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https://www.readbyqxmd.com/read/28093641/dwell-times-and-risk-of-non-elective-removal-of-1-french-peripherally-inserted-central-catheters-according-to-catheter-tip-position-in-very-preterm-infants
#1
Daniela M Erhard, Sarah Nguyen, Katelyn J Guy, Dan M Casalaz, Kai König
: We investigated dwell times and risk of non-elective removal of 975 single-lumen 1-French peripherally inserted central catheters (1FR-PICC) according to tip position in a cohort of very preterm infants with a mean (SD) gestational age of 27(+6) (2(+1)) weeks and a mean (SD) birth weight of 988 (294) g over an eight-year period. Infants with a 1FR-PICC inserted for continuous infusion of intravenous fluids within the first 30 days of life were eligible. Dwell times of PICC with elective versus non-elective removal, risk of non-elective removal of PICC according to tip position, and differences between upper versus lower limb catheter insertion were analysed...
January 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28079778/association-of-intended-route-of-delivery-and-maternal-morbidity-in-twin-pregnancy
#2
Sarah Rae Easter, Julian N Robinson, Ellice Lieberman, Daniela Carusi
OBJECTIVE: To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. METHODS: We assembled a 7-year retrospective cohort (2007-2014) of women delivering viable, vertex-presenting twins beyond 32 weeks of gestation without contraindication to labor or uterine scar. We classified women as undergoing a trial of labor to attempt vaginal birth or choosing an elective cesarean delivery. Our primary outcome was a measure of composite maternal morbidity including death, postpartum hemorrhage, infection, major procedure, readmission for infection or reoperation, need for dilation and evacuation for hemorrhage or infection, venous thromboembolism, small bowel obstruction or ileus, or intensive care unit admission...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28078858/use-of-lactated-ringer%C3%A2-s-solution-does-not-eliminate-the-risk-of-strong-ion-difference-related-metabolic-acidosis-following-on-pump-cardiac-surgery
#3
T Jovaisa, V Vicka, G Linkaitė, J Guseinovaitė, D Ringaitienė, I Norkienė
There is a growing interest in the effects of plasma sodium levels on postoperative outcomes. A trend of using balanced crystalloid solutions is based on the extensive data on chloride and the strong ion difference-related acidosis. However, effects of sodium are often overlooked in this context. The aim of the study was to establish the effects of the routine use of Lactated Ringer’s Solution (RL) on postoperative changes in sodium concentrations and whether these changes result in metabolic acidosis. We performed database analysis of 358 consecutive elective on-pump cardiac surgery cases in a tertiary referral university hospital...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28074799/basic-arterial-blood-gas-biomarkers-as-a-predictor-of-mortality-in-tetralogy-of-fallot-patients
#4
Vandana Bhardwaj, Poonam Malhotra Kapoor, Kalpana Irpachi, Suruchi Ladha, Ujjwal Kumar Chowdhury
BACKGROUND: Serum lactate and base deficit have been shown to be a predictor of morbidity and mortality in critically ill patients. Poor preoperative oxygenation appears to be one of the significant factors that affects early mortality in tetralogy of Fallot (TOF). There is little published literature evaluating the utility of serum lactate, base excess (BE), and oxygen partial pressure (PO 2 ) as simple, widely available, prognostic markers in patients undergoing surgical repair of TOF...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28069013/decreased-physical-activity-is-a-predictor-for-a-complicated-recovery-post-cardiac-surgery
#5
Charlotte van Laar, Simone T TImman, Luc Noyez
BACKGROUND: Physical activity (PA) reduces the risk of cardiovascular disease and physically active survivors of a cardiac event are at lower risk of recurrent events. We hypothesized that patients with a decreased PA, undergoing cardiac surgery, are at higher risk for a postoperative complicated recovery (PCR). METHODS: Three thousand three hundred eighty two patients undergoing elective cardiac surgery between January 2007 and December 2013 were included. The group was divided into three subgroups: group A, aged ≤ 65 years (N = 1329); group B, aged > 65 years and ≤ 75 years (N = 1250); and group C aged >75 years (N = 803)...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28066980/how-spain-reached-40-deceased-organ-donors-per-million-population
#6
REVIEW
R Matesanz, B Domínguez-Gil, E Coll, B Mahíllo, R Marazuela
With 40 donors and more than 100 transplant procedures per million population in 2015, Spain holds a privileged position worldwide in providing transplant services to its patient population. The Spanish success derives from a specific organizational approach to ensure the systematic identification of opportunities for organ donation and their transition to actual donation and to promote public support for the donation of organs after death. The Spanish results are to be highlighted in the context of the dramatic decline in the incidence of brain death and the changes in end-of-life care practices in the country since the beginning of the century...
January 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#7
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28005944/ventricular-dysfunction-in-patients-with-acute-coronary-syndrome-undergoing-coronary-surgical-revascularization-prognostic-impact-on-long-term-outcomes
#8
Batric Popovic, Nelly Agrinier, Damien Voilliot, Mazen Elfarra, Jean Pierre Villemot, Pablo Maureira
BACKGROUND: Patients with non-ST elevation acute coronary syndrome complicated by left ventricular dysfunction (LVEF) are a poor prognosis group. The aim of our study was to assess the short and long term LEVF prognostic value in a cohort of NSTE-ACS patients undergoing surgical revascularization. METHODS: We performed elective and isolated CABG on a cohort of 206 consecutive patients with LVEF≤0.40 complicating acute coronary syndrome. The case cohort was compared with a cohort of controls (LVEF>0...
2016: PloS One
https://www.readbyqxmd.com/read/27965298/right-ventricular-outflow-tract-stenting-in-tetralogy-of-fallot-infants-with-risk-factors-for-early-primary-repair
#9
Juan Pablo Sandoval, Rajiv R Chaturvedi, Lee Benson, Gareth Morgan, Glen Van Arsdell, Osami Honjo, Christopher Caldarone, Kyong-Jin Lee
BACKGROUND: Tetralogy of Fallot with cyanosis requiring surgical repair in early infancy reflects poor anatomy and is associated with more clinical instability and longer hospitalization than those who can be electively repaired later. We bridged symptomatic infants with risk factors for early primary repair by right ventricular outflow tract stenting (stent). METHODS AND RESULTS: Four groups of tetralogy of Fallot with confluent central pulmonary arteries were studied: stent group (n=42), primary repair (aged <3 months) with pulmonary stenosis (early-PS group; n=44), primary repair (aged <3 months) with pulmonary atresia (early-PA group; n=49), and primary repair between 3 and 11 months of age (surg>3mo group; n=45)...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27932571/esmolol-before-cardioplegia-and-as-cardioplegia-adjuvant-reduces-cardiac-troponin-release-after-cardiac-surgery-a-randomized-trial
#10
Elena Bignami, Marcello Guarnieri, Annalisa Franco, Chiara Gerli, Monica De Luca, Fabrizio Monaco, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero...
December 8, 2016: Perfusion
https://www.readbyqxmd.com/read/27926655/maternal-morbidity-after-previable-prelabor-rupture-of-membranes
#11
Sarah K Dotters-Katz, Alexis Panzer, Matthew R Grace, Marcela C Smid, J Adeolu Keku, Catherine J Vladutiu, Kim A Boggess, Tracy A Manuck
OBJECTIVE: To identify risk factors for maternal morbidity after previable prelabor rupture of membranes (PROM). METHODS: We conducted a case-control study of singleton and twin pregnancies complicated by previable PROM (14.0-22.9 weeks of gestation) at a single tertiary care referral institution, 2000-2015. Pregnancies complicated by fetal anomalies, previable PROM within 2 weeks of chorionic villus sampling or amniocentesis, and those with contraindications to expectant management (eg, chorioamnionitis) were excluded...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#12
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27895441/a-retrospective-analysis-of-postoperative-patients-admitted-to-the-intensive-care-unit
#13
S Uzman, Y Yilmaz, M Toptas, I Akkoc, Y G Gul, H Daskaya, Y Toptas
BACKGROUND: The aim of this retrospective study was to evaluate postoperative patients admitted to the intensive care unit (ICU) and to describe their characteristics and outcomes. METHODS: We performed a retrospective chart review of 1,756 postoperative patients admitted to the ICU of a tertiary referral hospital from January 2008 to December 2012. For each patient we recorded: demographic data, reason for admission to the ICU, duration of mechanical ventilation, elective versus emergency surgery, type of anaesthesia, American Society of Anesthesiologists (ASA) physical status, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow Coma Score (GCS), and outcome...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27892784/management-and-outcome-challenges-in-newborns-with-gastroschisis-a-6-year-retrospective-french-study
#14
Barthelemy Tosello, Meriem Zahed, Floriane Guimond, Karine Baumstarck, Alice Faure, Fabrice Michel, Olivier Claris, Catherine Gire, Isabelle Berakdar, Jerome Massardier, Claude D'Ercole, Thierry Merrot
OBJECTIVE: To identify the gestational age (GA) at which risk of mortality and severe outcome was minimized comparing preterm delivery and expectant management. METHODS: Retrospective study performed between 2009 and 2014 of newborns with gastroschisis in three large French level III neonatal intensive care units. Each department followed two distinct strategies: elective delivery at 35 weeks' GA and a delayed approach. RESULTS: We included 69 gastroschisis cases...
December 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27884486/epidemiologic-analysis-prophylaxis-and-multidrug-resistance-in-surgery
#15
H Solís-Téllez, E E Mondragón-Pinzón, M Ramírez-Marino, F R Espinoza-López, F Domínguez-Sosa, J F Rubio-Suarez, R D Romero-Morelos
BACKGROUND: Surgical site infection is defined as an infection related to the surgical procedure in the area of manipulation occurring within the first 30 postoperative days. The diagnostic criteria include: purulent drainage, isolation of microorganisms, and signs of infection. AIMS: To describe the epidemiologic characteristics and differences among the types of prophylactic regimens associated with hospital-acquired infections at the general surgery service of a tertiary care hospital...
November 21, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27878573/prognostic-value-of-procalcitonin-in-patients-after-elective-cardiac-surgery-a-prospective-cohort-study
#16
Matthias Klingele, Hagen Bomberg, Simone Schuster, Hans-Joachim Schäfers, Heinrich Volker Groesdonk
BACKGROUND: Procalcitonin (PCT) is a well-known prognostic marker after elective cardiac surgery. However, the impact of elevated PCT in patients with an initially uneventful postoperative course is still unclear. The aim of this study was to evaluate PCT levels as a prognostic tool for delayed complications after elective cardiac surgery. METHODS: A prospective study was performed in 751 patients with an apparently uneventful postoperative course within the first 24 h after elective cardiac surgery...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27875668/use-of-a-perclose-proglide-device-for-percutaneous-endovascular-aortic-aneurysm-repair-in-a-general-hospital-experience
#17
Chih-Hsien Lee, Jau-Kang Huang, Ten-Fang Yang
BACKGROUND: This study evaluated the safety and efficacy of percutaneous endovascular aortic aneurysm repair (EVAR) with a Perclose ProGlide device compared with endovascular aortic repair with surgical cutdown of common femoral artery in patients at a general hospital. METHODS: A retrospective clinical study was conducted using data on 10 patients with elective EVAR, 7 patients with percutaneous EVAR, and 9 patients with consecutive rupture abdominal aortic aneurysm treated with emergency EVAR from January 2010 to December 2014...
October 2016: Discovery Medicine
https://www.readbyqxmd.com/read/27872976/development-and-validation-of-a-scoring-system-to-predict-surgical-site-infection-after-ventral-hernia-repair-a-michigan-surgical-quality-collaborative-study
#18
Efstathios Karamanos, Pridvi Kandagatla, Jenna Watson, Nathan Schmoekel, Aamir Siddiqui
INTRODUCTION: Surgical site infections (SSIs) are a rare but significant complication following an elective ventral hernia repair. This study aims to develop a risk assessment tool in order to predict the risk of developing SSIs postoperatively. METHODS: All patients undergoing an elective ventral hernia repair were identified using the Michigan Surgical Quality Collaborative (MSQC) database. Patients' demographics, comorbidities and technical aspects of the operations were extracted...
November 21, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27871595/a-comparison-of-king-vision-video-laryngoscopy-and-direct-laryngoscopy-as-performed-by-residents-a-randomized-controlled-trial
#19
Jose A Valencia, Katherine Pimienta, Darwin Cohen, Daniel Benitez, David Romero, Oswaldo Amaya, Enrique Arango
STUDY OBJECTIVE: For more than 40 years, direct laryngoscopy (DL) has been used to assure the airway during endotracheal intubation. The King Vision video laryngoscope is one of the latest devices introduced for endotracheal intubation. We hypothesize that, relative to direct laryngoscopy, it improves the intubation success rate with fewer intubation attempts and no difference in intubation time or complications. DESIGN: This randomized controlled clinical trial included...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27860143/ageing-acute-surgical-population-the-auckland-experience
#20
Hannah Linkhorn, Li Hsee
BACKGROUND: This study provides data supporting the supposition that more elderly patients are requiring surgical care and illustrates the risks associated with acute surgical illness in elderly patients. METHODS: The clinical records database was accessed to identify all patients discharged from general surgery and acute surgical unit (ASU) during 2013 and 2014. These groups were stratified by age (over 80 years). Data were collected on number of patients discharged per year, length of stay, number of intensive care unit admissions and number of procedures and mortality rates...
November 15, 2016: ANZ Journal of Surgery
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