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Vascular surgery anesthesia

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https://www.readbyqxmd.com/read/29920193/time-driven-activity-based-costing-in-fracture-care-is-this-a-more-accurate-way-to-prepare-for-alternative-payment-models
#1
Dylan L McCreary, Melissa White, Sandy Vang, Brad Plowman, Brian P Cunningham
OBJECTIVES: To use surgical treatment of isolated ankle fractures as a model to compare time-driven activity-based costing (TDABC) and our institution's traditional cost accounting (TCA) method to measure true cost expenditure around a specific episode of care. METHODS: Level I trauma center ankle fractures treated between 2012 and 2016 were identified through a registry. Inclusion criteria were age greater than 18 years and same-day ankle fracture operation. Exclusion criteria were pilon fractures, vascular injuries, soft-tissue coverage, and external fixation...
July 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29894349/anesthetic-considerations-for-a-patient-with-chronic-systemic-capillary-leak-syndrome-a-case-report
#2
Resham Datta, Jason K Panchamia
Systemic capillary leak syndrome (SCLS) is an idiopathic vascular hyperpermeability that leads to profound hypotension, hypoalbuminemia, and hemoconcentration. Sixty years since its inauguration into literature, SCLS is still elusive, underdiagnosed, and profoundly dangerous. Few authors have documented anesthetic implications of classical acute SCLS, a form with complete recovery between exacerbations. However, minimal information is available about chronic SCLS, continuous generalized edema with or without exacerbations...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29880427/dobutamine-and-nitroglycerin-versus-milrinone-for-perioperative-management-of-pulmonary-hypertension-in-mitral-valve-surgery-a-randomized-controlled-study
#3
Ashraf M Eskandr, Ahmed A Metwally, Montasser S Abu Elkassem, Sadik A Sadik, Ashraf E Elmiligy, Mohamed Mourad, Lamiaa Hussein
OBJECTIVE: To compare the effects of dobutamine and nitroglycerin to milrinone in young patients with severe pulmonary hypertension undergoing mitral valve replacement. DESIGN: A prospective randomized, double-blinded, controlled study. SETTING: Single university hospital. PARTICIPANTS: Forty patients had systolic pulmonary arterial pressure ≥60 mmHg and were scheduled for elective mitral valve replacement. The patients were divided randomly into 2 equal groups according to the drugs given during the study...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29877979/dog-attack-causing-lip-wound
#4
Gabriela Vasconcelos Maia, Amanda Lobão de Albuquerque, Talyne Albuquerque Ximenes, Tibério Gomes Magalhães, Abrahão Cavalcante Gomes de Souza Carvalho
Animal bites are relatively common occurrences reaching about 4.5 millions of people every year. The main aggressor is the domesticated dog, responsible for around 90% of the patients, with children being the most affected, with 70% of the registered patients, while with adults that number is a lot lower (15%). Bites around the head and neck require special attention. Due to the presence of noble structures and the rich local vascularization, any wounds have been immediately addressed to stop bleeding and further complications...
June 5, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29807496/axillo-axillary-artery-bypass-with-coil-embolization-of-the-innominate-artery-for-a-traumatic-innominate-artery-aneurysm-a-case-report
#5
Ryota Sugisawa, Masaki Sano, Naoto Yamamoto, Kazunori Inuzuka, Hiroki Tanaka, Takaaki Saito, Kazuto Katahashi, Tatsuro Yata, Takafumi Kayama, Yuta Yamanaka, Hiroya Takeuchi, Naoki Unno
BACKGROUND: Innominate artery aneurysm (IAA) is a rare cervical artery aneurysm. Although atherosclerosis is its most common cause, IAAs due to cervical injury are often reported. Operative indications for IAAs include rupture or symptomatic aneurysm, saccular aneurysm, aneurysm with a diameter of 3 cm or greater, and aneurysmal change of the origin of the innominate artery. Although the ligature of the innominate artery or open surgical repair is well described, the usefulness of endovascular repair has also recently been reported...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29790120/changes-in-the-augmentation-index-and-postoperative-orthostatic-intolerance-in-orthopedic-surgery-a-prospective-cohort-study
#6
Stavros G Memtsoudis, Eva E Mörwald, Kara Fields, Crispiana Cozowicz, Nigel E Sharrock, Mathias Opperer, Ottokar Stundner, Angie Zhang, George Go, Thomas Danninger
BACKGROUND: Postoperative orthostatic intolerance (OI) can be a major obstacle to early ambulation and its determinants are poorly understood. We aimed to study postoperative changes in vascular tone and their potential association with OI in various orthopedic surgical settings. METHODS: In this prospective cohort study, 350 patients undergoing total joint arthroplasty under neuraxial anesthesia or spine surgery under general anesthesia were enrolled. We determined the augmentation index (AI) as a measure of vascular tone and studied symptoms of OI using a validated questionnaire at various postoperative time points...
May 22, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29783029/comparison-of-stanford-b-aortic-dissection-patients-who-received-tevar-combined-with-or-without-sleep-apnea-syndrome
#7
Xin Li, Wenwu Cai, Ping Zhang, Kun Fang, Jieting Zhu, Chang Shu
BACKGROUND: Patients with Stanford B aortic dissection usually complicated with sleep apnea syndrome. This condition always threatens the patients' respiration situation. In this study, we collected and analysis data of patients' peri-operative managements of Thoracic Endovascular Aortic Repair (TEVAR) for Stanford B Aortic Dissection (AD) complicated with Sleep Apnea Syndrome (SAS). Comparison has been made between these SAS patients and those who without SAS. METHODS: Between June 2013 and June 2014, the clinical data and outcomes of the Stanford B AD patients in the department of vascular surgery in the Second Xiangya Hospital were retrospectively reviewed and studied...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29780644/spindle-cell-hemangioma-in-the-mucosa-of-the-upper-lip-a-case-report-and-review-of-the-literature
#8
Kazuhiro Murakami, Kazuhiko Yamamoto, Tsutomu Sugiura, Tadaaki Kirita
Spindle cell hemangioma (SCH) is a unique benign vascular lesion. We present a case of SCH in the upper lip of a 41-year-old woman. A submucosal nodular mass 30 × 20 mm in size was observed in the left upper lip. The mass developed 5 years earlier and enlarged after repeated ethanol injections. The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic resonance imaging. Under the clinical diagnosis of hemangioma, surgical excision was performed under local anesthesia. Microscopically, the lesion was composed of irregular cavernous spaces and multiple solid cellular areas...
2018: Case Reports in Dentistry
https://www.readbyqxmd.com/read/29750688/feasibility-of-fully-automated-hypnosis-analgesia-and-fluid-management-using-2-independent-closed-loop-systems-during-major-vascular-surgery-a-pilot-study
#9
Alexandre Joosten, Vincent Jame, Brenton Alexander, Thierry Chazot, Ngai Liu, Maxime Cannesson, Joseph Rinehart, Luc Barvais
Automated titration of intravenous anesthesia and analgesia using processed electroencephalography monitoring is no longer a novel concept. Closed-loop control of fluid administration to provide goal-directed fluid therapy has also been increasingly described. However, simultaneously combining 2 independent closed-loop systems together in patients undergoing major vascular surgery has not been previously detailed. The aim of this pilot study was to evaluate the clinical performance of fully automated hypnosis, analgesia, and fluid management using 2 independent closed-loop controllers in patients undergoing major vascular surgery before implementation within a larger study evaluating true patient outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29736287/acute-parotitis-after-lower-limb-amputation-a-case-report-of-a-rare-complication
#10
Konstantinos Ioannis Avgerinos, Nikolaos Degermetzoglou, Sofia Theofanidou, Georgia Kritikou, Ioannis Bountouris
Background: Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report: An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee...
2018: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29734894/-in-situ-vascular-nerve-graft-for-restoration-of-intrinsic-hand-function-an-anatomical-study
#11
Kamran Mozaffarian, Hamid Reza Zemoodeh, Mohammad Zarenezhad, Mohammad Owji
BACKGROUND: In combined high median and ulnar nerve injury, transfer of the posterior interosseous nerve branches to the motor branch of the ulnar nerve (MUN) is previously described in order to restore intrinsic hand function. In this operation a segment of sural nerve graft is required to close the gap between the donor and recipient nerves. However the thenar muscles are not innervated by this nerve transfer. The aim of the present study was to evaluate whether the superficial radial nerve (SRN) can be used as an "in situ vascular nerve graft" to connect the donor nerves to the MUN and the motor branch of median nerve (MMN) at the same time in order to address all denervated intrinsic and thenar muscles...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29724541/the-year-in-perioperative-echocardiography-selected-highlights-from-2017
#12
Brett Cronin, Swapnil Khoche, Timothy M Maus
This article is the second of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to start this series. In most cases, these will be research articles that are targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; however, in some cases, these articles will target the use of perioperative echocardiography in general...
April 3, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#13
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29707296/sevoflurane-did-not-show-better-protective-effect-on-endothelial-glycocalyx-layer-compared-to-propofol-during-lung-resection-surgery-with-one-lung-ventilation
#14
Hye-Jin Kim, Eunsoo Kim, Seung-Hoon Baek, Hee Young Kim, Joo-Yun Kim, Juyeon Park, Eun-Ji Choi
Background: The endothelial glycocalyx layer (EGL) coats the alveolar capillary endothelium and plays important roles in pulmonary vascular protection, modulation, and hemostasis. Ischemia-reperfusion, which occurs during lung resection surgery with one lung ventilation (OLV), can damage the EGL. Sevoflurane is known for its protective effect against ischemia-reperfusion injury. Therefore, we hypothesized that lung resection surgery produces EGL damage and sevoflurane protects the EGL better than the intravenous anesthetic propofol...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29703011/desmoplastic-small-round-cell-tumor-of-the-middle-ear-a-case-report
#15
Jing Xu, Mengwei Yao, Xinxin Yang, Tao Liu, Shaohua Wang, Dengdian Ma, Xiaoyu Li
RATIONALE: Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive and malignant tumor. This report describes a case involving DSRCT of the middle ear which no case has been reported in the literature till date. PATIENT CONCERN: A 59-year-old Chinese man with a 40-year history of repeated suppuration of his right ear and 1-year history of drooping of the angle of mouth. The CT of the middle ear and brain scan and enhanced MRI showed space occupying lesion in the right middle ear...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29700275/anesthesia-management-of-modified-ex-vivo-liver-resection-and-autotransplantation
#16
Fujun Cheng, Zhiyong Yang, Jing Zeng, Jianteng Gu, Jian Cui, Jiaoning Ning, Bin Yi
BACKGROUND Ex situ liver surgery allows liver resection and vascular reconstruction in patients who have liver tumors located in critical sites. Only a small series of studies about ex situ liver surgery is available in the literature. No anesthesia management experience has been previously published. The aim of the currents study was to summarize our experience with anesthetic management of patients during ex vivo liver surgery. MATERIAL AND METHODS The first 43 patients who received ex vivo liver surgery between January 2007 and April 2012 were included...
April 27, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29697508/in-line-filtration-reduces-postoperative-venous-peripheral-phlebitis-associated-with-cannulation-a-randomized-clinical-trial
#17
Gianluca Villa, Cosimo Chelazzi, Rosa Giua, Lorenzo Tofani, Giovanni Zagli, Paolo Boninsegni, Fulvio Pinelli, A Raffaele De Gaudio, Stefano Romagnoli
BACKGROUND: Peripheral venous cannulation is an everyday practice of care for patients undergoing anesthesia and surgery. Particles infused with intravenous fluids (eg, plastic/glass/drugs particulate) contribute to the pathogenesis of peripheral phlebitis. The aim of this study is to demonstrate the efficacy of in-line filtration in reducing the incidence of postoperative phlebitis associated with peripheral short-term vascular access. METHODS: In this controlled trial, 268 surgical patients were randomly assigned to in-line filtration and standard care (NCT03193827)...
April 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#18
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29681959/levosimendan-in-patients-with-low-ejection-fraction-undergoing-cardiac-surgery
#19
Ewa M Kucewicz-Czech, Tomasz Maciejewski, Barbara Budziarz, Tadeusz Kołodziej, Kazimierz Kiermasz, Leszek Machej
Introduction: Significant impairment of left ventricular function causes low cardiac output syndrome in the immediate postoperative period in 3-14% of patients undergoing surgery, increasing the mortality 15-fold. Aim: To assess the use of levosimendan in patients undergoing cardiac surgery in 2016. Material and methods: The analysis included 14 patients: 3 (21.4%) women and 11 (78.6%) men aged 65.4 ±11.8 years. The mean value of left ventricular ejection fraction amounted to 20 ±6...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29676814/potential-of-carnosine-a-histamine-precursor-in-rat-model-of-bilateral-common-carotid-artery-occlusion-induced-vascular-dementia
#20
Nidhi Tiwari, Pankaj Bhatia, Amit Kumar, Amteshwar S Jaggi, Nirmal Singh
The present study investigates the potential of Carnosine, a histamine precursor in rat model of bilateral common carotid artery occlusion (BCCAo)-induced vascular dementia (VaD). Wistar rats were subjected to BCCAo procedure under anaesthesia to induce VaD. The rats were subjected to Morris water maze (MWM) test (6th day onwards post-surgery). MWM test was employed to assess learning and memory of the animals whereby escape latency time, time spent in target quadrant and Path length (distance travelled) taken as important parameters...
April 20, 2018: Fundamental & Clinical Pharmacology
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