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pulmonary evaluation perioperative

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https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#1
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27884744/technical-description-of-oblique-lateral-interbody-fusion-at-l1-l5-olif25-and-at-l5-s1-olif51-and-evaluation-of-complication-and-fusion-rates
#2
Kamal R M Woods, James B Billys, Richard A Hynes
BACKGROUND: The OLIF procedure is aimed at mitigating some of the challenges seen with traditional ALIF and transpsoas LLIF and allows for interbody fusion at L1-S1. PURPOSE: To describe the OLIF technique and assess the complication and fusion rates. STUDY DESIGN: A retrospective cohort study. PATIENT SAMPLE: 137 patients who underwent the oblique lateral interbody fusion (OLIF) procedure. OUTCOME MEASURES: Adverse events within 6 months of surgery: Infection, symptomatic pseudarthrosis, hardware failure, vascular injury, perioperative blood transfusion, ureteral injury, bowel injury, renal injury, prolonged postoperative ileus (greater than 3 days), incisional hernia, pseudohernia, reoperation, neurological deficits (weakness, numbness, paresthesia), hip flexion pain, retrograde ejaculation, sympathectomy affecting lower extremities, deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, and cerebrovascular accident...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#3
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27867563/single-port-video-assisted-thoracic-surgery-in-the-treatment-of-non-small-cell-lung-cancer-a-propensity-matched-comparative-analysis
#4
Fuqiang Dai, Shenglan Meng, Longyong Mei, Chen Guan, Zheng Ma
BACKGROUND: Video-assisted thoracic surgery (VATS)-assisted lobectomy is widely used to treat non-small cell lung carcinoma (NSCLC). There are no reports concerning the comparison between single-port VATS and two-port VATS in treating NSCLC. This study aimed to compare the perioperative and short-term follow-up results between these two methods for treating NSCLC. METHODS: A retrospective surgical evaluation of patients undergoing either single-port VATS or two-port VATS for NSCLC between January 2013 and June 2015 was conducted...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867301/perioperative-evaluation-of-patients-with-pulmonary-conditions-undergoing-non-cardiothoracic-surgery
#5
REVIEW
Gilda Diaz-Fuentes, Hafiz Rizwan Talib Hashmi, Sindhaghatta Venkatram
This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27837039/low-risk-for-local-and-systemic-complications-after-primary-repair-of-1626-achilles-tendon-ruptures
#6
Nicholas Rensing, Brian R Waterman, Rachel M Frank, Kenneth A Heida, Justin D Orr
INTRODUCTION: Historically, Achilles tendon repairs and other surgeries about the hindfoot have demonstrated a significantly higher rate of wound healing complications and surgical site morbidity. The purpose of this study was to evaluate the comprehensive complication profile and risk factors for adverse short-term, clinical outcomes after primary repair of Achilles tendon ruptures. METHODS: Between the years 2005 and 2014, all cases of primary Achilles tendon repair (Current Procedural Terminology code 27650) entered into the National Surgical Quality Improvement Project (NSQIP) database were extracted for analysis...
November 10, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27832003/development-of-a-model-of-pediatric-lung-failure-pathophysiology
#7
John M Trahanas, Fares Alghanem, Catalina Ceballos-Muriel, Hayley R Hoffman, Alice Xu, Kristopher B Deatrick, Marie Cornell, Alvaro Rojas-Pena, Robert H Bartlett, Ronald B Hirschl
A pediatric artificial lung (PAL) is under development as a bridge to transplantation or lung remodeling for children with end-stage lung failure (ESLF). In order to evaluate the efficiency of a PAL, a disease model mimicking the physiologic derangements of pediatric ESLF is needed. Our previous right pulmonary artery ligation (rPA-LM) ovine model achieved that goal, but caused immediate mortality in nearly half of the animals. In this study, we evaluated a new technique of gradual postoperative right pulmonary artery (rPA) occlusion using a Rummel tourniquet (rPA-RT) in seven (25-40 Kg) sheep...
November 9, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27826778/comparison-of-single-and-multi-incision-minimally-invasive-esophagectomy-mie-for-treating-esophageal-cancer-a-propensity-matched-study
#8
Jang-Ming Lee, Shang-Chi Chen, Shun-Mao Yang, Ying-Fan Tseng, Pei-Wen Yang, Pei-Ming Huang
OBJECTIVE: To compare the perioperative outcome of minimally invasive (MIE) esophagectomy performed with a single- or a multi-incision in treating esophageal cancer. METHOD: Patients with esophageal cancer who underwent MIE from 2006 to 2016 were evaluated. A 3-4-cm incision was created in both the thoracoscopic and the laparoscopic phases during the single-incision MIE procedures. A propensity-matched comparison was made between the two groups of patients. RESULTS: We analyzed a total of 48 pairs of patients with propensity-matched from the cohort of 360 patients undergoing MIE during 2006-2015...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27822378/changes-in-exercise-capacity-muscle-strength-and-health-related-quality-of-life-in-esophageal-cancer-patients-undergoing-esophagectomy
#9
Takayuki Inoue, Satoru Ito, Masahiko Ando, Motoki Nagaya, Hiromichi Aso, Yota Mizuno, Keiko Hattori, Hiroki Nakajima, Yoshihiro Nishida, Yukiko Niwa, Yasuhiro Kodera, Masahiko Koike, Yoshinori Hasegawa
BACKGROUND: Surgery for cancer of the thoracic esophagus is a challenging procedure associated with high morbidity and mortality. Perioperative rehabilitation has been introduced to promote early mobilization of the patients and to prevent postoperative pulmonary complications. The purpose of the present study was to characterize the preoperative functional exercise capacity, muscle strength, anxiety, depression, and health-related quality of life (QOL) in patients with esophageal cancer, and to evaluate the impact of radical esophagectomy on these parameters...
2016: BMC Sports Science, Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27816135/anesthesia-for-patients-with-concomitant-hepatic-and-pulmonary-dysfunction
#10
REVIEW
Geraldine C Diaz, Michael F O'Connor, John F Renz
Hepatic function and pulmonary function are interrelated with failure of one organ system affecting the other. With improved therapies, patients with concomitant hepatic and pulmonary failure increasingly enjoy a good quality of life and life expectancy. Therefore, the prevalence of such patients is increasing with more presenting for both emergent and elective surgical procedures. Hypoxemia requires a thorough evaluation in patients with end-stage liver disease. The most common etiologies respond to appropriate therapy...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27802921/impact-of-charlson-indices-and-comorbid-conditions-on-complication-risk-in-bilateral-simultaneous-total-knee-arthroplasty
#11
S K S Marya, Priyadarshi Amit, Chandeep Singh
BACKGROUND: The purpose of this study was to evaluate the influence of Charlson indices and comorbid conditions on the risk of perioperative complications in bilateral simultaneous total knee arthroplasty (BSTKA). METHODS: In our retrospective analysis, 556 patients including 133 males and 423 females (mean age 65.8years), who had undergone bilateral simultaneous total knee arthroplasty between 2011 and 2014 were included. Risk factors (Charlson comorbidity index (CCI), age-adjusted Charlson comorbidity index (ACCI), and comorbid illnesses) and perioperative complications were noted, and subsequently, statistical tests were applied...
October 29, 2016: Knee
https://www.readbyqxmd.com/read/27788201/meta-analysis-of-laparoscopic-versus-open-hepatectomy-for-live-liver-donors
#12
Jun Xu, Chen Hu, Hua-Li Cao, Mang-Li Zhang, Song Ye, Shu-Sen Zheng, Wei-Lin Wang
OBJECTIVE: To document the safety and efficacy of laparoscopic living donor hepatectomy in comparison with open liver resection for living donor liver transplantation. METHODS: Medline database, EMASE and Cochrane library were searched for original studies comparing laparoscopic living donor hepatectomy (LLDH) and open living donor hepatectomy (OLDH) by January 2015. Meta-analysis was performed to evaluate donors' perioperative outcomes. RESULTS: Nine studies met selection criteria, involving 1346 donors of whom 318 underwent LLDH and 1028 underwent OLDH...
2016: PloS One
https://www.readbyqxmd.com/read/27783014/practical-guidelines-for-venous-thromboembolism-prophylaxis-in-free-tissue-transfer
#13
Joseph A Ricci, Kayva Crawford, Olivia A Ho, Bernard T Lee, Ketan M Patel, Matthew L Iorio
BACKGROUND: Venous thromboembolism encompasses a spectrum of disease, ranging from asymptomatic deep vein thrombosis to fatal pulmonary embolism. As microsurgical techniques increase in complexity, the overriding benefit from a microsurgical versus a venous thromboembolism prophylactic regimen remains unclear. This study evaluated the current recommendations and procedure-specific strategies for venous thromboembolism prophylaxis with a focus on the utility of prophylaxis in microsurgical procedures...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27777435/a-phase-ii-clinical-trial-of-the-efficacy-and-safety-of-short-term-3-days-enoxaparin-for-the-prevention-of-venous-thromboembolism-after-gastric-cancer-surgery
#14
Shinji Kuroda, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Shiro Hinotsu, Toshiyoshi Fujiwara
Although intermittent pneumatic compression (IPC) has become common as perioperative prophylaxis for venous thromboembolism (VTE) consisting of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), the prophylactic effect against VTE, especially lethal PE, is not yet satisfactory. Therefore, pharmacologic prophylaxis, such as with enoxaparin, is desirable. While the efficacy and safety of enoxaparin have been proven in several clinical trials, concern about bleeding with longterm (at least 7 days) use have potentially decreased its widespread adoption...
October 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27776904/prevalence-of-venous-thromboembolic-events-is-low-in-asians-after-total-knee-arthroplasty-without-chemoprophylaxis
#15
Hamid Rahmatullah Bin Abd Razak, Noorul Faeyza Binte Abd Razak, Hwee-Chye Andrew Tan
BACKGROUND: This retrospective cohort study was designed to establish the prevalence of clinically significant venous thromboembolic events (VTE) in our patients undergoing total knee arthroplasty (TKA) without chemoprophylaxis. METHODS: A single-surgeon cohort of patients who underwent TKA from 2006 to 2014 were included. All patients had a pneumatic tourniquet applied and a drain inserted postoperatively. Tranexamic acid was not used perioperatively. All patients were under a standardized postoperative protocol with routine mechanical prophylaxis against VTE...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27776697/perioperative-and-long-term-impact-of-chronic-kidney-disease-on-carotid-artery-interventions
#16
Derek Klarin, Robert T Lancaster, Emel Ergul, Daniel Bertges, Philip Goodney, Marc L Schermerhorn, Richard P Cambria, Virendra I Patel
OBJECTIVE: Chronic kidney disease (CKD) increases morbidity and mortality after vascular procedures and adversely affects late survival of patients. The presence of CKD also confers increased risk of stroke in patients with asymptomatic carotid stenosis. Patients undergoing carotid intervention in the Vascular Study Group of New England database were stratified by CKD status referable to periprocedural and late outcomes. METHODS: All carotid artery stenting and carotid endarterectomies (CEAs) performed from 2003 to 2013 were stratified by CKD severity as mild (estimated glomerular filtration rate [eGFR] >60 mL/min/1...
November 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27771417/the-role-of-exhaled-nitric-oxide-in-patients-with-chronic-obstructive-pulmonary-disease-undergoing-laparotomy-surgery-the-noxious-study
#17
Helena Logotheti, Chryssa Pourzitaki, Georgia Tsaousi, Zoi Aidoni, Artemis Vekrakou, Amaniti Ekaterini, Konstantinos Gourgoulianis
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) has been associated with major perioperative morbidities or mortalities, especially in surgical patients receiving general anesthesia. The severity of the COPD and the degree of bronchial hyperreactivity can determine the perioperative anesthetic risk; therefore they have to be assessed by a thorough preoperative evaluation in order to give the rationale on which to decide for optimum anesthetic management. OBJECTIVE: Aim of the study was to assess the predictive applicability of exhaled Nitric Oxide (NO) in smoking surgical population with COPD, on the basis of morbidity and mortality...
October 19, 2016: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/27769228/quantifying-the-effect-of-complications-on-patient-flow-costs-and-surgical-throughputs
#18
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27765455/evaluating-the-effect-of-comorbidities-on%C3%A2-the-success-risk-and-cost-of-digital%C3%A2-replantation
#19
Joshua W Hustedt, Andrew Chung, Daniel D Bohl, Neil Olmscheid, Scott Edwards
PURPOSE: The clinical decision to replant an amputated digit is driven primarily by surgical indication. However, the extent to which patient comorbidity should play into this decision is less well defined. This study was designed to determine the effect of patient comorbidities on the success, risk, and cost of digital replantation. METHODS: All amputation injuries and digital replantation procedures captured by the National Inpatient Sample during 2001 to 2012 were identified...
October 17, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27760527/outcome-of-cardiac-surgery-in-patients-with-low-preoperative-ejection-fraction
#20
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
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