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https://www.readbyqxmd.com/read/28924136/a-case-of-tracheobronchomalacia-mimicking-acute-pulmonary-embolism
#1
Stefani M Schwartz, Katherine J Greco, Venugopal Reddy
BACKGROUND Pulmonary embolism is a common acute postoperative complication and is associated with 100,000 deaths per year in the USA. Tracheobronchomalacia is an uncommon condition, which presents with similar symptoms to pulmonary embolism, including hypoxemia, tachycardia, and shortness of breath. We describe a case of a patient who presented with postoperative pulmonary symptoms that were initially thought to be due to pulmonary embolism. However, following imaging investigations these symptoms were found to be due to tracheobronchomalacia...
September 19, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28922985/delayed-development-of-malignant-hyperthermia-following-cardiopulmonary-bypass
#2
Stephen Hall Sams, Stephen Revilla, David Lawrence Stahl
Malignant hyperthermia (MH) is a rare but potentially life-threatening disorder encountered during general anesthesia. The use of cardiopulmonary bypass during cardiac surgery can obscure many of the cardinal signs and symptoms of MH. The development of postoperative MH following cardiac surgery is rare, but anesthesiologists and intensivists must maintain a high index of suspicion in order to make a prompt diagnosis. Initiation and tailored maintenance of MH therapy must also consider the complex physiologic changes of patients in the immediate post-cardiac surgery period...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28910340/successful-1-1-proportion-ventilation-with-a-unique-device-for-independent-lung-ventilation-using-a-double-lumen-tube-without-complications-in-the-supine-and-lateral-decubitus-positions-a-pilot-study
#3
Michał Kowalczyk, Sławomir Sawulski, Wojciech Dąbrowski, Luiza Grzycka-Kowalczyk, Edyta Kotlińska-Hasiec, Agnieszka Wrońska-Sewruk, Artur Florek, Rafał Rutyna
INTRODUCTION: Adequate blood oxygenation and ventilation/perfusion matching should be main goal of anaesthetic and intensive care management. At present, one of the methods of improving gas exchange restricted by ventilation/perfusion mismatching is independent ventilation with two ventilators. Recently, however, a unique device has been developed, enabling ventilation of independent lungs in 1:1, 2:1, 3:1, and 5:1 proportions. The main goal of the study was to evaluate the device's utility, precision and impact on pulmonary mechanics...
2017: PloS One
https://www.readbyqxmd.com/read/28899526/association-between-severity-of-untreated-sleep-apnoea-and-postoperative-complications-following-major-cardiac-surgery-a-prospective-observational-cohort-study
#4
Martina Mason, Jules Hernández Sánchez, Alain Vuylsteke, Ian Smith
OBJECTIVE: To examine whether untreated sleep apnoea is associated with prolonged Intensive Care Unit (ICU) stay and increased frequency of postoperative ICU complications, in patients undergoing major cardiac surgery. PATIENTS/METHODS: Adult patients, undergoing elective coronary artery bypass grafting with or without cardiac valve surgery, between March 2013 and July 2014, were considered. We excluded patients participating in other interventional studies, those who had a tracheostomy before surgery, required emergency surgery or were due to be admitted on the day of surgery...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28898615/breech-presentation-vaginal-versus-cesarean-delivery-which-intervention-leads-to-the-best-outcomes
#5
Andreia Fonseca, Rita Silva, Inês Rato, Ana Raquel Neves, Carla Peixoto, Zita Ferraz, Inês Ramalho, Ana Carocha, Nisa Félix, Sandra Valdoleiros, Ana Galvão, Daniela Gonçalves, Joana Curado, Maria João Palma, Isabel Lobo Antunes, Nuno Clode, Luís Mendes Graça
INTRODUCTION: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries. MATERIAL AND METHODS: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality. RESULTS: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean...
June 30, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28893013/effects-of-intraperitoneal-local-anaesthetics-bupivacaine-and-ropivacaine-versus-placebo-on-postoperative-pain-after-laparoscopic-cholecystectomy-a-randomised-double-blind-study
#6
Neha T Das, Charulata Deshpande
INTRODUCTION: Laparoscopic Cholecystectomy (LC) is the most frequently performed elective daycare surgery and provision of postoperative pain relief is of importance. After laparoscopic cholecystectomy shoulder and abdominal pain causes considerable distress. Visceral pain during coughing, respiration and mobilization increases morbidity, hospital stay and costs. AIM: To compare the analgesic efficacy of intraperitoneally instilled equipotent concentrations of bupivacaine and ropivacaine versus placebo in relieving postoperative pain after laparoscopic cholecystectomy when used as a part of multimodal analgesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28880724/prevalence-of-recent-antimicrobial-exposure-among-elective-surgical-patients
#7
Christopher A Guidry, Robert G Sawyer
BACKGROUND: The annual prevalence of antimicrobial exposure is high in the outpatient setting and should be a common exposure for surgical patients. Antimicrobials have negative side effects and may be associated with poor outcomes. Logically, one would expect surgical patients to be particularly susceptible to any negative effects of recent antimicrobial exposure. Despite these observations, however, the prevalence of recent antimicrobial exposure among surgical patients remains undefined...
September 7, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28879078/left-ventricle-and-systemic-air-embolism-after-percutaneous-lung-biopsy
#8
Juan M Galvis, David R Nunley, Teoh Zheyi, Lu Anne V Dinglasan
BACKGROUND: Systemic arterial air embolism following a percutaneous transthoracic lung biopsy is a rare but known complication, with current literature reporting an incidence of 0.01-0.45%. A prompt diagnosis of arterial air embolism is important as complications resulting from migration of air to the systemic circulation with correspondent complications. CASE REPORT: A 60-year-old female who presented for an elective percutaneous lung biopsy of an incidentally found pulmonary nodule...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28871602/elective-transfers-of-preterm-neonates-to-regional-centres-on-non-invasive-respiratory-support-is-cost-effective-and-increases-tertiary-care-bed-capacity
#9
Hussein Zein, Kamran Yusuf, Renee Paul, Derek Kowal, Sumesh Thomas
AIM: Managing capacity at regional facilities caring for sick neonates is increasingly challenging. This study estimated the clinical and economic impact of the elective transfer of stable infants requiring nasal continuous positive airway pressure (NCPAP) from level three to level two neonatal intensive care units (NICUs) within an established clinical network of five NICUs. METHODS: We retrospectively analysed the records of 99 stable infants transferred on NCPAP between two level three NICUs and three level two NICUs in Calgary, Canada, between June 2014 and May 2016...
September 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28868165/serum-vitamin-d-level-at-icu-admission-and-mortality
#10
Hakan Korkut Atalan, Bülent Güçyetmez
OBJECTIVE: Vitamin D is a fat-soluble vitamin that plays a major role in the regulation of bone and calcium metabolism and has effects on the immune and cardiovascular systems. Vitamin D deficiency is commonly seen in the general population as well as in critically ill patients and is reported to be associated with increased mortality and morbidity. Our aim was to determine the relationship between vitamin D level at ICU admission and mortality. METHODS: A total of 491 patients admitted to the ICU between January 2014 and January 2015 were evaluated retrospectively...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28866910/factors-associated-with-living-situation-among-alzheimer-s-caregivers-in-the-south-of-spain-that-affect-the-election-of-external-support-services
#11
Manuel Ruiz-Adame Reina, Juan de Dios Jiménez Aguilera
Alzheimer's is a syndrome mainly suffered by women and the care they need is also mainly provided by other women. The aim of this paper is to describe the profile of users of professional support services and to find out if some socio-demographic factors are linked with those elections. The study was conducted from January to June 2012 thanks to the cooperation of over 41 Alzheimer's Associations in Andalusia, in the south of Spain. A person trained by the main researcher (a social worker or a psychologist) completed the questionnaire during an interview with the caregiver...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28854542/association-between-delirium-and-cognitive-change-after-cardiac-surgery
#12
A C Sauër, D S Veldhuijzen, T H Ottens, A J C Slooter, C J Kalkman, D van Dijk
Background: Previous studies provide inconsistent data on whether postoperative delirium (POD) is a risk factor for postoperative cognitive decline (POCD). We thus investigated the relationship between POD and cognitive change after cardiac surgery and assessed the relationship between preoperative cognitive domain scores and POD. Methods: Postoperative delirium was assessed with the Confusion Assessment Method (CAM) adapted for the intensive care unit and the conventional CAM accompanied by chart review...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28839863/short-term-changes-in-liver-tests-predict-long-term-mortality
#13
Eliana Saffouri, Eugénie S Lim, Susan W Kim, Paul Hakendorf, Campbell H Thompson
OBJECTIVE: To determine whether short-term changes in liver tests (bilirubin, albumin, gamma glutamyl transferase, alkaline phosphatase, alanine aminotransferase (ALT) and aspartate aminotransferase) predict 12-month mortality and, if so, which test is most informative. DESIGN: Retrospective review of general medicine inpatients at a tertiary hospital (2005-2012) identified non-elective admissions of minimum 7 days' duration. Patients with liver disease, malignancy, admission to the intensive care unit or inpatient mortality were excluded...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28830362/impact-of-intrathecal-morphine-analgesia-on-the-incidence-of-pulmonary-complications-after-cardiac-surgery-a-single-center-propensity-matched-cohort-study
#14
Christoph Ellenberger, Tornike Sologashvili, Krishnan Bhaskaran, Marc Licker
BACKGROUND: Acute pain and systemic opioids may both negatively impact respiratory function after cardiac surgery. This study analyzes the local practice of using intrathecal morphine analgesia (ITMA) with minimal parenteral opioid administration in cardiac surgery, specifically the impact on postoperative pulmonary complications (PPCs). METHODS: Data from adult patients who underwent elective cardiac surgery between January 2002, and December 2013 in a single center were analyzed...
August 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28828765/fast-track-extubation-in-adult-patients-on-pump-open-heart-surgery-at-a-tertiary-care-hospital
#15
Mohammad Irfan Akhtar, Hasanat Sharif, Mohammad Hamid, Khalid Samad, Fazal Hameed Khan
Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28815849/molecular-aspects-of-uterine-diseases-in-dogs
#16
REVIEW
R Hagman
Uterine diseases are common in dogs, particularly in countries where elective spaying is not usually performed. The associated clinical illnesses may be of varying degree ranging from merely decreased fertility to a critical pyometra requiring intensive care to survive. The diagnosis of some uterine diseases is generally uncomplicated, such as in a classic pyometra presenting with enlarged, fluid-filled uterus, purulent vaginal discharge and characteristic signs of illness or in other disorders associated with uterine enlargement...
August 2017: Reproduction in Domestic Animals, Zuchthygiene
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#17
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28802877/declining-mortality-in-critically-ill-patients-with-cirrhosis-in-australia-and-new-zealand-between-2000-and-2015
#18
Avik Majumdar, Michael Bailey, William M Kemp, Rinaldo Bellomo, Stuart K Roberts, David Pilcher
BACKGROUND AND AIMS: Few studies have described the outcomes of patients with cirrhosis receiving intensive care unit (ICU) admission at a population level. We aimed to describe trends in the mortality of such patients in Australia and New Zealand (ANZ), and to investigate the relationship with associated organ failures. METHODS: We studied patients admitted to 172 ICUs on a non-elective basis, with and without cirrhosis between January 1(st) 2000 and December 31(st) 2015 as recorded by the ANZ Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database...
August 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28802377/an-innovative-approach-to-improve-ear-nose-and-throat-surgical-access-for-remote-living-cape-york-indigenous-children
#19
Susan P Jacups, Denise Newman, Deborah Dean, Ann Richards, Kate M McConnon
INTRODUCTION: On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28797752/efficacy-of-continuous-positive-airway-pressure-and-incentive-spirometry-on-respiratory-functions-during-the-postoperative-period-following-supratentorial-craniotomy-a-prospective-randomized-controlled-study
#20
Hulya Kahraman Sah, Eren Fatma Akcil, Yusuf Tunali, Hayriye Vehid, Ozlem Korkmaz Dilmen
STUDY OBJECTIVE: Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DESIGN: A prospective, randomized controlled study. SETTING: Intensive care unit in a university hospital in Istanbul...
August 7, 2017: Journal of Clinical Anesthesia
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