keyword
https://read.qxmd.com/read/38425057/wireless-continuous-single-lead-st-segment-monitoring-to-detect-new-onset-myocardial-injury-at-the-general-ward-an-exploratory-subanalysis
#21
JOURNAL ARTICLE
Jonathan Attilla Koefoed Starling, Camilla Haahr-Raunkjaer, Søren S Rasmussen, Luna Ekenberg, Frederik Cornelius Loft, Christian Sylvest Meyhoff, Eske Kvanner Aasvang
Patients admitted for acute medical conditions and major noncardiac surgery are at risk of myocardial injury. This is frequently asymptomatic, especially in the context of concomitant pain and analgesics, and detection thus relies on cardiac biomarkers. Continuous single-lead ST-segment monitoring from wireless electrocardiogram (ECG) may enable more timely intervention, but criteria for alerts need to be defined to reduce false alerts. This study aimed to determine optimal ST-deviation thresholds from wireless single-lead ECG for detection of myocardial injury following major abdominal cancer surgery and during acute exacerbation of chronic obstructive pulmonary disease...
February 29, 2024: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/38416481/outcomes-of-women-undergoing-noncardiac-surgery-in-veterans-affairs-compared-with-non-veterans-affairs-care-settings
#22
JOURNAL ARTICLE
Elizabeth L George, Michael A Jacobs, Katherine M Reitz, Nader N Massarweh, Ada O Youk, Shipra Arya, Daniel E Hall
IMPORTANCE: Recent legislation facilitates veterans' ability to receive non-Veterans Affairs (VA) surgical care. Although veterans are predominantly male, the number of women receiving care within the VA has nearly doubled to 10% over the past decade and recent data comparing the surgical care of women in VA and non-VA care settings are lacking. OBJECTIVE: To compare postoperative outcomes among women treated in VA hospitals vs private-sector hospitals. DESIGN, SETTING, AND PARTICIPANTS: This coarsened exact-matched cohort study across 9 noncardiac specialties in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) and American College of Surgeons National Surgical Quality Improvement Program (NSQIP) took place from January 1, 2016, to December 31, 2019...
February 28, 2024: JAMA Surgery
https://read.qxmd.com/read/38413849/influence-of-a-chronic-beta-blocker-therapy-on-perioperative-opioid-consumption-a-post-hoc-secondary-analysis
#23
MULTICENTER STUDY
Ralf F Trauzeddel, Luisa M Rothe, Michael Nordine, Lukas Dehé, Kathrin Scholtz, Claudia Spies, Daniel Hadzidiakos, Georg Winterer, Friedrich Borchers, Jochen Kruppa, Sascha Treskatsch
BACKGROUND: Beta-blocker (BB) therapy plays a central role in the treatment of cardiovascular diseases. An increasing number of patients with cardiovascular diseases undergoe noncardiac surgery, where opioids are an integral part of the anesthesiological management. There is evidence to suggest that short-term intravenous BB therapy may influence perioperative opioid requirements due to an assumed cross-talk between G-protein coupled beta-adrenergic and opioid receptors. Whether chronic BB therapy could also have an influence on perioperative opioid requirements is unclear...
February 27, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38413342/multicentre-validation-of-a-machine-learning-model-for-predicting-respiratory-failure-after-noncardiac-surgery
#24
JOURNAL ARTICLE
Hyun-Kyu Yoon, Hyun Joo Kim, Yi-Jun Kim, Hyeonhoon Lee, Bo Rim Kim, Hyongmin Oh, Hee-Pyoung Park, Hyung-Chul Lee
BACKGROUND: Postoperative respiratory failure is a serious complication that could benefit from early accurate identification of high-risk patients. We developed and validated a machine learning model to predict postoperative respiratory failure, defined as prolonged (>48 h) mechanical ventilation or reintubation after surgery. METHODS: Easily extractable electronic health record (EHR) variables that do not require subjective assessment by clinicians were used...
February 26, 2024: British Journal of Anaesthesia
https://read.qxmd.com/read/38407141/postoperative-length-of-stay-in-patients-with-stress-hyperglycemia-compared-to-patients-with-diabetic-hyperglycemia-a-retrospective-cohort-study
#25
JOURNAL ARTICLE
Jason Shiffermiller, Matthew Anderson, Rachel Thompson
BACKGROUND: Postoperative hospital length of stay (LOS) is longer in patients with diabetes than in patients without diabetes. Stress hyperglycemia (SH) in patients without a history of diabetes has been associated with adverse postoperative outcomes. The effect of SH on postoperative LOS is uncertain. The aim of this study is to compare postoperative LOS in patients with SH to patients with diabetic hyperglycemia (DH) following noncardiac surgery. METHODS: We carried out a retrospective cohort study of inpatients with at least two glucose measurements ≥180 mg/dL...
February 26, 2024: Journal of Diabetes Science and Technology
https://read.qxmd.com/read/38404717/how-long-after-coronary-artery-bypass-surgery-can-patients-have-elective-safer-non-cardiac-surgery
#26
JOURNAL ARTICLE
Li-Chin Sung, Chuen-Chau Chang, Chun-Chieh Yeh, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao
OBJECTIVE: To evaluate the complications and mortality after noncardiac surgeries in patients who underwent previous coronary artery bypass grafting (CABG). METHODS: We used insurance data and identified patients aged ≥20 years undergoing noncardiac surgeries between 2010 and 2017 in Taiwan. Based on propensity-score matching, we selected an adequate number of patients with a previous history of CABG (within preoperative 24 months) and those who did not have a CABG history, and both groups had balanced baseline characteristics...
2024: Journal of Multidisciplinary Healthcare
https://read.qxmd.com/read/38389992/boerhaave-s-syndrome-presenting-in-the-setting-of-third-degree-heart-block
#27
Jay A Redan, Taylor Croteau, Colleen Gaughan
INTRODUCTION: Boerhaave's syndrome, or the spontaneous transmural perforation of the esophagus, is typically thought to be due to an increase in esophageal pressure such as that which occurs during vomiting or retching. Another common etiology of esophageal perforation is esophageal instrumentation, such as during esophagogastroduodenoscopy or transesophageal echocardiography. This life-threatening condition requires prompt diagnosis and treatment to prevent patient demise. While a history of vomiting can aid in diagnosis, this history can be difficult to elicit in an unconscious patient or may be altogether absent...
2024: CRSLS: MIS case reports from SLS
https://read.qxmd.com/read/38387241/kidney-disease-in-trials-of-perioperative-tranexamic-acid
#28
REVIEW
Cheng-Wei Liu, Joshua Anih, Victoria Lebedeva, Ata Gungor, Carol Wang, Lily Park, Pavel S Roshanov
STUDY OBJECTIVE: To assess how kidney disease is handled in randomized trials evaluating the safety and efficacy of perioperative tranexamic acid, and to evaluate its effects across levels of kidney function. DESIGN: Systematic review and meta-analysis of randomized controlled trials. SETTING: We screened studies from a previous comprehensive systematic review, and updated its search of PubMed, Embase, and Cochrane CENTRAL to July 31, 2023...
February 21, 2024: Journal of Clinical Anesthesia
https://read.qxmd.com/read/38364243/improving-neuromuscular-monitoring-through-education-based-interventions-and-studying-its-association-with-adverse-postoperative-outcomes-a-retrospective-observational-study
#29
JOURNAL ARTICLE
Shane G Carr, Jacob C Clifton, Robert E Freundlich, Leslie C Fowler, Edward R Sherwood, Matthew D McEvoy, Amy Robertson, Brent A Dunworth, Karen Y McCarthy, Matthew S Shotwell, Miklos D Kertai
BACKGROUND: We assessed the association between education-based interventions, the frequency of train-of-four (TOF) monitoring, and postoperative outcomes. METHODS: We studied adults undergoing noncardiac surgery from February 1, 2020 through October 31, 2021. Our education-based interventions consisted of 3 phases. An interrupted time-series analysis, adjusting for patient- and procedure-related characteristics and secular trends over time, was used to assess the associations between education-based interventions and the frequency of TOF monitoring, postoperative pulmonary complications (PPCs), 90-day mortality, and sugammadex dosage...
March 1, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38358109/renin-as-a-prognostic-marker-in-intensive-care-and-perioperative-settings-a-scoping-review
#30
JOURNAL ARTICLE
Yuki Kotani, Alessandro Belletti, Giacomo Maiucci, Martina Lodovici, Stefano Fresilli, Giovanni Landoni, Rinaldo Bellomo, Alexander Zarbock
Serum renin increases in response to sympathetic nerve activation and hypotension. Recent studies have reported the association of serum renin levels with adverse clinical outcomes in acute care settings. This scoping review aimed to systematically review the available literature on renin as a prognostic marker in intensive care and perioperative patients. We searched for studies published since inception until March 31, 2023, which assessed the association between serum renin levels and clinical outcomes or the effect of synthetic angiotensin II administration on serum renin levels in critically ill and perioperative patients in PubMed, Embase, and the Cochrane Library...
October 23, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/38350756/efficacy-of-sevoflurane-and-propofol-anesthesia-on-perioperative-adverse-cardiovascular-events-and-hemodynamics-in-elderly-patients-with-diabetes
#31
JOURNAL ARTICLE
Liling Jia, Hongfeng Li, Tuping Li
PURPOSE: This study was undertaken to compare the effects of sevoflurane and propofol anesthesia on perioperative hemodynamics and perioperative adverse cardiovascular events (PACE) in elderly patients with diabetes undergoing general anesthesia for noncardiac surgery. METHODS: According to the random number table (n = 40), 80 patients with diabetes undergoing noncardiac general anesthesia were divided into a control group and an observation group. In the control group, the patients were given propofol 4 to 6 mg/(kg·h), continuously pumped to maintain anesthesia...
February 12, 2024: Clinical Therapeutics
https://read.qxmd.com/read/38346717/plasma-somamer-proteomics-of-postoperative-delirium
#32
JOURNAL ARTICLE
Jacqueline M Leung, Julio C Rojas, Laura P Sands, Brandon Chan, Binita Rajbanshi, Zhiyuan Du, Pang Du
BACKGROUND: Postoperative delirium is prevalent in older adults and has been shown to increase the risk of long-term cognitive decline. Plasma biomarkers to identify the risk for postoperative delirium and the risk of Alzheimer's disease and related dementias are needed. METHODS: This biomarker discovery case-control study aimed to identify plasma biomarkers associated with postoperative delirium. Patients aged ≥65 years undergoing major elective noncardiac surgery were recruited...
February 2024: Brain and Behavior
https://read.qxmd.com/read/38343871/perioperative-myocardial-injury-and-infarction-after-noncardiac-surgery-a-review-of-pathophysiology-diagnosis-and-management
#33
REVIEW
Besher Kashlan, Menhel Kinno, Mushabbar Syed
Perioperative myocardial injury is a relatively common complication after noncardiac surgery associated with significant morbidity and mortality. It is frequently driven by physiologic factors such as hypotension, tachycardia, and anemia. Diagnosis of perioperative myocardial injury after noncardiac surgery is based on elevated cardiac troponin levels, greater than the 99th percentile of the assay's upper reference limit within 30 days of surgery. Perioperative myocardial injury is further classified into non-ischemic and ischemic based on the underlying pathophysiology...
2024: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/38341283/preoperative-n-terminal-pro-b-type-natriuretic-peptide-and-myocardial-injury-after-stopping-or-continuing-renin-angiotensin-system-inhibitors-in-noncardiac-surgery-a-prespecified-analysis-of-a-phase-2-randomised-controlled-multicentre-trial
#34
JOURNAL ARTICLE
Ana Gutierrez Del Arroyo, Akshaykumar Patel, Tom E F Abbott, Salma Begum, Priyanthi Dias, Sameer Somanath, Alexander Middleditch, Stuart Cleland, David Brealey, Rupert M Pearse, Gareth L Ackland
BACKGROUND: Patients with elevated preoperative plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP >100 pg ml-1 ) experience more complications after noncardiac surgery. Individuals prescribed renin-angiotensin system (RAS) inhibitors for cardiometabolic disease are at particular risk of perioperative myocardial injury and complications. We hypothesised that stopping RAS inhibitors before surgery increases the risk of perioperative myocardial injury, depending on preoperative risk stratified by plasma NT-proBNP concentrations...
February 9, 2024: British Journal of Anaesthesia
https://read.qxmd.com/read/38340803/the-correlation-between-high-sensitivity-troponin-t-and-cell-free-cardiac-dna-in-the-blood-of-patients-undergoing-noncardiac-predominantly-vascular-surgery
#35
COMPARATIVE STUDY
Tural Alekberli, Braha Lea Ohana, Hai Zemmour, Rudy Khader, Ruth Shemer, Yuval Dor, Giora Landesberg
OBJECTIVE: To present a novel method that uses an epigenetic fingerprint to measure changes in plasma concentrations of cardiac-specific cell-free DNA (CS-cfDNA) as a marker of myocardial cell death. METHODS: This prospective, analytic, observational comparative study included patients with heart disease or multiple risk factors for heart disease undergoing major noncardiac, mostly vascular surgery, requiring an arterial-line, and at least 24 h hospitalization in the post anaesthesia care unit or critical care unit after surgery...
February 2024: Journal of International Medical Research
https://read.qxmd.com/read/38334810/-anesthesia-for-aortic-valve-stenosis-anesthesiological-management-of-patients-with-aortic-valve-stenosis-during-noncardiac-surgery
#36
REVIEW
Sebastian Billig, Marc Hein, Moritz Uhlig, David Schumacher, Marcus Thudium, Mark Coburn, Christina K Weisheit
Aortic valve stenosis is a common condition that requires an anesthesiologist's in-depth knowledge of the pathophysiology, diagnostics and perioperative features of the disease. A newly diagnosed aortic valve stenosis is often initially identified from the anamnesis (dyspnea, syncope, angina pectoris) or a suspicious auscultation finding during the anesthesiologist's preoperative assessment. Interdisciplinary collaboration is essential to ensure the optimal management of these patients in the perioperative setting...
February 9, 2024: Anaesthesiologie
https://read.qxmd.com/read/38323973/postanesthesia-care-unit-and-anesthetic-management-outcomes-among-patients-undergoing-noncardiac-surgery-differences-by-race-and-ethnicity
#37
JOURNAL ARTICLE
Steven B Porter, Yvette Martin-McGrew, Catherine Njathi-Ori, Danette L Bruns, Allison M LeMahieu, Carlos B Mantilla, Adam J Milam, Beth L Ladlie
PURPOSE: To investigate the association of patient race and ethnicity with postanesthesia care unit (PACU) outcomes in common, noncardiac surgeries requiring general anesthesia. DESIGN: Single tertiary care academic medical center retrospective matched cohort. METHODS: We matched 1:1 1836 adult patients by race and/or ethnicity undergoing common surgeries. We compared racial and ethnic minority populations (62 American Indian, 250 Asian, 315 Black or African American, 281 Hispanic, and 10 Pacific Islander patients) to 918 non-Hispanic White patients...
February 5, 2024: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://read.qxmd.com/read/38313304/design-of-a-workshop-for-focused-transesophageal-echocardiography-during-noncardiac-surgery-in-nurse-anesthesia-education
#38
JOURNAL ARTICLE
Barry Swerdlow, Lisa Osborne-Smith, Julie Soelberg
OBJECTIVE: The use of transesophageal echocardiography (TEE) by certified registered nurse anesthetists (CRNAs) during noncardiac surgery is relatively uncommon despite its unique potential to diagnose causes of hemodynamic instability. To address this problem, educational endeavors designed to provide practical TEE skills to CRNAs are needed. The aim of the current study was to evaluate the feasibility, acceptability, efficacy, and utility of a 2-day focused TEE workshop in nurse anesthesia education that employed a protocol involving a limited number of views and used goal-directed, qualitative assessments of critical physiologic parameters...
2024: Journal of Medical Education and Curricular Development
https://read.qxmd.com/read/38311886/comparison-of-effects-of-telmisartan-versus-valsartan-on-post-induction-hypotension-during-noncardiac-surgery-a-prospective-observational-study
#39
JOURNAL ARTICLE
Chung-Sik Oh, Jun Young Park, Seong-Hyop Kim
BACKGROUND: Telmisartan is considered more potent than valsartan. Hemodynamic response during anesthesia induction may be influenced by anti-hypertension (HTN) medication. The present study compared the effect of anti-HTN medications on post-induction hypotension during noncardiac surgeries. METHODS: This observational study standardized the anesthetic regimen across patients, with hypotension defined as mean blood pressure (BP) of less than 65 mmHg. The hemodynamic changes within 5 min before and after endotracheal intubation, and within 10 min before and after surgical incision were measured...
February 5, 2024: Korean Journal of Anesthesiology
https://read.qxmd.com/read/38310264/serum-metabolism-characteristics-of-patients-with-myocardial-injury-after-noncardiac-surgery-explored-by-the-untargeted-metabolomics-approach
#40
JOURNAL ARTICLE
Yuanjia Zhang, Mengjia Kou, Kuanzhi Liu, Yaqing Zhan, Weiyi Xu, Chanyan Huang, Wenqi Huang, Xu Zhao
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) is one of the most common complications associated with postoperative adverse cardiovascular outcomes and mortality. However, MINS often fails to be timely diagnosed due to the absence of clinical symptoms and limited diagnostic methods. The metabolomic analysis might be an efficient way to discover new biomarkers of MINS. Characterizing the metabolomic features of MINS patients may provide new insight into the diagnosis of MINS...
February 3, 2024: BMC Cardiovascular Disorders
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