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pulmonary evaluation perioperative

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https://www.readbyqxmd.com/read/29151453/diastolic-dysfunction-is-a-risk-of-perioperative-myocardial-injury-assessed-by-high-sensitivity-cardiac-troponin-t-in-elderly-patients-undergoing-non-cardiac-surgery
#1
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29138974/medical-complications-and-mortality-in-octogenarians-undergoing-elective-spinal-fusion-surgeries
#2
Sharad Rajpal, E Lee Nelson, Alan T Villavicencio, Jayratna Telang, Roshan Kantha, Kara Beasley, Sigita Burneikiene
BACKGROUND: The consequences of suffering postoperative complications in elderly undergoing spinal surgeries may be different compared to younger patients. The primary objective of this study was to identify the types and frequency of medical complications and mortality rates in patients 80 years of age or older undergoing elective spinal fusion surgeries for degenerative spinal disease. METHODS: A prospective observational study with a retrospective chart review was performed, which included all consecutive patients ≥80 years old undergoing elective spinal fusion surgeries from May 2012 to August 2015...
November 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29138242/role-of-ecmo-in-congenital-diaphragmatic-hernia
#3
REVIEW
Merrill McHoney, Philip Hammond
Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology and low preductal saturations despite optimal ventilatory and inotropic support may be considered for extracorporeal membrane oxygenation (ECMO). Systematic reviews into the benefits of ECMO in CDH concluded that any benefit is unclear. Few randomised trials exist to demonstrate clear benefit and guide management...
November 14, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29136038/midterm-outcomes-of-single-port-thoracoscopic-surgery-for-major-pulmonary-resection
#4
Kook Nam Han, Hyun Koo Kim, Young Ho Choi
INTRODUCTION: Single-port thoracoscopic surgery has widened the current minimally invasive surgical techniques toward more less invasive procedures in terms of reducing the number of incisions. However, the current status of oncologic outcome with this technique is not well known for lung cancer surgery. The purpose of this study is to evaluate the oncologic outcomes in early stage lung cancer for impact of the survival outcomes with our experience of conversion to a single-port approach from the conventional three-port approach...
2017: PloS One
https://www.readbyqxmd.com/read/29121664/does-preoperative-mechanical-prophylaxis-have-additional-effectiveness-in-preventing-postoperative-venous-thromboembolism-in-elderly-patients-with-hip-fracture-retrospective-case-control-study
#5
Ji-Hoon Nam, Dae-Hwan Kim, Je-Hyun Yoo, Ji-Hyo Hwang, Jun-Dong Chang
BACKGROUND: Elderly patients undergoing hip fracture surgery (HFS) are at increased risk of postoperative venous thromboembolism (VTE). To reduce this risk, combined postoperative mechanical and chemical thromboprophylaxis has been routinely performed after HFS in these patients. This retrospective case-control study was conducted to evaluate the additional effectiveness of preoperative mechanical thromboprophylaxis for the prevention of VTE following HFS in elderly patients. METHODS: Of 539 consecutive patients aged 70 years or older undergoing HFS, 404 (control group) did not receive preoperative mechanical thromboprophylaxis, while 135 (study group) received mechanical thromboprophylaxis using an intermittent pneumatic compression device and graduated compression stockings from the time of admission until surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29093790/perioperative-evaluation-of-respiratory-muscle-strength-after-scoliosis-correction-in-patients-with-duchenne-muscular-dystrophy
#6
Wataru Saito, Kosuke Mizuno, Gen Inoue, Takayuki Imura, Toshiyuki Nakazawa, Masayuki Miyagi, Eiki Shirasawa, Kentaro Uchida, Masashi Takaso
Study Design: Retrospective cohort study. Purpose: To investigate the effect of spinal correction on respiratory muscle strength in patients with Duchenne muscular dystrophy (DMD). Overview of Literature: Several studies have reported that scoliosis correction in patients with DMD does not improve pulmonary function. In these studies, pulmonary function was evaluated using the traditional spirometric values of percent vital capacity (%VC) and percent forced vital capacity (%FVC)...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#7
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29067747/effects-of-carbon-monoxide-on-early-dysfunction-and-microangiopathy-following-galt-ko-porcine-pulmonary-xenotransplantation-in-cynomolgus-monkeys
#8
Hisashi Sahara, Mitsuhiro Sekijima, Yuichi Ariyoshi, Akihiro Kawai, Kohei Miura, Shiori Waki, Louras Nathan, Yusuke Tomita, Takehiro Iwanaga, Kazuaki Nakano, Hitomi Matsunari, Hiroshi Date, Hiroshi Nagashima, Akira Shimizu, Kazuhiko Yamada
BACKGROUND: Despite progress in the current genetic manipulation of donor pigs, most non-human primates were lost within a day of receiving porcine lung transplants. We previously reported that carbon monoxide (CO) treatment improved pulmonary function in an allogeneic lung transplant (LTx) model using miniature swine. In this study, we evaluated whether the perioperative treatment with low-dose inhalation of CO has beneficial effects on porcine lung xenografts in cynomolgus monkeys (cynos)...
October 25, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/29061024/-comparison-of-laparoscopic-distal-pancreatectomy-and-open-distal-pancreatectomy-in-pancreatic-ductal-adenocarcinoma
#9
K Xu, J J Su, M Su, L Yan, J Feng, X L Xin, Y L Chen
Objective: To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma. Methods: The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed. Results: The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226...
October 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29053070/relationship-between-patient-safety-indicator-events-and-comprehensive-stroke-center-volume-status-in-the-treatment-of-unruptured-cerebral-aneurysms
#10
Chad W Washington, L Ian Taylor, Robert J Dambrino, Paul R Clark, Gregory J Zipfel
OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification. METHODS Using the 2002-2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29049780/video-assisted-thoracic-surgery-is-associated-with-better-short-term-outcomes-than-open-thoracotomy-in-adult-patients-with-intralobar-pulmonary-sequestration
#11
Qiuyuan Li, Dong Xie, Alan Sihoe, Jie Dai, Haifeng Wang, Diego Gonzalez-Rivas, Yuming Zhu, Gening Jiang
OBJECTIVES: This study was aimed to investigate potential benefits of thoracoscopic surgery for intralobar pulmonary sequestration in adult patients in terms of short-term surgical outcomes when compared with open surgery. METHODS: Data of 110 consecutive adult patients undergoing thoracoscopic surgery or open surgery for intralobar sequestration from January 2000 to December 2015 at our institution were reviewed. A total of 42 video-assisted thoracic surgery cases and 68 open surgery cases were identified...
September 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049745/clinical-presentation-and-surgical-treatment-of-primary-pulmonary-artery-sarcoma
#12
Long Deng, Jiade Zhu, Jianping Xu, Shaoxian Guo, Sheng Liu, Yunhu Song
OBJECTIVES: Pulmonary artery sarcoma (PAS) is a rare and devastating disease. The diagnosis modality and optimal surgical strategy remain unclear. The aim of this study was to report our surgical experience in this disease. METHODS: Between 2000 and 2017, 13 patients underwent operations for PAS at our institution. Five patients underwent tumour resection alone, whereas the other 8 patients received pulmonary endarterectomy. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings and the postoperative outcomes...
September 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049708/two-staged-hybrid-ablation-of-non-paroxysmal-atrial-fibrillation-clinical-outcomes-and-functional-improvements-after-1%C3%A2-year
#13
Petr Budera, Pavel Osmancik, David Talavera, Anna Kraupnerova, Richard Fojt, Jana Zdarska, Tomas Vanek, Zbynek Straka
OBJECTIVES: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy; however, data regarding its efficacy and safety are still limited. METHODS: Patients with non-paroxysmal AF were enrolled. First, a thoracoscopic, epicardial isolation of pulmonary veins and the left atrial posterior wall ('box lesion') was performed; a novel unipolar/bipolar radiofrequency device was used. Moreover, in 12 patients enrolled thereafter, the left atrial appendage was occluded...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28985025/multidisciplinary-approach-to-cardiac-and-pulmonary-vascular-disease-risk-assessment-in-liver-transplantation-an-evaluation-of-the-evidence-and-consensus-recommendations
#14
Lisa B VanWagner, Matthew E Harinstein, James R Runo, Christopher Darling, Marina Serper, Shelley Hall, Jon A Kobashigawa, Laura L Hammel
Liver transplant (LT) candidates today are older, have greater medical severity of illness, and have more cardiovascular comorbidities than ever before. In addition, there are specific cardiovascular responses in cirrhosis that can be detrimental to the LT candidate. Cirrhotic cardiomyopathy, a condition characterized by increased cardiac output and a reduced ventricular response to stress, is present in up to 30% of patients with cirrhosis thus challenging perioperative management. Current noninvasive tests that assess for subclinical coronary and myocardial disease have low sensitivity, and altered hemodynamics during the LT surgery can unmask latent cardiovascular disease either intraoperatively or in the immediate postoperative period...
October 6, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28971029/comparison-of-pulmonary-artery-catheter-echocardiography-and-arterial-waveform-analysis-monitoring-in-predicting-the-hemodynamic-state-during-and-after-cardiac-surgery
#15
Paul Power, Allison Bone, Nicholas Simpson, Cheng-Hon Yap, Simon Gower, Michael Bailey
OBJECTIVE: The aim of this trial was to determine whether Flotrac Vigileo™ (FV™) provides a reliable representation of the hemodynamic state of a cardiac surgical patient population when compared to pulmonary artery catheter (PAC) and echocardiography in the peril-operative period. DESIGN: This was a prospective observational trial comparing perioperative hemodynamic states using transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), FV™ and PAC during and post cardiothoracic surgery...
July 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28936993/coarctation-of-the-aorta-with-aortic-arch-hypoplasia-midterm-outcomes-of-aortic-arch-reconstruction-with-autologous-pulmonary-artery-patch
#16
Zhi-Ling Ma, Jun Yan, Shou-Jun Li, Zhong-Dong Hua, Fu-Xia Yan, Xu Wang, Qiang Wang
BACKGROUND: Coarctation of the aorta (CoA) with aortic arch hypoplasia (AAH) is a relatively common congenital heart disease in clinical practice. Nonetheless, the corrective surgical technique for infants and children is a clinical problem that remains controversial. In this study, we sought to evaluate the surgical effects of aortic arch (AA) reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch for infants and young children with CoA and AAH...
September 21, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28882352/adult-spinal-deformity-national-trends-in-the-presentation-treatment-and-perioperative-outcomes-from-2003-to-2010
#17
Peter G Passias, Cyrus M Jalai, Nancy Worley, Shaleen Vira, Bryan Marascalchi, Shearwood McClelland, Virginie Lafage, Thomas J Errico
STUDY DESIGN: Retrospective review of a prospective database. OBJECTIVES: To investigate adult spinal deformity (ASD) surgery outcome trends on a nationwide scale using the Nationwide Inpatient Sample (NIS) from 2003 to 2010. METHODS: ASD patients ≥25 years from 2003 to 2010 in the NIS undergoing anterior, posterior, or combined surgical approaches were included. Fractures, 9+ levels fused, or any cancer were excluded. Patient demographics, hospital data, and procedure-related complications were evaluated...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28859919/nationwide-analysis-of-adrenocortical-carcinoma-reveals-higher-perioperative-morbidity-in-functional-tumors
#18
Punam P Parikh, Gustavo A Rubio, Josefina C Farra, John I Lew
BACKGROUND: Current adrenalectomy outcomes for functional adrenocortical carcinoma (ACC) remain unclear. This study examines nationwide in-hospital post-adrenalectomy outcomes for ACC. METHODS: A retrospective analysis of the Nationwide Inpatient Sample database (2006-2011) to identify unilateral adrenalectomy patients for functional or nonfunctional ACC was performed. Patient demographics, comorbidities and postoperative outcomes were evaluated by t-test, Chi-square and multivariate regression...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28852473/evaluation-of-operating-room-reverse-trendelenburg-positioning-and-its-effect-on-postoperative-hypoxemia-aspiration-and-length-of-stay-a-retrospective-study-of-consecutive-patients
#19
C Michael Dunham, Barbara M Hileman, Amy E Hutchinson, Tamara Antonaccio, Elisha A Chance, Gregory S Huang, Gregory Szmaj, Kristen Calabro, Cynthia Bishop, Tyson T Schrickel
BACKGROUND: In 2014, this group published an investigation of surgical patients from 2012 who had substantial rates of postoperative hypoxemia (POH) and perioperative pulmonary aspiration (POPA). Therefore, we investigated whether intraoperative reverse Trendelenburg positioning (RTP) decreases POH and POPA rates. METHODS: Consecutive ASA I-IV surgical patients who had preoperative pulmonary stability requiring general anesthesia with endotracheal intubation were evaluated...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28817978/transcutaneous-electrical-nerve-stimulation-tens-as-an-adjunct-for-pain-management-in-perioperative-settings-a-critical-review
#20
Mark I Johnson
Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settings...
August 24, 2017: Expert Review of Neurotherapeutics
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