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postoperative hypothermia

Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
Kangjun Shen, Xinmin Zhou, Ling Tan, Feng Li, Jun Xiao, Hao Tang
BACKGROUND: We hypothesized that the arch-first procedure without extra devices under moderate-to-mild systemic hypothermia during acute type A aortic dissection is safe and efficient and will improve patient outcome compared with the standard total arch replacement technique. METHODS: From December 2014 to February 2017, 89 patients were enrolled in this study, 52 of whom underwent conventional deep hypothermic circulatory arrest (DHCA, 24.2 ± 0.71°C) using the antegrade cerebral perfusion surgical procedure (Group A) and 37 of whom underwent the "arch-first" technique with moderate (27...
March 12, 2018: Journal of Cardiovascular Surgery
Hyun-Seok Park, Jae-Hyung Choi
OBJECTIVE: The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. METHODS: From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at 34°C after hemicraniectomy in malignant MCA infarction (hypothermia group)...
March 2018: Journal of Korean Neurosurgical Society
S-H Min, S Yoon, S-H Yoon, J-H Bahk, J-H Seo
BACKGROUND: In the supine position, forced-air warming is more effective on the lower body than on the upper body to prevent intraoperative hypothermia. However, it is unknown in the lateral decubitus position. We thus compared forced-air warming on the upper and lower bodies in the lateral position. METHODS: Patients (n=123) were randomised to receive forced-air warming on the upper body or lower body during thoracoscopic surgery in the lateral position. We measured the nasopharyngeal temperature at 0, 30, 60, 90, and 120 min after lateral positioning during surgery and the infrared tympanic membrane temperature at 0, 30, 60, 90, and 120 min after surgery...
March 2018: British Journal of Anaesthesia
Sahin Iscan, Bortecin Eygi, Yuksel Besir, Ismail Yurekli, Habib Cakir, Levent Yilik, Orhan Gokalp, Ali Gurbuz
Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response...
January 31, 2018: Current Pharmaceutical Design
Judy Munday, Sonya Osborne, Patsy Yates
PURPOSE: Rates of inadvertent perioperative hypothermia among women undergoing spinal anesthesia for cesarean delivery are reported to be high. Intrathecal morphine has been noted to have a potentially potent effect on thermoregulation. This retrospective case-control study sought to investigate the incidence of perioperative hypothermia in women undergoing cesarean delivery with and without intrathecal morphine and to describe any clinical factors associated with the condition, the identification of which would provide direction for nursing priorities in the care of the condition...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Jed Duff, Kim Walker, Karen-Leigh Edward
BACKGROUND: Perioperative hypothermia significantly increases a patient's risk of adverse complications, such as surgical site infection; morbid cardiac events, and surgical bleeding. Although guideline recommendations are relatively simple and inexpensive, they are often not adhered to in clinical practice. Knowledge tools are tangible resources that assist clinicians to provide evidence-based care. PURPOSE: This article reports the collaborative development of a knowledge tool-a perioperative thermal care bundle...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Boris N Kozlov, Dmitri S Panfilov, Igor V Ponomarenko, Andrey G Miroshnichenko, Aleksandra A Nenakhova, Alexander I Maksimov, Vladimir M Shipulin
OBJECTIVES: The aim of the study was to access the extended occlusion of the intercostal arteries by a stent graft in the development of postoperative spinal cord injury during aortic arch surgery using the frozen elephant trunk technique. METHODS: A total of 37 consecutive patients underwent total aortic arch surgery using the frozen elephant trunk technique between March 2012 and July 2017. The mean age of the patients was 54.7 ± 10.5 years. Type A and Type B aortic dissections were the indications for surgery...
January 17, 2018: Interactive Cardiovascular and Thoracic Surgery
Raphael Okoué, Daniela Calabrese, Pascal Nzé, Simon Msika, Hawa Keita
BACKGROUND: Hypothermia is associated with an increased postoperative morbidity and mortality. Forced-air warming systems are the most effective methods for its prevention. When using a mattress, a reduction in the area of diffusion of warm air by crushing due to excess weight cannot be ruled out. METHODS: We designed a prospective study to compare the efficacy of a forced-air warming mattress (Bair Hugger® 585) to prevent hypothermia (core temperature (CT°) < 36 °C) in morbidly obese (group MO, body mass index (BMI) ≥ 40 kg/m2 ) and non-obese patients (group NO, BMI < 30 kg/m2 )...
January 11, 2018: Obesity Surgery
Brittney Williams, Evan Chriss, Jennifer Kaplan, Alexander Cartron, Bradley Taylor, James Gammie, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: To determine the relationships between hypothermia and pH at surgery end and postoperative red blood cell (RBC) transfusion in massively transfused adult cardiac surgery patients. DESIGN: Retrospective cohort study. SETTING: Single tertiary care, academic medical center. PARTICIPANTS: A total of 395 adult patients having cardiac surgery with cardiopulmonary bypass who were massively transfused during an 8-year period...
November 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Barak Cohen, Benjamin Meilik, Ahuva Weiss-Meilik, Aviv Tarrab, Idit Matot
BACKGROUND: Several preoperative factors have been shown to influence outcome of body contouring surgeries. The effect of intraoperative features, including fluid volume administered, hemodynamic and respiratory parameters, and body temperature on postoperative complication, has not been reported to date. MATERIALS AND METHODS: All subsequent patients undergoing body contouring surgery in the Tel Aviv Medical Center between 2007 and 2012 were enrolled. Demographic and intraoperative data were collected and analyzed for possible associations with postoperative complications, including formation of seroma, hematoma/bleeding, other surgical site complications (infection, adhesiolysis, or need for debridement), formation of a hypertrophic scar, any documented, infection or a composite outcome of any of the previously mentioned...
January 2018: Journal of Surgical Research
Victoria M Steelman, Sena Chae, Jed Duff, Michael J Anderson, Adnan Zaidi
PURPOSE: To determine whether warming of irrigation fluids (32°C-40°C) compared with using room-temperature irrigation fluids (20°C-22°C) decreases the risk of perioperative hypothermia (<36°C) for patients undergoing shoulder, hip, or knee arthroscopy. METHODS: One reviewer, with the assistance of a medical librarian, searched the following databases: PubMed, Embase, Cochrane Central, SPORTDiscus, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature)...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Chung-Ching Chio, Chien-Chin Hsu, Yu-Feng Tian, Chung-Han Wang, Mao-Tsun Lin, Ching-Ping Chang, Hung-Jung Lin
Background: Clinical assessment reveals that patients after surgery of cardiopulmonary bypass or coronary bypass experience postoperative cognitive dysfunction. This study aimed to investigate whether resuscitation after a hemorrhagic shock (HS) and/or mild cerebral ischemia caused by a unilateral common carotid artery occlusion (UCCAO) can cause brain injury and concomitant neurological dysfunction, and explore the potential mechanisms. Methods: Blood withdrawal (6 mL/100 g body weight) for 60 min through the right jugular vein catheter-induced an HS...
2017: International Journal of Medical Sciences
Jordan B Simpson, Vijai S Thomas, Sabir K Ismaily, Pavel I Muradov, Philip C Noble, Stephen J Incavo
BACKGROUND: Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation, and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients. METHODS: In a retrospective review of 204 patients undergoing primary hip and 179 undergoing primary knee replacement surgeries, time and temperature parameters were collected from the electronic health records from preoperative and postoperative recovery room nursing assessments, intraoperative anesthesia records, and floor nursing notes...
November 8, 2017: Journal of Arthroplasty
R Grote, A J Wetz, A Bräuer, M Menzel
BACKGROUND: Inadvertent perioperative hypothermia, which is defined as a core body temperature of less than 36.0 °C, can have serious consequences in surgery patients. These include cardiac complications, increased blood loss, wound infections and postoperative shivering; therefore, the scientific evidence that inadvertent perioperative hypothermia should be avoided is undisputed and several national guidelines have been published summarizing the scientific evidence and recommending specific procedures...
November 20, 2017: Der Anaesthesist
Rudolf Mörgeli, Tobias Wollersheim, Claudia Spies, Felix Balzer, Susanne Koch, Sascha Treskatsch
Frail patients are more prone to develop complications during and after surgery. As the syndrome becomes more common, recognition and special management of frail patients in the perioperative setting is becoming crucial to improve short- and long-term outcomes. Based on current literature and guidelines, we present a compilation of strategies that could be employed to reduce postoperative complication rates in frail patients. Due to their impaired response to stressors, potential perioperative hazards to frail patients are identified and discussed...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
K Ousey, K-L Edward, S Lui, J Stephenson, K Walker, J Duff, D Leaper
OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs...
November 2, 2017: Journal of Wound Care
Deepak Singh-Ranger, Edmund Leung, Mei-Ling Lau-Robinson, Sean Ramcharan, James Francombe
OBJECTIVES: In 2011, the Royal College of Surgeons published Emergency Surgery: Standards for Unscheduled Care in response to variable clinical outcomes for emergency surgery. The purpose of this study was to examine whether different treatment modalities would alter survival. METHODS: All patients who underwent emergency laparotomy between April 2011 and December 2012 at Warwick Hospital (Warwick, UK) were included retrospectively. Information relating to their demographics; preoperative score; primary pathology; timing of surgery; intraoperative details; and postoperative outcome, including 30-day mortality, were collated for statistical analysis...
November 2017: Southern Medical Journal
Jill M Cholette, David Faraoni, Susan M Goobie, Victor Ferraris, Nabil Hassan
Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population...
October 5, 2017: Anesthesia and Analgesia
Ramon AntÔnio Oliveira, Gabrielle Meriche GalvÃo Bento da Silva Guatura, Aparecida de Cássia Giani Peniche, Ana Lúcia Siqueira Costa, Vanessa de Brito Poveda
We undertook an integrative literature review of articles pertaining to perioperative nursing care provided to patients using postoperative accelerated recovery protocols. To select the articles, we searched the MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature, and LiteraturaLatino-Americana e do Caribe em Ciências da Saúde databases. We identified 329 studies, 13 of which met our inclusion criteria and described perioperative nursing care activities. Nursing activities noted in these articles were hypothermia prevention and maintenance of normothermia, restriction of IV fluids, assessment of vital signs, management of symptoms and pain, support of early ambulation, care for tubes and drains, oral administration of carbohydrate-rich foods, assessment of ability to tolerate diet, and encouragement to resume activities of daily living...
October 2017: AORN Journal
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