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https://www.readbyqxmd.com/read/28743152/-prevention-of-perioperative-hypothermia-guidelines-for-daily-clinical-practice
#1
Timo Iden, Jan Höcker
Inadvertent perioperative hypothermia (body core temperature < 36 °C) is a serious complication leading to increased rates of wound infection, higher blood loss associated with increased transfusion requirements as well as patient dissatisfaction among others. Body core temperature is a vital parameter and needs constant monitoring just like heart rate, blood pressure and arterial oxygen saturation. Patient-, anesthesia-, surgery- and environment-related risk factors were identified for occurring perioperative hypothermia...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743150/-anesthesiology-and-outcome-impact-of-the-perioperative-process
#2
Jörg Zieger, Helene A Häberle
In recent years, the role of the anesthesiologist has turned tremendously from the "anaesthesia doctor" into a perioperative physician and risk specialist. Patients are older, multimorbid, and are called up for more and more extensive surgery and interventions. Socioeconomic aspects have grown in importance. The anesthesiologist, paving the way for a good outcome, is involved in nearly all perioperative processes: preoperative evaluation, definition and optimization of preoperative and intraoperative conditions, management of modern intraoperative anesthesia as well as postoperative medically indicated, effective and efficient treatment of partially highly complex patients...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28741745/venous-thromboembolism-prophylaxis-in-urology-a-review
#3
REVIEW
Manmeet Saluja, Peter Gilling
Venous thromboembolism is potentially a lethal problem, and is associated with chronic morbidity. Venous thromboembolism is frequently diagnosed after urological surgery, yet the role of perioperative venous thromboembolism prophylaxis is not clearly defined. Any current recommendations are largely based on evidence derived from other surgical specialties. Even within different guidelines, there remains significant variation, suggesting a consensus is required. The present review aims to define the problem of venous thromboembolism within the urological population, and identifies patients at risk...
July 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28741039/association-of-opioid-prescription-and-perioperative-complications-in-obstructive-sleep-apnea-patients-undergoing-total-joint-arthroplasties
#4
Eva E Mörwald, Ashley Olson, Crispiana Cozowicz, Jashvant Poeran, Madhu Mazumdar, Stavros G Memtsoudis
PURPOSE: Obstructive sleep apnea (OSA) has been linked to higher rates of perioperative complications. Practice guidelines recommend minimizing opioids in this cohort to reduce complications. However, a paucity of evidence exists relating different levels of opioid prescription to perioperative complications. Our aim was to investigate if different levels of opioid prescription are related to perioperative complication risk in patients with OSA. METHODS: A total of 107,610 OSA patients undergoing total knee or hip arthroplasty between 2006 and 2013 were identified in a nationwide database and divided into subgroups according to the amount of opioids prescribed...
July 24, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28739038/anesthetic-and-perioperative-management-of-patients-with-brugada-syndrome
#5
REVIEW
Gregory Dendramis, Claudia Paleologo, Giuseppe Sgarito, Umberto Giordano, Roberto Verlato, Adrian Baranchuk, Pedro Brugada
Brugada syndrome (BrS) is an arrhythmogenic disease reported to be one among the leading causes of cardiac death in subjects under the age of 40 years. In these patients, episodes of lethal arrhythmias may be induced by several factors or situations, and for this reason, management during anesthesia and surgery must provide some precautions and drugs restrictions. To date, it is difficult to formulate guidelines for anesthetic management of patients with BrS because of the absence of prospective studies, and there is not a definite recommendation for neither general nor regional anesthesia, and there are no large studies in merit...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#6
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737843/non-steroidal-anti-inflammatory-drugs-nsaids-for-cancer-related-pain-in-children-and-adolescents
#7
REVIEW
Tess E Cooper, Lauren C Heathcote, Brian Anderson, Marie-Claude Grégoire, Gustaf Ljungman, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for persisting pain in children acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28735375/perioperative-practices-concerning-one-anastomosis-mini-gastric-bypass-a-survey-of-210-surgeons
#8
Kamal K Mahawar, Kuldeepak Singh Kular, Chetan Parmar, Michael Van den Bossche, Yitka Graham, William R J Carr, Brijesh Madhok, Conor Magee, Sanjay Purkayastha, Peter K Small
BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB. METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included...
July 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28730776/institutional-variations-in-nutritional-aspects-of-enhanced-recovery-pathways-after-elective-surgery-for-colon-cancer
#9
Fotios Seretis, Panagiota Kaisari, Kasun Wanigasooriya, Edward Rawstorne, Charalampos Seretis
PURPOSE: Perioperative nutritional optimisation is one of the key aspects of the Enhanced Recovery after Surgery (ERAS) pathway after elective colorectal cancer resections. Despite the general acceptance of ERAS as a safe and cost-effective perioperative care bundle, significant variations in terms of nutritional support exist among colorectal units. METHODS: To assess these variations, we performed a cross-sectional online survey among colorectal surgical residents within a UK region...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730640/2016-updated-thai-rheumatism-association-recommendations-for-the-use-of-biologic-and-targeted-synthetic-disease-modifying-anti-rheumatic-drugs-in-patients-with-rheumatoid-arthritis
#10
Worawit Louthrenoo, Nuntana Kasitanon, Wanruchada Katchamart, Duangkamol Aiewruengsurat, Parawee Chevaisrakul, Praveena Chiowchanwisawakit, Pornchai Dechanuwong, Punchong Hanvivadhanakul, Ajanee Mahakkanukrauh, Siriporn Manavathongchai, Chayawee Muangchan, Pongthorn Narongroeknawin, Veerapong Phumethum, Boonjing Siripaitoon, Anawat Suesuwan, Siraphop Suwannaroj, Parichat Uea-Areewongsa, Sittichai Ukritchon, Paijit Asavatanabodee, Ajchara Koolvisoot, Ratanavadee Nanagara, Kitti Totemchokchyakarn, Kanokrut Nuntirooj, Tasanee Kitumnuaypong
AIM: In June 2015, the Thai Rheumatism Association (TRA) approved an update of its recommendation for the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) and targeted synthetic (tsDMARD) in the treatment of rheumatoid arthritis (RA) to cover those currently available in Thailand (etanercept, infliximab, golimumab, rituximab, tocilizumab, abatacept and tofacitinib). METHOD: A search of the literature was performed between January 2000 and June 2015...
July 21, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28729903/tranexamic-acid-and-trauma-induced-coagulopathy
#11
REVIEW
Takeshi Nishida, Takahiro Kinoshita, Kazuma Yamakawa
Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the interaction of plasminogen with the lysine residues of fibrin. Historically, TXA is commonly used for reduction of blood loss in perioperative situations, while recently it has attracted attention for clinical use in the trauma field. In 2010, the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage 2 (CRASH-2) trial demonstrated that intravenous administration of TXA improved mortality significantly in trauma patients with significant bleeding...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28728273/-a-retrospective-study-of-the-perioperative-complications-following-whole-lung-lavage-in-the-treatment-of-pulmonary-alveolar-proteinosis
#12
Z Q Zhou, W L Guo, Y Chen, C H Zhong, S Y Li
Objective: To evaluate the safety of the procedures of whole lung lavage(WLL) for pulmonary alveolar proteinosis(PAP) in perioperative period. Methods: In this retrospective study, we collected clinical data from 78 WLL procedures of PAP patients from January 2006 to June 2016 in Guangzhou Institute of Respiratory Disease. The causes of perioperative complications were analyzed. Results: Eighteen (23.07%) of the 78 procedures developed complications, including pleural effusion(n=4), pneumonia(n=4), cardiac failure(n=2), cardiac arrhythmia (n=2), pneumothorax(n=2), atelectasis(n=1), lung edema(n=1), laryngeal edema(n=1), pleural effusion and pneumonia(n=1)...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#13
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28721349/hepatocellular-carcinoma-early-stage-management-challenges
#14
REVIEW
Derek J Erstad, Kenneth K Tanabe
Hepatocellular carcinoma (HCC) is a major cause of cancer death and is increasing in incidence. This review focuses on HCC surveillance and treatment of early-stage disease, which are essential to improving outcomes. Multiple societies have published HCC surveillance guidelines, but screening efforts have been limited by noncompliance and overall lack of testing for patients with undiagnosed chronic liver disease. Treatment of early-stage HCC has become increasingly complex due to expanding therapeutic options and better outcomes with established treatments...
2017: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/28719780/venous-thromboembolic-prophylaxis-in-foot-and-ankle-surgery-a-review-of-current-literature-and-practice
#15
Martin H S Weisman, James R Holmes, Todd A Irwin, Paul G Talusan
Venous thromboembolism (VTE) is a well-known and feared complication following foot and ankle surgery, as it is a source of morbidity and mortality in the perioperative phase. The most recent CHEST guidelines recommended against the use of chemoprophylaxis and the majority of the literature has found a low incidence of VTE following foot and ankle surgery. Some authors prefer screening patients for risk factors and recommend the use of chemoprophylaxis on a case-by-case basis. Interestingly, studies that found high incidence of VTE were unable to determine a statistically significant difference between the prophylaxis and placebo groups...
August 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#16
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#17
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28711167/perioperative-management-of-hypertensive-neuroblastoma-a-study-from-the-italian-group-of-pediatric-surgical-oncologists-gicop
#18
Luca Pio, Stefano Avanzini, Girolamo Mattioli, Giuseppe Martucciello, Angela Rita Sementa, Massimo Conte, Annarita Gigliotti, Claudio Granata, Ernesto Leva, Anna Maria Fagnani, Umberto Caccioppoli, Nino Tedesco, Jurgen Schleef, Elisa Tirtei, Fortunato Siracusa, Paolo D'Angelo, Pierluigi Lelli Chiesa, Lucia Miglionico, Bruno Noccioli, Elisa Severi, Claudio Carlini, Francesco Vaccarella, Francesco Camoglio, Simone Cesaro, Alessandra Narciso, Giovanna Riccipetitoni, Giovanni Cecchetto, Alessandro Inserra
BACKGROUND: Hypertension (HT) is rarely reported in patients affected by Neuroblastoma (NB), and management guidelines are lacking. Clinical features and perioperative medical treatment in such patients were reviewed to 1) ascertain whether a shared treatment strategy exists among centers and 2) if possible, propose some recommendations for the perioperative management of HT in NB patients. METHODS: A retrospective multicenter survey was conducted on patients affected by NB who presented HT symptoms...
July 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28708482/metabolic-surgery-for-treating-type-2-diabetes-mellitus-now-supported-by-the-world-s-leading-diabetes-organizations
#19
REVIEW
Philip R Schauer, Zubaidah Nor Hanipah, Francesco Rubino
The term metabolic surgery describes bariatric surgical procedures used primarily to treat type 2 diabetes and related metabolic conditions. Originally, bariatric surgery was used as an alternative weight-loss therapy for patients with severe obesity, but clinical data revealed its metabolic benefits in patients with type 2 diabetes. Metabolic surgery is more effective than lifestyle or medical management in achieving glycemic control, sustained weight loss, and reducing diabetes comorbidities. Perioperative adverse events are similar to other gastrointestinal surgeries...
July 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28708024/quality-improvement-initiative-preventative-surgical-site-infection-protocol-in-vascular-surgery
#20
David Parizh, Enrico Ascher, Syed Ali Raza Rizvi, Anil Hingorani, Michael Amaturo, Eric Johnson
Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. SUMMARY BACKGROUND DATA: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications...
January 1, 2017: Vascular
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