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pulmonary evaluation perioperative

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https://www.readbyqxmd.com/read/29778818/the-fate-of-the-tricuspid-valve-following-the-transatrial-closure-of-the-ventricular-septal-defect
#1
Raffaele Giordano, Massimiliano Cantinotti, Luigi Di Tommaso, Giuseppe Comentale, Andrea Tozzi, Emanuele Pilato, Gabriele Iannelli, Gaetano Palma
BACKGROUND: The transatrial repair of the ventricular septal defect (VSD) requires an adequate exposure of its rim. We retrospectively evaluated the impact of adopting the tricuspid valve incision (TVI) technique, either with detachment or radial incision, on the postoperative outcome of children undergoing surgical VSD repair. METHODS: From January 2008 to September 2017 we retrospectively enrolled 141 patients, divided into two groups: 97 patients were subjected to TVI (68...
May 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29756496/bilateral-total-hip-arthroplasty-one-stage-versus-two-stage-procedure
#2
Afshin Taheriazam, Gholamreza Mohseni, Ali A Esmailiejah, Farshad Safdari, Hashem Abrishamkarzadeh
BACKGROUND: Despite several studies, controversy has prevailed over the rate of complications following 1-stage and 2-stage bilateral total hip arthroplasty (THA). In the current study, we compare the complications and functional outcomes of 1-stage and 2-stage procedures. METHODS: One hundred and eighty patients (ASA class I or II) with bilateral hip osteoarthritis were assigned randomly to two equal groups. The two groups were matched in terms of age and sex. All of the surgeries were performed via the Hardinge approach using uncemented implants...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29750691/propensity-score-methods-theory-and-practice-for-anesthesia-research
#3
Phillip J Schulte, Edward J Mascha
Observational data are often readily available or less costly to obtain than conducting a randomized controlled trial. With observational data, investigators may statistically evaluate the relationship between a treatment or therapy and outcomes. However, inherent in observational data is the potential for confounding arising from the nonrandom assignment of treatment. In this statistical grand rounds, we describe the use of propensity score methods (ie, using the probability of receiving treatment given covariates) to reduce bias due to measured confounders in anesthesia and perioperative medicine research...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29749884/perioperative-complications-and-risk-factors-in-neuromuscular-scoliosis-surgery
#4
Brandon J Toll, Amer F Samdani, M Burhan Janjua, Shashank Gandhi, Joshua M Pahys, Steven W Hwang
OBJECTIVE High rates of perioperative complications are associated with deformity correction in neuromuscular scoliosis. The current study aimed to evaluate complications associated with surgical correction of neuromuscular scoliosis and to characterize potential risk factors. METHODS Data were retrospectively collected from a single-center cohort of 102 consecutive patients who underwent spinal fusions for neuromuscular scoliosis between January 2008 and December 2016 and who had a minimum of 6 months of follow-up...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29710128/association-of-timing-of-aortic-valve-replacement-surgery-after-stroke-with-risk-of-recurrent-stroke-and-mortality
#5
Charlotte Andreasen, Mads Emil Jørgensen, Gunnar H Gislason, Andreas Martinsson, Robert D Sanders, Jawdat Abdulla, Per Føge Jensen, Christian Torp-Pedersen, Lars Køber, Charlotte Andersson
Importance: Timing of surgical aortic valve replacement (SAVR) in patients with aortic valve stenosis and previous stroke for the risk of recurrent stroke is insufficiently investigated. Objective: To evaluate the association of time elapsed between previous stroke and SAVR with the risk of recurrent perioperative stroke, major adverse cardiovascular events (MACE), and mortality among patients with aortic valve stenosis. Design, Setting, and Participants: This cohort study using data from Danish administrative registries included all patients with aortic valve stenosis older than 18 years who underwent SAVR between 1996 and 2014 (n = 14 030)...
April 25, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29707308/the-clinical-value-of-circulating-tumour-cells-ctcs-in-patients-undergoing-pulmonary-metastasectomy-for-metastatic-colorectal-cancer
#6
Masaki Hashimoto, Fumihiro Tanaka, Kazue Yoneda, Teruhisa Takuwa, Ayumi Kuroda, Seiji Matsumoto, Yoshitomo Okumura, Nobuyuki Kondo, Tohru Tsujimura, Takashi Nakano, Seiki Hasegawa
Background: Circulating tumour cells (CTCs) are a potential surrogate for distant metastasis and are considered a useful clinical prognostic marker for metastatic colorectal cancer (mCRC). This prospective study evaluated the preoperative CTC count as a prognostic factor for pulmonary metastasectomy in mCRC patients. Methods: Seventy-nine mCRC patients who underwent curative-intent pulmonary metastasectomy were included. Preoperatively, 7.5 mL of peripheral blood from each patient was quantitatively evaluated for CTCs with the CellSearch® system...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29702994/a-case-report-regarding-general-anesthesia-management-of-a-patient-with-pulmonary-vein-stenosis-that-underwent-balloon-dilatation-and-stent-implantation
#7
Fangzhou Li, Guoyan Qiao, Peng Liang, Jin Liu
RATIONALE: Pulmonary vein stenosis (PVS) is a rare cardiovascular deformity that can lead to high mortality if left untreated. Patients frequently experience multiple complications such as hemoptysis, pulmonary hypertension, bronchial venous rupture and cardiac insufficiency. Currently, pulmonary vein stenosis balloon dilatation (stent implantation) is the only treatment, and this can be performed under local or general anesthesia. However, a case report on the general anesthesia management of PVS has not been previously reported...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29699825/chronic-obstructive-pulmonary-disease-is-associated-with-short-term-complications-following-total-knee-arthroplasty
#8
George A Yakubek, Gannon L Curtis, Anton Khlopas, Mhamad Faour, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major global health issue and a leading cause of morbidity and mortality. Patients with COPD are at increased risk of complications following surgery. The purpose of this study is to evaluate the postoperative total knee arthroplasty (TKA) outcomes in these patients in comparison to a non-COPD matching cohort. Specifically, we asked the following questions: (1) "Is COPD associated with adverse perioperative outcomes?" and (2) "Does COPD increase the risk of short-term complications following TKA?" METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 111,168 patients who underwent TKA between 2008 and 2014...
March 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29694446/clinical-biochemical-and-genetic-risk-factors-for-30-day-and-5-year-mortality-in-518-adult-patients-subjected-to-cardiopulmonary-bypass-during-cardiac-surgery-the-inflacor-study
#9
Maciej Michał Kowalik, Romuald Lango, Piotr Siondalski, Magdalena Chmara, Maciej Brzeziński, Krzysztof Lewandowski, Dariusz Jagielak, Andrzej Klapkowski, Jan Rogowski
There is increasing evidence that genetic variability influences patients' early morbidity after cardiac surgery performed using cardiopulmonary bypass (CPB). The use of mortality as an outcome measure in cardiac surgical genetic association studies is rare. We publish the 30-day and 5-year survival analyses with focus on pre-, intra-, postoperative variables, biochemical parameters, and genetic variants in the INFLACOR (INFLAmmation in Cardiac OpeRations) cohort. In a prospectively recruited cohort of 518 adult Polish Caucasians, who underwent cardiac surgery in which CPB was used, the clinical data, biochemical parameters, IL-6, soluble ICAM-1, TNFα, soluble E-selectin, and 10 single nucleotide polymorphisms were evaluated for their association with 30-day and 5-year mortality...
April 25, 2018: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/29663179/the-impact-of-obesity-on-pulmonary-deterioration-in-patients-undergoing-robotic-assisted-laparoscopic-prostatectomy
#10
Sebastian Blecha, Marion Harth, Florian Zeman, Timo Seyfried, Matthias Lubnow, Maximilian Burger, Stefan Denzinger, Michael T Pawlik
Obesity affects respiratory and hemodynamic function in anesthetized patients. The aim of this study was to evaluate the influence of the body mass index (BMI) on pulmonary changes in a permanent 45° steep Trendelenburg position (STP) during robotic-assisted laparoscopic prostatectomy (RALP). 51 patients undergoing RALP under standardized anesthesia were included. Perioperative pulmonary function and oxygenation were measured in awake patients (T0 ), 20 min after the induction of anesthesia (T1 ), after insufflation of the abdomen in supine position (T2 ), after 30 min in STP (T3 ), when controlling Santorini's plexus in STP (T4 ), before awakening while supine (T5 ), and after 45 min in the recovery room (T6 )...
April 16, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29656329/comparison-of-perioperative-and-oncological-outcome-of-thoracoscopic-esophagectomy-in-left-decubitus-position-and-in-prone-position-for-esophageal-cancer
#11
Shirou Kuwabara, Kazuaki Kobayashi, Akira Kubota, Ikuma Shioi, Kenji Yamaguchi, Norio Katayanagi
PURPOSE: The aim of this study was to clarify the differences between thoracoscopic esophagectomy in the left decubitus position (LP) and in the prone position (PP) in terms of short-term perioperative outcomes and long-term oncological outcomes after more than 5 years of follow-up. METHODS: Patients with esophageal cancer who underwent thoracoscopic esophagectomy and were followed up for more than 5 years were analyzed retrospectively. Of 142 patients, 72 underwent LP esophagectomy and 70 underwent PP esophagectomy...
April 15, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29624530/diagnostic-accuracy-of-point-of-care-gastric-ultrasound
#12
Richelle Kruisselbrink, Angineh Gharapetian, Luis E Chaparro, Noam Ami, Dustin Richler, Vincent W S Chan, Anahi Perlas
BACKGROUND: Pulmonary aspiration of gastric contents is associated with significant perioperative morbidity and mortality. Previous studies have investigated the validity, reliability, and possible clinical impact of gastric ultrasound for the assessment of gastric content at the bedside. In the present study, we examined the accuracy (evaluated as sensitivity, specificity, and likelihood ratios) of point-of-care gastric ultrasound to detect a "full stomach" in a simulated scenario of clinical equipoise...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29601378/is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#13
Vimal Desai, Priscilla H Chan, Heather A Prentice, Gary L Zohman, Glenn R Diekmann, Gregory B Maletis, Brian H Fasig, Diana Diaz, Elena Chung, Chunyuan Qiu
BACKGROUND: Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. QUESTIONS/PURPOSES: (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? METHODS: We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29600060/positive-correlation-between-postoperative-tumor-recurrence-and-changes-in-circulating-tumor-cell-counts-in-pulmonary-venous-blood-pvctc-during-surgical-manipulation-in-non-small-cell-lung-cancer
#14
Masaki Hashimoto, Fumihiro Tanaka, Kazue Yoneda, Teruhisa Takuwa, Seiji Matsumoto, Yoshitomo Okumura, Nobuyuki Kondo, Tohru Tsujimura, Takashi Nakano, Seiki Hasegawa
Background: In non-small cell lung cancer (NSCLC), circulating tumor cells (CTC) are shed and circulate to the peripheral blood through the pulmonary vein. Previously, CTC count in pulmonary venous blood (pvCTC) was shown to significantly increase after surgical manipulation. Therefore, we assessed the correlation between the changes in the pvCTC count (ΔpvCTC) and clinical outcomes. Methods: Consecutive patients with peripheral-type, NSCLC, who underwent lobectomy or bi-lobectomy through open thoracotomy, were enrolled prospectively...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29594164/upper-gastrointestinal-surgery-robotic-surgery-versus-laparoscopic-procedures-for-esophageal-malignancy
#15
REVIEW
Matthias Biebl, Andreas Andreou, Sascha Chopra, Christian Denecke, Johann Pratschke
Background: The evolution of minimally invasive surgery (MIS) also extends to the field of esophageal surgery and has brought forth the development of several approaches of minimally invasive esophagectomy (MIE). Hybrid and total minimally invasive operative techniques have proven beneficial compared to open surgery and are currently evaluated against robotic-assisted minimally invasive esophagectomy (RAMIE). We aim to review the current literature regarding the position of MIE versus RAMIE...
February 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29560351/cardiac-output-monitoring-by-pulse-contour-analysis-the-technical-basics-of-less-invasive-techniques
#16
REVIEW
Jörn Grensemann
Routine use of cardiac output (CO) monitoring became available with the introduction of the pulmonary artery catheter into clinical practice. Since then, several systems have been developed that allow for a less-invasive CO monitoring. The so-called "non-calibrated pulse contour systems" (PCS) estimate CO based on pulse contour analysis of the arterial waveform, as determined by means of an arterial catheter without additional calibration. The transformation of the arterial waveform signal as a pressure measurement to a CO as a volume per time parameter requires a concise knowledge of the dynamic characteristics of the arterial vasculature...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29552434/focused-review-of-perioperative-care-of-patients-with-pulmonary-hypertension-and-proposal-of-a-perioperative-pathway
#17
REVIEW
Jochen Steppan, Natalia Diaz-Rodriguez, Viachaslau M Barodka, Daniel Nyhan, Erica Pullins, Traci Housten, Rachel L Damico, Stephen C Mathai, Paul M Hassoun, Dan E Berkowitz, Bryan G Maxwell, Todd M Kolb
Morbidity and mortality risk increase considerably for patients with pulmonary hypertension (PH) undergoing non-cardiac surgery. Unfortunately, there are no comprehensive, evidence-based guidelines for perioperative evaluation and management of these patients. We present a brief review of the literature on perioperative outcomes for patients with PH and describe the implementation of a collaborative perioperative management program for these high-risk patients at a tertiary academic center.
January 15, 2018: Curēus
https://www.readbyqxmd.com/read/29545513/intraoperative-acute-respiratory-failure-in-an-immunocompromised-patient-with-human-metapneumovirus
#18
Justin S Merkow, Erik J Nelson
BACKGROUND Providing anesthesia to immunocompromised patients introduces unique challenges, including difficulty in detecting respiratory infections. Detailed preoperative evaluation and preparation for perioperative complications is crucial. Human metapneumovirus is a common but lesser known respiratory virus that can lead to pneumonia and respiratory compromise and is challenging to detect in the immunocompromised patient. CASE REPORT We present a case of an immunocompromised individual scheduled for umbilical hernia repair who developed severe bronchospasm and intraoperative respiratory failure after induction of general anesthesia...
March 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29542058/feasibility-of-surgery-for-pulmonary-aspergilloma-analysis-of-the-operative-modes
#19
Kazuyuki Komori, Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
PURPOSE: We evaluated the feasibility of surgery for pulmonary aspergilloma. METHODS: We retrospectively evaluated 35 surgical patients with pulmonary aspergilloma. The clinical characteristics and perioperative surgical morbidity were compared based on the operative modes. Preoperative artery embolization (PAE) was selectively performed to reduce the expected surgical stress caused by intraoperative blood loss. RESULTS: The cohort comprised 19 males and 16 females with a mean age of 56 years...
May 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29535528/effects-of-degree-of-pulmonary-fissure-completeness-on-major-in-hospital-outcomes-after-video-assisted-thoracoscopic-lung-cancer-lobectomy-a-retrospective-cohort-study
#20
Shuangjiang Li, Zhiqiang Wang, Kun Zhou, Yan Wang, Yanming Wu, Pengfei Li, Guowei Che
Background: To evaluate the clinical significance of degree of pulmonary fissure completeness (PFC) on major in-hospital outcomes following video-assisted thoracoscopic (VATS) lobectomy for non-small-cell lung cancer (NSCLC). Materials and methods: We carried out a single-center retrospective analysis on the prospectively maintained database at our unit between August 2014 and October 2015. Patients were divided into two groups based on their fissure sum average (FSA)...
2018: Therapeutics and Clinical Risk Management
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