing-Wa Yan
BACKGROUND: Red cell distribution width (RDW) has been shown to be associated with mortality in cardiac surgical patients. This study investigates the association of RDW with the 30-day mortality for those patients who undergo major- or ultra-major noncardiac surgery. METHODS: Patients who received major- or ultra-major noncardiac surgery between July 2012 and May 2013 were included in the study and patients those with preoperative hemoglobin <10 g/day were excluded from the study...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27992634/perioperative-statin-use-in-noncardiac-surgery-who-and-when
#15
Richard L Weinberg, Kim A Eagle
No abstract text is available yet for this article.
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#16
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27989375/con-cardiothoracic-anesthesiologists-are-not-necessary-for-the-management-of-patients-with-ventricular-assist-devices-undergoing-noncardiac-surgery
#17
Sujatha Bhandary
No abstract text is available yet for this article.
September 30, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27988091/pulmonary-complications-after-open-abdominal-aortic-surgery-a-systematic-review-and-meta-analysis
#18
Laura Pasin, Pasquale Nardelli, Alessandro Belletti, Massimiliano Greco, Giovanni Landoni, Luca Cabrini, Roberto Chiesa, Alberto Zangrillo
OBJECTIVES: Postoperative pulmonary complications (PPC) are among the most common complications after noncardiac surgery. Men, smokers, and elderly patients with chronic obstructive pulmonary disease or heart failure are more likely to experience PPC. The majority of patients undergoing vascular surgery belong in these categories and are at higher risk of developing PPC. Moreover, the surgical site is one of the most important risk factors associated with PPC, and aortic surgery carries the highest risk...
October 1, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27982268/utility-of-ultraportable-echocardiography-in-the-preoperative-evaluation-of-noncardiac-surgery
#19
Jean Allan Costa, Maria Lucia Pereira Almeida, Tereza Cristina Duque Estrada, Guilherme Lobosco Werneck, Alexandre Marins Rocha, Maria Luiza Garcia Rosa, Mario Luiz Ribeiro, Claudio Tinoco Mesquita
Background: The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. Objectives: To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. Methods: A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study...
November 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27941063/prognostic-implications-of-adding-urine-output-to-serum-creatinine-measurements-for-staging-of-acute-kidney-injury-after-major-surgery-a-cohort-study
#20
Samuel Quan, Neesh Pannu, Todd Wilson, Chad Ball, Zhi Tan, Marcello Tonelli, Brenda R Hemmelgarn, Elijah Dixon, Matthew T James
BACKGROUND: Current guidelines recommend staging acute kidney injury (AKI) according to the serum creatinine (SCr) or urine output (UO) criteria that achieve the highest stage. There is little information about the implications of adding UO to SCr measurements for staging AKI outside intensive care units and after cardiac surgery. METHODS: We performed a cohort study of all adults without end-stage renal disease who underwent major noncardiac surgery between January 2005 and March 2011 in Calgary, AB, Canada...
December 2016: Nephrology, Dialysis, Transplantation
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