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staged extubation

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https://www.readbyqxmd.com/read/29750405/heartmate-3-implantation-via-left-antero-lateral-thoracotomy-to-avoid-resternotomy-in-high-risk-patients
#1
Raymond Pfister, Piergiorgio Tozzi, Roger Hullin, Patrick Yerly, Fritz-Patrick Jahns, René Prêtre, Matthias Kirsch
Left ventricular assist devices (LVADs) are currently the best alternative to cardiac transplantation for patients with end-stage heart failure (HF) as a bridge to transplant or to decision, or as destination therapy. Full median sternotomy or minimally invasive techniques are the more standard approaches used at present.  LVADs are usually implanted between the left ventricle apex and the ascending aorta. An implantation through a left thoracotomy with an outflow graft connected to the descending aorta is much less performed nowadays due to the longer times to extubation, higher incidence of postoperative pain, and poorer hemodynamics in the ascending aorta, which may lead to thrombosis...
April 25, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29690736/-observation-on-safety-and-effects-of-analgesic-and-sedative-treatment-in-severely-burned-patients-during-shock-stage
#2
R B Li, Q Chen, H Y Zhang, H A Deng, G H Guo, Y G Mao, Z H Fu
Objective: To observe the safety and effects of application of analgesic and sedative drugs in severely burned patients during shock stage. Methods: One hundred and eighty patients with severe burns, conforming to the study criteria, were admitted to our unit from August 2014 to August 2016. Patients were divided into analgesia and sedation group and control group according to whether receiving analgesic and sedative treatment or not, with 90 cases in each group. Patients in control group received conventional treatment, while those in analgesia and sedation group received analgesic and sedative treatment for 24 hours besides conventional treatment...
April 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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
#3
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/29605348/systematic-review-meta-analysis-comparing-successful-outcomes-after-single-vs-double-stage-laryngotracheal-reconstruction
#4
REVIEW
Reema Padia, Phayvanh Sjogren, Marshall Smith, Harlan Muntz, Gregory Stoddard, Jeremy Meier
OBJECTIVE: To compare operation-specific decannulation rates between single-stage (SSLTR) and double-stage laryngotracheal reconstruction (DSLTR) when controlling for grade of airway stenosis. METHODS: A systematic review and meta-analysis were performed using PubMed, EMBASE and Cochrane databases from 1970 to 2015 to examine primary SSLTR and DSLTR for subglottic stenosis in patients 18 years or younger. Primary outcome was decannulation or extubation after LTR...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29579836/early-bacterial-pneumonia-after-hepatic-transplantation-epidemiologic-profile
#5
J Prieto Amorin, M Lopez, K Rando, J Castelli, J Medina Presentado
BACKGROUND: Postoperative pulmonary complications are major cause of morbidity and mortality in patients receiving liver transplantation (LT), particularly bacterial pneumonia occurring within the first 100 days after transplantation. Our aim in this study was to determine the incidence, microorganisms involved, associated factors, and morbidity of bacterial pneumonia presenting in the first 100 days posttransplant. METHODS: We performed a cohort study in which patients receiving liver transplantation were included prospectively in our national database (Database of Infections in Transplantation of Solid Organs)...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579835/risk-factors-of-mortality-after-liver-transplantation-in-uruguay
#6
D Olivari, V Mainardi, K Rando, G Rey, J Menendez, J Prieto, J Medina, M Valverde, J Castelli, G Grecco, A Leites, G Zunini, S Gozalez, M Harguindeguy, S Gerona
INTRODUCTION: Identification of predictive factors of mortality in a liver transplant (LT) program optimizes patient selection and allocation of organs. OBJECTIVE: To determine survival rates and predictive factors of mortality after LT in the National Liver Transplant Program of Uruguay. METHODS: A retrospective study was conducted analyzing data prospectively collected into a multidisciplinary database. All patients transplanted since the beginning of the program on July 2009 to April 2017 were included (n = 148)...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29577233/an-assessment-of-the-tolerability-of-the-cook-staged-extubation-wire-in-patients-with-known-or-suspected-difficult-airways-extubated-in-intensive-care
#7
S McManus, L Jones, C Anstey, S Senthuran
The Cook staged extubation set (Cook Medical) has been developed to facilitate management of the difficult airway. A guidewire inserted before tracheal extubation provides access to the subglottic airway should re-intubation be required. This prospective cohort study examines patients' tolerance of the guidewire and its impact on clinical status around tracheal extubation in the intensive care unit. Vital signs, incidence of symptoms and patient tolerance of the wire were recorded. Twenty-three patients were enrolled and 17 (73%) tolerated the wire for 4 h...
March 25, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29561482/improving-postoperative-nasal-airway-patency-in-le-fort-based-maxillofacial-trauma-patients-via-a-modified-nasal-packing-technique
#8
Amir Wolff, Gabriel F Santiago, Micah Belzberg, Omri Emodi, Chad R Gordon
INTRODUCTION: Combined mid-face and nasal apparatus trauma injuries pose a significant challenge to airway patency (AW), in the immediate postoperative setting following fracture reduction. As such, the authors describe a modified technique with the goal of maintaining a patent nasal AW, while at the same time, minimizing nasopharyngeal bleeding and nasal AW edema-which can complicate patients requiring intermaxillary fixation (IMF) in the setting of pan-facial trauma. METHODS: A modified technique was devised to assist the reconstruction surgeon in avoiding the risks associated with tracheostomy placement...
March 20, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29519925/impact-of-sleep-alterations-on-weaning-duration-in-mechanically-ventilated-patients-a-prospective-study
#9
Arnaud W Thille, Faustine Reynaud, Damien Marie, Stéphanie Barrau, Ludivine Rousseau, Christophe Rault, Véronique Diaz, Jean-Claude Meurice, Rémi Coudroy, Jean-Pierre Frat, René Robert, Xavier Drouot
Sleep is markedly altered in intensive care unit (ICU) patients and may alter respiratory performance. Our objective was to assess the impact of sleep alterations on weaning duration.We conducted a prospective physiological study at a French teaching hospital. ICU patients intubated for at least 24 h and difficult to wean were included. Complete polysomnography (PSG) was performed after the first spontaneous breathing trial failure. Presence of atypical sleep, duration of sleep stages, particularly rapid eye movement (REM) sleep, and electroencephalogram (EEG) reactivity at eyes opening were assessed by a neurologist...
April 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29502374/-a-randomized-controlled-study-of-erlotinib-versus-pemetrexed-combined-with-cisplatin-in-neoadjuvant-therapy-of-stage-%C3%A2-a-egfr-mutant-lung-adenocarcinoma
#10
RANDOMIZED CONTROLLED TRIAL
W Q Chen, P Li, Q Wang, Y J Zhang, H Y Li, X T Jin, S Yan, G F Kou, S L Cai, G Liu
Objective: To evaluate the feasibility, efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for neoadjuvant therapy. Methods: Eighty-six patients with stage ⅢA EGFR-mutant lung adenocarcinoma were assigned to 2 groups ( n =43 in each group) according to the random number table method: neoadjuvant targeted therapy group (single oral dose of erlotinib 150 mg per day, for 9 weeks) and neoadjuvant chemotherapy group (2 cycles of pemetrexed combined with cisplatin chemotherapy followed by 3- week discontinuation)...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29491518/fast-tracking-in-adult-living-donor-liver-transplantation-a-case-series-of-15-patients
#11
Pooja Bhangui, Prashant Bhangui, Nikunj Gupta, Annu Sarin Jolly, Seema Bhalotra, Nishant Sharma, A S Soin, Vijay Vohra
Background and Aims: Fast tracking (FT) for more efficacious use of resources may be difficult after living donor liver transplantation (LDLT) due to a partial liver graft, complex vascular anastomoses and longer operating time. Our study was aimed at reporting our experience with FT (on table extubation) in LDLT recipients. A secondary objective of our study was to look at defining a subgroup of patients who could be prospectively planned for FT. Methods: We studied the demographics and outcomes of 15 LDLT recipients extubated immediately in the operating suite based on an uneventful intraoperative course, haemodynamic stability after graft reperfusion and improvement of metabolic parameters post-implantation and vascular anastomoses...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#12
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
January 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29381921/immediate-postoperative-tracheal-extubation-in-a-liver-transplant-recipient-with-encephalopathy-and-the-mayo-end-stage-liver-disease-score-of-41-a-care-compliant-case-report-revealed-meaningful-challenge-in-recovery-after-surgery-eras-for-liver-transplantation
#13
Jianbo Li, Chengdi Wang, Nan Chen, Jiulin Song, Yan Sun, Qin Yao, Lunan Yan, Jiayin Yang
RATIONALE: Immediate postoperative tracheal extubation (IPTE) is one of the most important subject in recovery after surgery (ERAS) for liver transplantation. However, the criteria for IPTE is not uniform at present. PATIENT CONCERNS: We reported a successful IPTE in a liver transplant recipient with encephalopathy and a high Mayo end-stage liver disease (MELD) score of 41, which beyond the so-called criteria reported in the literature. The patient was 48-year-old man, admitted in September 2016 for end-stage liver cirrhosis secondary to hepatitis B...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29373404/idiopathic-canalicular-inflammatory-disease-new-disease-description-of-clinical-patterns-investigations-management-and-outcomes
#14
Mohammad Javed Ali
PURPOSE: The objective of this perspective is to present a separate disease description of "idiopathic canalicular inflammatory disease" and outline the diagnostic criteria and early experiences with its investigations and management. METHODS: Retrospective case series of 44 canaliculi of 22 eyes of 11 patients presenting at a tertiary care Dacryology service over a period of 2 years with typical clinical patterns of inflammatory canaliculitis and its outcomes were studied...
January 25, 2018: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29362047/impact-of-dexmedetomidine-on-pediatric-agitation-in-the-postanesthesia-care-unit
#15
Hongyan Li, Longming Zhang, Min Shi, Shengqiang Yang, Shengde Li, Shenqiang Gao
PURPOSE: This study aims to investigate the impacts of dexmedetomidine (DEX) on agitation in the postanesthesia care unit (PACU) for pediatric patients undergoing tonsillectomy. DESIGN: Eighty-two pediatric patients with elective tonsillectomy were randomly divided into the DEX group (group D) and the control group (group C). All patients' surgery in the two study groups were completed under tracheal cannula-based general anesthesia. Group D was infused 0.2 mcg/kg/hour DEX...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29284885/anesthetic-management-for-prolonged-incidental-surgery-in-advanced-liver-disease
#16
Riddhi Kundu, Rajeshwari Subramaniam, Arijit Sardar
In spite of advances in perioperative management, operative procedures in patients with chronic liver disease pose a significant challenge for the anesthesiologist due to multisystem involvement, high risk of postoperative hepatic decompensation, and mortality. We describe the anesthetic management of an elderly patient with advanced liver disease (model for end-stage liver disease 16) for prolonged abdominal surgery. The use of invasive hemodynamic monitoring, point-of-care biochemical, and hematological surveillance coupled with prompt correction of all abnormalities was responsible for good outcome...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284879/a-comparison-of-dexmedetomidine-and-clonidine-in-attenuating-the-hemodynamic-responses-at-various-surgical-stages-in-patients-undergoing-elective-transnasal-transsphenoidal-resection-of-pituitary-tumors
#17
Summaira Jan, Zulfiqar Ali, Yasir Nisar, Imtiaz Ahmad Naqash, Syed Amer Zahoor, Shabir Ahmad Langoo, Khan Azhar
Background: Transsphenoidal approach to pituitary tumors is a commonly performed procedure with the advantage of a rapid midline access to the sella with minimal complications. It may be associated with wide fluctuations in hemodynamic parameters due to intense noxious stimulus at various stages of the surgery. As duration of the surgery is short and the patients have nasal packs, it is prudent to use an anesthestic technique with an early predictable recovery. Materials and Methods: A total of 60 patients of either sex between 18 and 65 years of age, belonging to the American Society of Anesthesiologists I and II who were undergoing elective transnasal transsphenoidal pituitary surgery were chosen for this study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29218260/a-case-of-streptococcus-anginosus-brain-abscess-caused-by-contiguous-spread-from-sinusitis-in-an-immunocompetent-patient
#18
Nathan Esplin, John W Stelzer, Sean All, Sundeep Kumar, Ejaz Ghaffar, Sayed Ali
Brain abscesses are infections of the brain parenchyma that can arise from either contiguous spread from local infection or by hematogenous spread from a distant site. Streptococcus anginosus of the Streptococcus anginosus group (SAG) is a commensal microbe of the mucosae of the oral cavity, gastrointestinal tract, and urogenital tract. We present a case of mono-microbial brain abscess caused by contiguous spread from relatively asymptomatic sinusitis that initially presented as a subdural hemorrhage on computed tomography...
October 4, 2017: Curēus
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#19
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29037430/total-spinal-block-after-local-anesthetic-administration-through-the-wrong-access-port-of-a-spinal-infusion-pump
#20
Sensar
We present a case reported on the SENSAR database. A patient with a spinal infusion pump was admitted for reservoir refill. On administration of 22ml of 0.75% bupivacaine the patient suffered a total spinal block with widespread loss strength and respiratory arrest. The patient required emergency orotracheal intubation, mechanical ventilation and admission to ICU, where extubation was achieved within two hours without incidences. At a later stage it was stated that the local anaesthetic had been administered via the access port for bolus or contrast administration instead of via the access to the reservoir...
October 13, 2017: Revista Española de Anestesiología y Reanimación
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