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anesthesia and acute renal failure

Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
M Clerc, J Prothet, T Rimmelé
Composite tissue allotransplantation (CTA) is a complex procedure requiring a multidisciplinary collaboration between surgeons, anesthetists, and transplantation specialists. We will describe the perioperative management of a bilateral forearm allograft performed at our facility. A 40-year-old man who lost both forearms was registered on the transplant waiting list; a suitable graft was available 11months later. Anesthesia required planning for vascular access, hemodynamic monitoring, fluid therapy management and prevention of deep vein thrombosis...
June 2016: Hand Surgery and Rehabilitation
Emanuela Viviani, Anna Maria Giribono, Donatella Narese, Doriana Ferrara, Giuseppe Servillo, Luca Del Guercio, Umberto Marcello Bracale
Compartment syndrome (CS) is a pathological increase of the interstitial pressure within the closed osseous fascial compartments. Trauma is the most common cause, followed by embolization, burns, and iatrogenic injuries; it usually involves the limbs. The major issue when dealing with CS is the possibility to do an early diagnosis in order to intervene precociously, through a fasciotomy, reducing the risk of tissue, vascular and nervous damage. Although it is an infrequent condition, it is potentially life threatening...
August 31, 2016: International Journal of Lower Extremity Wounds
Matthew J G Sigakis, Lisa R Leffert, Hooman Mirzakhani, Nadir Sharawi, Baskar Rajala, William M Callaghan, Elena V Kuklina, Andreea A Creanga, Jill M Mhyre, Brian T Bateman
BACKGROUND: Discharge diagnoses are used to track national trends and patterns of maternal morbidity. There are few data regarding the validity of the International Classification of Diseases (ICD) codes used for this purpose. The goal of our study was to try to better understand the validity of administrative data being used to monitor and assess trends in morbidity. METHODS: Hospital stay billing records were queried to identify all delivery admissions at the Massachusetts General Hospital for the time period 2001 to 2011 and the University of Michigan Health System for the time period 2005 to 2011...
September 2016: Anesthesia and Analgesia
Miriam Aparecida Moreira, Maria Claudia Irigoyen, Karen Ruggeri Saad, Paulo Fernandes Saad, Marcia Kiyomi Koike, Edna Frasson de Souza Montero, José Luiz Martins
BACKGROUND: Renal ischemia/reperfusion injury induced by hemorrhagic shock (HS) and subsequent fluid resuscitation is a common cause of acute renal failure. The objective of this study was to evaluate the effect of combining N-acetylcysteine (NAC) with fluid resuscitation on renal injury in rats that underwent HS. MATERIALS AND METHODS: Two groups of male Wistar rats were induced to controlled HS at 35 mm Hg mean arterial pressure for 60 min. After this period, the HS and fluid resuscitation (HS/R) group was resuscitated with lactate containing 50% of the blood that was withdrawn...
June 1, 2016: Journal of Surgical Research
Suchita Parikh, Snehlata Tavri, Shubha Mohite
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic syndrome of headache, visual changes, altered mental status and seizures with radiologic findings of posterior cerebral white matter edema. It is seen in hypertensive encephalopathy, renal failure, and autoimmune disorders or in patients on immunosuppressants. We report a case of 24-year-old primigravida who presented at term with sudden onset hypertension, neurological deficits, and an episode of the visual blackout. Magnetic resonance imaging showed features suggestive of PRES...
May 2016: Anesthesia, Essays and Researches
Ji-Yeon Bang, JungBok Lee, Jimi Oh, Jun-Gol Song, Gyu-Sam Hwang
BACKGROUND: Acute kidney injury (AKI) is a primary cause of morbidity and mortality after major abdominal surgery; however, little is known about the effect of anesthetics on the development of AKI after colorectal surgery. The objective of this study was to compare the effects of anesthesia with propofol and sevoflurane on postoperative AKI after colorectal surgery. METHODS: For this study, we reviewed the electronic medical records of 4320 patients who underwent colorectal surgeries between January 2008 and December 2011...
August 2016: Anesthesia and Analgesia
Victoria Peer, Ramzia Abu Hamad, Sylvia Berman, Shai Efrati
BACKGROUND: Massive DNA destruction/accumulation of cell-free DNA debris is a sensitive biomarker of progressive organ/tissue damage. Deleterious consequences of DNA debris accumulation are evident in cardiac ischemia, thrombosis, auto-inflammatory diseases, SLE-induced lupus nephritis and cystic fibrosis. In case of renal pathologies, degradation and elimination of DNA debris are suppressed, due to downregulated DNAse-I activity within the diseased kidneys. The aim of the current study was to evaluate whether exogenous DNAse-I administration might exert renoprotective effects in the setting of acute kidney injury (AKI or acute renal failure)...
2016: American Journal of Nephrology
Yu-Chi Tung, Ya-Hui Hsu, Guann-Ming Chang
Hip fractures are a global public health problem. During surgery following hip fractures, both general and regional anesthesia are used, but which type of anesthesia offers a better outcome remains controversial. There has been little research evaluating different anesthetic types on mortality and readmission rates for hip fracture surgery using nationwide population-based data.We used nationwide population-based data to examine the effect of anesthetic type on mortality and readmission rates for hip fracture surgery...
April 2016: Medicine (Baltimore)
Angel Espinosa, Javier Ripollés-Melchor, Rubén Casans-Francés, Alfredo Abad-Gurumeta, Sergio D Bergese, Alix Zuleta-Alarcon, Francisco López-Timoneda, José María Calvo-Vecino
BACKGROUND: Clevidipine is an ultrashort-acting drug for rapid reduction of blood pressure by selectively acting on the L-type Ca2+ channels on arteriolar smooth muscle. The drug's ultrashort action in reducing the blood pressure is due to its rapid hydrolysis by blood and extravascular tissue esterases, which does not depend on hepato-renal metabolism and excretion. An analysis of the perioperative management of blood pressure should be considered to compare with other intravenous antihypertensive agents...
2016: PloS One
C N Xu, Y Liu, X F Li, W S Chen, X L Yang, X W Wang, Y S Zhu, H L Li, R Ma, M Chen, S Q Yu, J Yang
OBJECTIVE: To evaluate the efficacy of transcatheter intervention of paravalvular leakage (PVL) after mitral valve replacement. METHODS: Present respective study included 15 patients (8 males and mean age (53.5±11.7) years) with mitral PVL who underwent interventional therapy in our hospital from April 2014 to May 2015. There were 9 cases with NYHA heart function Ⅲ, 6 cases with NYHA heart function Ⅳ. Left ventricular ejection fraction was (46.8±8.2)%, and mitral regurgitation volume was 12...
March 2016: Zhonghua Xin Xue Guan Bing za Zhi
Christophe Vinsonneau, Emma Allain-Launay, Clarisse Blayau, Michael Darmon, Damien Ducheyron, Theophile Gaillot, Patrick M Honore, Etienne Javouhey, Thierry Krummel, Annie Lahoche, Serge Letacon, Matthieu Legrand, Mehran Monchi, Christophe Ridel, René Robert, Frederique Schortgen, Bertrand Souweine, Patrick Vaillant, Lionel Velly, David Osman, Ly Van Vong
Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD)...
December 2015: Annals of Intensive Care
Ayako Yokoi, Hisayuki Iwakura, Keiko Fujimoto
McArdle disease, known as type V glycogen storage disease, is a rare skeletal muscle disorder. Patients with McArdle disease lack skeletal muscle specific glycogen phosphorylase, and myophosphorylase. This subsequently leads to an elevation in serum creatine kinase levels, and results in suffering from exercise intolerance. They have such anesthesiological problems as follows; rhabdomyolysis, myoglobinuria, acute renal failure, and a higher risk of developing malignant hyperthermia. We report a case of general anesthesia for a patient with McArdle disease...
November 2015: Masui. the Japanese Journal of Anesthesiology
Zeynep Ersoy, Aycan Ozdemirkan, Arash Pirat, Adnan Torgay, Gulnaz Arslan, Mehmet Haberal
OBJECTIVES: Reasons for chronic liver and kidney failure may vary; sometimes more than 1 family member may be affected, and may require a transplant. The aim of this study was to examine the similarities or differences between the perioperative characteristics of siblings undergoing liver or kidney transplant. MATERIALS AND METHODS: The medical records of 6 pairs of siblings who underwent liver transplant and 4 pairs of siblings who underwent kidney transplant at Baskent University Hospital between 1989 and 2014 were retrospectively analyzed...
November 2015: Experimental and Clinical Transplantation
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Acute kidney injury (AKI) is a relatively common complication of cardiothoracic surgery and has both short- and long-term survival implications, even when AKI does not progress to severe renal failure. Given that currently, there are no active effective treatments for AKI, other than renal replacement therapy when indicated, the focus of clinicians ought to be on prevention and risk factor management. In the AKI-surgery literature, there exists this general consensus that intraoperative hypotension (IH) following hypotensive anesthesia (HA) or controlled hypotension (CH) in the operating room has no significant short-term and long-term impacts on renal function...
2015: Journal of Renal Injury Prevention
Patrick Meybohm, Berthold Bein, Oana Brosteanu, Jochen Cremer, Matthias Gruenewald, Christian Stoppe, Mark Coburn, Gereon Schaelte, Andreas Böning, Bernd Niemann, Jan Roesner, Frank Kletzin, Ulrich Strouhal, Christian Reyher, Rita Laufenberg-Feldmann, Marion Ferner, Ivo F Brandes, Martin Bauer, Sebastian N Stehr, Andreas Kortgen, Maria Wittmann, Georg Baumgarten, Tanja Meyer-Treschan, Peter Kienbaum, Matthias Heringlake, Julika Schön, Michael Sander, Sascha Treskatsch, Thorsten Smul, Ewa Wolwender, Thomas Schilling, Georg Fuernau, Dirk Hasenclever, Kai Zacharowski
BACKGROUND: Remote ischemic preconditioning (RIPC) is reported to reduce biomarkers of ischemic and reperfusion injury in patients undergoing cardiac surgery, but uncertainty about clinical outcomes remains. METHODS: We conducted a prospective, double-blind, multicenter, randomized, controlled trial involving adults who were scheduled for elective cardiac surgery requiring cardiopulmonary bypass under total anesthesia with intravenous propofol. The trial compared upper-limb RIPC with a sham intervention...
October 8, 2015: New England Journal of Medicine
Patricia Martín-Hernández, Hugo Gutiérrez-Leonard, José Luis Ojeda-Delgado, Jorge Fagoaga-Valdivia, Rodolfo Barrios-Nanni, Martha Elena Rodríguez-Somarriba, Luis Manuel Páez-Lizárraga, Luis Enrique Berúmen-Domínguez, Lázaro Hernández-Jiménez, Victoria Rebollo-Hurtado, María Del Rocio Blázquez-Cruz
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is an alternative treatment for patients with severe symptomatic aortic stenosis, inoperable or at high surgical risk. The purpose of this communication is to report the results of the experience of this new technique and compare them with literature. METHODS: Review of 17 patients data with symptomatic severe aortic stenosis at high surgical risk or inoperable, treated with a transcatheter implantation aortic valve (TAVI) via femoral surgical access with Core Valve (Medtronic, EE...
October 2015: Archivos de Cardiología de México
Meena Kalyanaraman, Derrick McQueen, Joseph Sykes, Tej Phatak, Farhaan Malik, Preethi S Raghava
Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut...
April 2015: Korean Journal of Pediatrics
Joseph A Hyder, J Kyle Bohman, Daryl J Kor, Arun Subramanian, Edward A Bittner, Bradly J Narr, Robert R Cima, Victor M Montori
BACKGROUND: A patient undergoing surgery may receive anesthesia care from several anesthesia providers. The safety of anesthesia care transitions has not been evaluated. Using unconditional and conditional multivariable logistic regression models, we tested whether the number of attending anesthesiologists involved in an operation was associated with postoperative complications. METHODS: In a cohort of patients undergoing elective colorectal surgical in an academic tertiary care center with a stable anesthesia care team model participating in the American College of Surgeons National Surgical Quality Improvement Program, using unconditional and conditional multivariable logistic regression models, we tested adjusted associations between numbers of attending anesthesiologists and occurrence of death or a major complication (acute renal failure, bleeding that required a transfusion of 4 units or more of red blood cells within 72 hours after surgery, cardiac arrest requiring cardiopulmonary resuscitation, coma of 24 hours or longer, myocardial infarction, unplanned intubation, ventilator use for 48 hours or more, pneumonia, stroke, wound disruption, deep or organ-space surgical-site infection, superficial surgical-site infection, sepsis, septic shock, systemic inflammatory response syndrome)...
January 2016: Anesthesia and Analgesia
Kosuke Shibamori, Takanobu Yamamoto, Masahiro Matsuki, Yohei Matsuda, Shuichi Kato, Fumiyasu Takei, Masahiro Yanase
Rhabdomyolysis is a rare perioperative complication, however, potentially lead to fatal outcome. We experienced 2 cases of rhabdomyolysis after radical nephrectomy and nephroureterectomy in the lateral decubitus position. (Case 1) A 40-years old man was seen in our hospital because of asymptomatic grosshematuria. Computed tomography revealed right renal pelvic cancer, cT3N0M0. Right radical nephroureterectomy, lymph node dissection, partial cystectomy was underwent, and the operation was finished without any trouble...
October 2014: Nihon Hinyōkika Gakkai Zasshi. the Japanese Journal of Urology
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