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https://www.readbyqxmd.com/read/29678158/dexmedetomidine-infusion-as-an-analgesic-adjuvant-during-laparoscopic-%C3%B1-holecystectomy-a-randomized-controlled-study
#1
Kateryna Bielka, Iurii Kuchyn, Volodymyr Babych, Kseniia Martycshenko, Oleksii Inozemtsev
BACKGROUND: Dexmedetomidine (DEX) has sedative, sympatholytic and analgesic effects and might be beneficial if used as an adjuvant to: improve analgesia; modulate haemodynamic responses to intubation and pneumoperitoneum and; reduce the number of opioid-associated adverse events. The aim of this study was to evaluate the efficacy and safety of DEX infusion during elective laparoscopic cholecystectomy (LC). METHODS: A randomized, single-centre, parallel-group, placebo-controlled study was carried out between May 2016 and June 2017...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29678147/protocol-based-evaluation-for-feasibility-of-extubation-compared-to-clinical-scoring-systems-after-major-oral-cancer-surgery-safely-reduces-the-need-for-tracheostomy-a-retrospective-cohort-study
#2
Axel Schmutz, Rolf Dieterich, Johannes Kalbhenn, Pit Voss, Torsten Loop, Sebastian Heinrich
BACKGROUND: Despite risks, complications and negative impact to quality of life, tracheostomy is widely used to bypass upper airway obstruction after major oral cancer surgery (MOCS). Decision to tracheostomy is frequently based on clinical scoring systems which mainly have not been validated by different cohorts. Delayed extubation in the Intensive Care Unit (ICU) may be a suitable alternative in selected cases. We hypothesize that delayed routine ICU extubation after MOCS instead of scoring system based tracheostomy is safe, feasible and leads to lower tracheostomy rates...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29674770/incidence-of-pulmonary-complications-with-the-prophylactic-use-of-high-flow-nasal-cannula-after-pediatric-cardiac-surgery-prophylactic-hfnc-study-protocol
#3
Naohiro Shioji, Tomoyuki Kanazawa, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Hirokazu Kawase, Satoshi Kimura, Yasutoshi Kuroe, Hiroshi Morimatsu
We will investigate the incidence of postoperative pulmonary complications (PPCs) with the prophylactic use of a high-flow nasal cannula (HFNC) after pediatric cardiac surgery. Children < 48 months old with congenital heart disease for whom cardiac surgery is planned will be included. The HFNC procedure will be commenced just after extubation, at a flow rate of 2 L/kg/min with adequate oxygen concentration to achieve target oxygen saturation ≥ 94%. This study will reveal the prevalence of PPCs after pediatric cardiac surgery with the prophylactic use of HFNC...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29674403/unexpected-case-of-pneumomediastinum-and-subcutaneous-emphysema-primary-or-secondary-aetiology
#4
Amanda J L Cheng, Timothy J Sadler
A 77-year-old man was admitted with a relapse of antineutrophil cytoplasmic antibody-positive vasculitis with pulmonary involvement and acute kidney injury. There was a background of pulmonary fibrosis (non-specific interstitial pneumonia type pattern) and superadded pulmonary haemorrhage, acute pulmonary oedema and sepsis. The patient was intubated for 4 days and remained dependent on high flow oxygen and continuous positive airway pressure after extubation. A chest radiograph performed 2 weeks after extubation demonstrated unexpected, extensive pneumomediastinum and subcutaneous emphysema...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29673638/outcome-after-surgery-for-aortic-dissection-type-a-in-morbidly-obese-patients
#5
Maximilian Kreibich, Bartosz Rylski, Joseph E Bavaria, Emanuela Branchetti, Daniel Dohle, Patrick Moeller, Prashanth Vallabhajosyula, Wilson Y Szeto, Nimesh D Desai
BACKGROUND: The number of obese patients is increasing and more obese patients are likely to present for surgical repair of aortic dissection Type A (ADA). We evaluated the effect of this procedure on mortality and morbidity of patients based on their body-mass-index (BMI; kg*m-2 ). METHODS: A total of 667 patients that underwent surgical repair of ADA between 2003 and 2017 were retrospectively analyzed. Patients were divided into four groups according to BMI: normal weight (18≤BMI<25; n=186), overweight (25≤BMI<30; n=238), obese (30≤BMI<35, n=144), and morbidly obese (BMI≥35; n=99)...
April 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29671866/isocapnic-hyperventilation-provides-early-extubation-after-head-and-neck-surgery-a-prospective-randomized-trial
#6
K Hallén, P Jildenstål, O Stenqvist, J Oras, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) shortens recovery time after inhalation anaesthesia by increasing ventilation while maintaining a normal airway carbon dioxide (CO2 )-level. One way of performing IHV is to infuse CO2 to the inspiratory limb of a breathing circuit during mechanical hyperventilation (HV). In a prospective randomized study, we compared this IHV technique to a standard emergence procedure (control). METHODS: Thirty-one adult ASA I-III patients undergoing long-duration (>3 hours) sevoflurane anaesthesia for major head and neck surgery were included and randomized to IHV-treatment (n = 16) or control (n = 15)...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29670781/-candida-krusei-empyema-thoracis-a-community-acquired-infection-requiring-a-high-index-of-suspicion
#7
Hazim Bukamur, Waseem Ahmed, Yazan Numan, Ibrahim Shahoub, Fuad Zeid
Empyema thoracis is a serious condition characterized by the accumulation of purulent fluid in the pleural cavity, typically following a pneumonia, subdiaphragmatic abscess, or esophageal rupture. Fungal empyema thoracis is a rare form of this condition with especially high mortality, in which the most frequently isolated fungus is Candida spp. This article presents a 74-year-old female with Candida krusei pneumonia and a complicated hospital course, initially presenting with nausea, vomiting, and dysphagia...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#8
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29666098/a-misplaced-peripherally-inserted-central-catheter-presenting-as-contralateral-pleural-effusion
#9
Jogender Kumar, Sudeep K C, Kanya Mukhopadhyay, Somosri Ray
A preterm neonate born at 27 weeks, with a birth weight of 555 g, was on continuous positive airway pressure (CPAP) for apnoea of prematurity and initially received total parenteral nutrition (TPN) through the umbilical venous catheter. Peripherally inserted central catheter (PICC) was inserted in the left basilica vein on day 8 to continue TPN. The baby developed respiratory distress with persistent hypoxia after TPN was initiated through the PICC line. The baby required mechanical ventilation due to worsening of respiratory distress, and chest X-ray, as well as ultrasound conducted 12 hours, postinfusion of TPN revealed right-sided pleural effusion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29665981/endotracheal-suction-in-intensive-care-a-point-prevalence-study-of-current-practice-in-new-zealand-and-australia
#10
Eileen Gilder, Rachael L Parke, Andrew Jull
BACKGROUND: Despite the evidence and available guidelines about endotracheal suction (ETS), a discrepancy between published guidelines and clinical practice persists. To date, ETS practice in the adult intensive care unit (ICU) population across New Zealand and Australia has not been described. OBJECTIVE: To describe ICU nurses' ETS practice in New Zealand and Australia including the triggers for performing endotracheal suction. METHODS: A single day, prospective observational, binational, multicentre point prevalence study in New Zealand and Australian ICUs...
April 14, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29662906/quantitative-relationships-between-pulmonary-function-and-residual-neuromuscular-blockade
#11
ShuYing Fu, WenDong Lin, XiNing Zhao, ShengJin Ge, ZhangGang Xue
Background: Neuromuscular blockade is a risk factor for postoperative respiratory weakness during the immediate postoperative period. The quantitative relationships between postoperative pulmonary-function impairment and residual neuromuscular blockade are unknown. Methods: 113 patients who underwent elective laparoscopic cholecystectomy were enrolled in this study. They all had a pulmonary-function test (PFT) during the preoperative evaluation. Predictive values based on demographic data were also recorded...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29661436/model-for-end-stage-liver-disease-score-before-hepatic-transplantation-and-root-mean-square-of-the-diaphragmatic-domes-affect-postoperative-extubation-time
#12
R P Duarte, A M O da Silva, R M Tonella, L S R Ratti, I F S F Boin
INTRODUCTION: The liver transplantation procedure, in addition to its prolonged surgical time, also predisposes to complications such as changes in respiratory mechanics, lung volumes, and gas exchange. OBJECTIVE: This study aims to verify if clinical factors related to the recipient, namely immediate pretransplant Model for End-Stage Liver Disease (MELD) score, surgical time, and root square metric (RMS) of the diaphragmatic domes, affect the extubation time after liver transplantation...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661382/comparison-of-target-controlled-infusion-and-manual-infusion-for-propofol-anaesthesia-in-children
#13
J Mu, T Jiang, X B Xu, V M Yuen, M G Irwin
BACKGROUND: One major criticism of prolonged propofol-based total i.v. anaesthesia (TIVA) in children is the prolonged recovery time. As target-controlled infusion (TCI) obviates the need to manually calculate the infusion rate, the use of TCI may better match clinical requirements, reduce propofol dose, and shorten recovery time. METHODS: Children of ASA grade 1, aged 1-12 yr, were recruited and randomly assigned to TCI or manual infusion. Children in the TCI group had propofol delivered by TCI...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29660267/recovery-process-and-determinants-of-adverse-event-occurrence-in-bronchoscopic-procedures-performed-under-general-anesthesia
#14
Derya Özden Omaygenç, Nermin Ünal, Saadet İpek Edipoğlu, Tuğçe Barca Şeker, Mehmet Akif Özgül, Demet Turan, Cengiz Özdemir, İbrahim Oğuz Karaca, Erdoğan Çetinkaya
OBJECTIVE: Regarding the fact that rigid bronchoscopy is generally performed under general anesthesia and this patient subgroup is remarkably morbid, encountering procedure and/or anesthesia related complications are highly likely. Here, we aimed to assess factors influencing recovery and detect possible determinants of adverse event occurence during these operations performed in a tertiary referral centre. METHODS: 81 consecutive ASA I-IV patients were recruited for this investigation...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29658860/pressure-support-breaths-triggered-by-total-artificial-heart-in-invasive-and-non-invasive-mechanical-ventilation
#15
Amit Prasad, Kai Singbartl, Behzad Soleimani, Christoph Brehm, Ali Ghodsizad
Because of the risks associated with extended mechanical ventilation, it is desirable to extubate patients as early as possible. However, weaning patients from mechanical ventilation too early has risks associated with it as well. Thus, it is important to note that in the two cases presented here, pressure-supported breaths were falsely triggered by a patient's a Syncardia® total artificial heart (TAH), influencing decisions about weaning the patient from mechanical ventilation.
March 2, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29656287/respiratory-management-of-extremely-preterm-infants-an-international-survey
#16
Marc Beltempo, Tetsuya Isayama, Máximo Vento, Kei Lui, Satoshi Kusuda, Liisa Lehtonen, Gunnar Sjörs, Stellan Håkansson, Mark Adams, Akihiko Noguchi, Brian Reichman, Brian A Darlow, Naho Morisaki, Dirk Bassler, Simone Pratesi, Shoo K Lee, Abhay Lodha, Neena Modi, Kjell Helenius, Prakesh S Shah
BACKGROUND: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies. OBJECTIVE: To evaluate practice variations in the respiratory management of extremely preterm infants born at < 29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration...
April 13, 2018: Neonatology
https://www.readbyqxmd.com/read/29652895/complications-after-transcatheter-aortic-valve-implantation-using-transfemoral-and-transapical-approach-in-general-anaesthesia
#17
Fabian Würschinger, Sigrid Wittmann, Sophia Goldfuß, Nina Zech, Kurt Debl, Michael Hilker, Bernhard M Graf, York A Zausig
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat degenerative heart valve disease. The implantation requires a highly specific and interdisciplinary management approach. Currently, TAVI is performed with the patient under local or general anaesthesia. METHODS: This study was a retrospective analysis of all TAVI procedures performed at the University Hospital of Regensburg between January 2009 and July 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29652686/massive-macroglossia-after-posterior-cranial-fossa-surgery-a-case-report
#18
Jennifer F Ha, Lisa N Vitale, Marie A Pfarr, Yu Kawai, David A Zopf
A 16-year-old boy with Chiari 1 malformation presented for an elective suboccipital craniectomy and C1 laminectomy. His intraoperative course was uneventful. At the conclusion of the procedure, he met extubation criteria and followed commands. After extubation, he developed progressive upper airway obstruction and became obtunded. He was reintubated via videolaryngoscopy, which showed edema not only to the tongue, but also to the posterior pharynx and blisters over the vocal folds and epiglottis. The patient was transferred to the pediatric intensive care unit intubated and sedated...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#19
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652269/immediate-extubation-after-cardiac-surgery-should-be-part-of-routine-anesthesia-practice-for-selected-patients
#20
EDITORIAL
Thomas M Hemmerling
No abstract text is available yet for this article.
April 2018: Annals of Cardiac Anaesthesia
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