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Perioperative guidelines

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https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#1
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29138076/the-effect-of-obesity-on-clinical-outcomes-following-minimally-invasive-spine-surgery-a-systematic-review-and-meta-analysis
#2
Tao Wang, Chao Han, Hongqiang Jiang, Peng Tian
BACKGROUND: Obesity is associated with increasing morbidity and mortality in many prevalent diseases, especially for lumbar degenerative disease. The relationship between minimally invasive spine (MIS) surgery and perioperative adverse events in obese patients with lumbar degenerative disease has not been well evaluated. METHODS: We conducted a systematic review and meta-analysis to identify relevant studies involving obese patients with MIS surgery in electronic databases, including Web of Science, Embase, PubMed, the Cochrane Controlled Trials Register, and the Cochrane Library up to June 2017...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137588/sodium-glucose-linked-transporter-2-inhibitor-associated-perioperative-euglycaemic-diabetic-ketoacidosis-a-case-for-a-perioperative-guideline
#3
C Hoffman, M Green, O Megafu
No abstract text is available yet for this article.
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136561/calibrated-automated-thrombogram-values-in-infants-with-cardiac-surgery-before-and-after-cardiopulmonary-bypass
#4
Alessandra Rizza, Giovina Di Felice, Rosa Luciano, Ottavia Porzio, Ombretta Panizzon, Maurizio Muraca, Paola Cogo
INTRODUCTION: Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. MATERIALS AND METHODS: Prospective observational study performed in children aged <24months undergoing cardiac surgery with CPB...
September 21, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29136086/intraoperative-oliguria-predicts-acute-kidney-injury-after-major-abdominal-surgery
#5
T Mizota, Y Yamamoto, M Hamada, S Matsukawa, S Shimizu, S Kai
Background: The threshold of intraoperative urine output below which the risk of acute kidney injury (AKI) increases is unclear. The aim of this retrospective cohort study was to investigate the relationship between intraoperative urine output during major abdominal surgery and the development of postoperative AKI and to identify an optimal threshold for predicting the differential risk of AKI. Methods: Perioperative data were collected retrospectively on 3560 patients undergoing major abdominal surgery (liver, colorectal, gastric, pancreatic, or oesophageal resection) at Kyoto University Hospital...
October 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#6
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29129637/a-multicentre-qualitative-study-assessing-implementation-of-an-enhanced-recovery-after-surgery-program
#7
D Martin, D Roulin, F Grass, V Addor, O Ljungqvist, N Demartines, M Hübner
BACKGROUND & AIMS: The existence of enhanced recovery specific guidelines (ERAS) is not enough to change patient management practice since many barriers exist to successful ERAS implementation. The present survey aimed to analyse motivations for implementation as well as encountered difficulties and challenges. Further, relevance and importance of perioperative care items and postoperative recovery targets were assessed. METHODS: A multicentre qualitative study was conducted between August and December 2016 among surgeons, anaesthesiologists and nurses from implemented ERAS centres in Switzerland (n = 16) and Sweden (n = 14)...
October 31, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29126584/comparison-of-4-cardiac-risk-calculators-in-predicting-postoperative-cardiac-complications-after-noncardiac-operations
#8
Steven L Cohn, Nerea Fernandez Ros
The 2014 American College of Cardiology/American Heart Association Perioperative Guidelines suggest using the Revised Cardiac Risk Index, myocardial infarction or cardiac arrest, or American College of Surgeons-National Surgical Quality Improvement Program calculators for combined patient-surgical risk assessment. There are no published data comparing their performance. This study compared these risk calculators and a reconstructed Revised Cardiac Risk Index in predicting postoperative cardiac complications, both during hospitalization and 30 days after operation, in a patient cohort who underwent select surgical procedures in various risk categories...
October 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29121311/guidelines-for-perioperative-pain-management-need-for-re-evaluation
#9
G P Joshi, H Kehlet
No abstract text is available yet for this article.
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121288/benefit-and-harm-of-pregabalin-in-acute-pain-treatment-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#10
M L Fabritius, C Strøm, S Koyuncu, P Jæger, P L Petersen, A Geisler, J Wetterslev, J B Dahl, O Mathiesen
Pregabalin has demonstrated anti-hyperalgesic properties and was introduced into acute pain treatment in 2001. Our aim was to evaluate the beneficial and harmful effects of pregabalin in postoperative pain management. We included randomized clinical trials investigating perioperative pregabalin treatment in adult surgical patients. The review followed Cochrane methodology, including Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and used trial sequential analyses (TSAs). The primary outcomes were 24 h morphine i...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29119207/anesthesia-in-a%C3%A2-child-with-suspected-peroxisomal-disorder
#11
J S Englbrecht, M Maas
We present the case of an 8‑year-old female child with suspected peroxisomal disorder requiring general anesthesia for adenotomy, paracentesis and brainstem-evoked response audiometry. Peroxisomes are small intracellular organelles that catalyse key metabolic reactions. Peroxisomal disorders are a heterogeneous group of rare genetic diseases. Anesthesia can be challenging as adrenal insufficiency, mental retardation, muscle weakness, risk of pulmonary aspiration, airway complications, seizure disorders and altered pharmacokinetics and pharmacodynamics can occur in these patients but guidelines for anesthesia do not exist due to the heterogeneity and rarity of these diseases and case reports are rare...
November 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29117272/risks-associated-with-primary-and-redo-carotid-endarterectomy-in-the-endovascular-era
#12
Isibor J Arhuidese, Muhammad Faateh, Besma J Nejim, Satinderjit Locham, Christopher J Abularrage, Mahmoud B Malas
Importance: Clinical experience suggests worse outcomes for redo carotid endarterectomy (CEA) relative to primary CEA. Objective quantification of the excess risk attributable to redo CEA in this era of proliferating endovascular therapy remains to be determined. Objective: To evaluate the risks of redo CEA relative to primary CEA. Design, Setting, and Participants: This study was a retrospective analysis of a prospective cohort of patients maintained by the Society for Vascular Surgery in the Vascular Quality Initiative between January 1, 2003, and April 30, 2016...
November 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29112553/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-executive-summary
#13
Arash Afshari, Walter Ageno, Aamer Ahmed, Jacques Duranteau, David Faraoni, Sibylle Kozek-Langenecker, Juan Llau, Jacky Nizard, Maurizio Solca, Jakob Stensballe, Emmanuel Thienpont, Eleftherios Tsiridis, Linas Venclauskas, Charles Marc Samama
No abstract text is available yet for this article.
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112552/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis
#14
Charles Marc Samama, Arash Afshari
No abstract text is available yet for this article.
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112551/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-inferior-vena-cava-filters
#15
Raquel Ferrandis Comes, Patrick Mismetti, Arash Afshari
: The indications for the use of an inferior vena cava filter (IVCF) in the context of deep venous thrombosis to prevent pulmonary embolism remain controversial. Despite wide use in clinical practice, great variation exists in national and international guidelines in regard to the indications. In addition, clinical practice is based on poor-quality data from trauma and bariatric surgery with a high incidence of complications. It is often difficult to assess their efficacy and lack of filter retrieval appears to be a substantial issue compared with a potential benefit by insertion of these devices...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112550/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-mechanical-prophylaxis
#16
Arash Afshari, Christian Fenger-Eriksen, Manuel Monreal, Peter Verhamme
: Institutional protocols need to address the indications for pharmacological and mechanical thromboprophylaxis. The use of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) strongly differs between institutions. As a consequence, no strong recommendations can be made based on the contemporary high-level evidence. Although different clinical practices can be supported, such approaches should be part of an institutional strategy to reduce the burden of venous thromboembolism (VTE)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112549/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-patients-with-preexisting-coagulation-disorders-and-after-severe-perioperative-bleeding
#17
Aamer Ahmed, Sibylle Kozek-Langenecker, François Mullier, Sue Pavord, Cedric Hermans
: In patients with inherited bleeding disorders undergoing surgery, we recommend assessment of individual risk for venous thromboembolism, taking into account the nature of the surgery and anaesthetic, type and severity of bleeding disorder, age, BMI, history of thrombosis, the presence of malignancy and other high-risk comorbidities. Venous thromboembolism risk should be balanced against the increased bleeding risk associated with anticoagulant use in patients with known bleeding disorders (Grade 1C). In these patients undergoing major surgery, we recommend against routine postoperative use of pharmacological thromboprophylaxis, especially for patients with haemophilia A and B (Grade 1B)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112548/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-aspirin
#18
Jean-Yves Jenny, Ingrid Pabinger, Charles Marc Samama
: There is a good rationale for the use of aspirin in venous thromboembolism prophylaxis in some orthopaedic procedures, as already proposed by the 9th American College of Chest Physicians' guidelines (Grade 1C). We recommend using aspirin, considering that it may be less effective than or as effective as low molecular weight heparin for prevention of deep vein thrombosis and pulmonary embolism after total hip arthroplasty, total knee arthroplasty and hip fracture surgery (Grade 1C). Aspirin may be less effective than or as effective as low molecular weight heparins for prevention of deep vein thrombosis and pulmonary embolism after other orthopaedic procedures (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112547/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-chronic-treatments-with-antiplatelet-agents
#19
Juan V Llau, Pieter Kamphuisen, Pierre Albaladejo
: Antiplatelet agents (APA) are considered first-line therapy in preventing cardiovascular thrombotic events, but they are of limited value in the prophylaxis of venous thromboembolism (VTE) during the perioperative period. Consequently, many patients should receive both an APA and an anticoagulant. This combination can increase the bleeding risk and it is necessary to make some recommendations to minimise that risk. In patients receiving APA chronically, if the risk of VTE outweighs the risk of bleeding, we suggest pharmacological prophylaxis (grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#20
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
November 6, 2017: European Journal of Anaesthesiology
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