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https://www.readbyqxmd.com/read/28625752/neurologic-complications-of-extracorporeal-membrane-oxygenation-a-review
#1
REVIEW
Ashleigh Xie, Phillip Lo, Tristan D Yan, Paul Forrest
OBJECTIVE: To review the evidence on neurologic complications in adult extracorporeal membrane oxygenation (ECMO) patients with regard to incidence, pathophysiology, risk factors, diagnosis, monitoring techniques, prevention, and management. DESIGN: Literature review. SETTING: Observational studies and case reports from a variety of institutions. PARTICIPANTS: Adult ECMO patients. INTERVENTIONS: Six electronic databases were searched from their dates of inception to October 2016...
March 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28623598/cost-effectiveness-of-two-decision-strategies-for-shunt-use-during-carotid-endarterectomy
#2
Joe L P Kolkert, Rolf H H Groenwold, Vanessa J Leijdekkers, Joep Ter Haar, Clark J Zeebregts, Anco Vahl
BACKGROUND: Arterial shunting during carotid endarterectomy (CEA) is essential in some patients because of insufficient cerebral perfusion during cross-clamping. However, the optimal diagnostic modality identifying these patients is still debated. None of the currently used modalities has been proved superior to another. The aim of this study was to assess the cost-effectiveness of two modalities, stump pressure measurement (SPM) versus electroencephalography (EEG) combined with transcranial Doppler (TCD) during CEA...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28622836/safety-assessment-of-the-use-of-ultrasonic-energy-in-the-proximity-of-the-recurrent-laryngeal-nerve-in-a-porcine-model
#3
Karla V Chávez, Elpidio M Barajas, Francisco Soroa, Armando Gamboa-Dominguez, Samuel Ordóñez, Juan P Pantoja, Mauricio Sierra, David Velázquez-Fernández, Miguel F Herrera
BACKGROUND: Advanced bipolar and ultrasonic energy have demonstrated reduction of operating time and blood loss in thyroidectomy. However, these devices generate heat and thermal dispersion that may damage adjacent structures such as the recurrent laryngeal nerve (RLN). This study was designed to evaluate the safety profile of the Harmonic Focus+(®) (HF+) device through the evaluation of thermal injury to the RLN using different algorithms of distance and time with state of the art technology...
June 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28619491/the-accuracy-of-multimodality-intraoperative-neuromonitoring-to-predict-postoperative-neurological-deficits-following-cervical-laminoplasty
#4
Junichi Oya, John F Burke, Todd Vogel, Boby Tay, Dean Chou, Praveen Mummaneni
BACKGROUND: Intraoperative neuromonitoring (IONM) has been reported to be sensitive and specific in the detection of neurological injury during spinal surgery. However, utilizing multimodality IONM to predict postoperative neural deficits following cervical laminoplasty remains unclear. OBJECTIVE: The purpose of this study is to clarify the incidence of C5 palsy utilizing multimodality IONM and to compare the accuracy of multimodality IONM to predict postoperative C5 palsy against isolated transcranial motor-evoked potential (MEP)...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#5
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). However, recently the use of external ventricular drains and intracranial pressure monitors in traumatic brain injury has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multimodality monitoring system, we continuously monitored brain tissue oxygenation (PbtO2) and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe traumatic brain injury (TBI)...
June 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28614281/transcranial-motor-evoked-potential-alarm-criteria-to-predict-foot-drop-injury-during-lumbosacral-surgery
#6
Arvydas Tamkus, Kent S Rice, Gregory Hoffman
STUDY DESIGN: Retrospective cohort analysis. OBJECTIVE: This study aims to investigate whether waveform alterations in transcranial motor evoked potentials (TCMEP) can reliably predict postoperative foot drop. SUMMARY OF BACKGROUND DATA: Nerve injury leading to foot drop is a potential complication of lumbosacral surgery. Very limited data exist on the use of intraoperative TcMEPs to identify iatrogenic foot drop. METHODS: We retrospectively reviewed neuromonitoring data from 130 consecutive spine surgeries with instrumentation involving L4-S1...
June 13, 2017: Spine
https://www.readbyqxmd.com/read/28593626/safety-of-lateral-interbody-fusion-surgery-without-intraoperative-monitoring
#7
Hong-Jae Lee, Kyeong-Sik Ryu, Jung-Woo Hur, Ji-Hoon Seong, Hyun-Jin Cho, Jin-Sung Kim
AIM: Oblique lateral interbody fusion (OLIF) is a minimally invasive surgical method that can access lumbar spine without direct dissection of psoas muscle and the need for intraoperative neuromonitoring (IOM) is questionable. The purpose of this study is to examine and document the transient and persistent perioperative complications in patients who underwent OLIF for degenerative lumbar disease without IOM. MATERIAL AND METHODS: Total 129 consecutive patients who were diagnosed as degenerative spinal disease from L1 to S1 and underwent the mini-open OLIF, were identified and retrospectively reviewed...
May 7, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28585717/a-meta-analysis-of-intraoperative-neuromonitoring-of-recurrent-laryngeal-nerve-palsy-during-thyroid-reoperations
#8
Wei Sun, Jinhao Liu, Hao Zhang, Ping Zhang, Zhihong Wang, Wenwu Dong, Liang He, Ting Zhang
BACKGROUND: The rate of recurrent laryngeal nerve (RLN) palsy, a common complication of thyroid surgery, is especially high in thyroid reoperations. The present meta-analysis assesses whether intraoperative neuromonitoring (IONM) reduces the prevalence of RLN palsy in thyroid reoperations. DESIGN AND METHODS: A systematic literature search was conducted in the PubMed, SCIE, and Wan Fang databases for studies published up to August 31, 2016. All data were analysed using STATA (version 11) software...
June 6, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28573388/medical-management-of-the-severe-traumatic-brain-injury-patient
#9
Jonathan Marehbian, Susanne Muehlschlegel, Brian L Edlow, Holly E Hinson, David Y Hwang
Severe traumatic brain injury (sTBI) is a major contributor to long-term disability and a leading cause of death worldwide. Medical management of the sTBI patient, beginning with prehospital triage, is aimed at preventing secondary brain injury. This review discusses prehospital and emergency department management of sTBI, as well as aspects of TBI management in the intensive care unit where advances have been made in the past decade. Areas of emphasis include intracranial pressure management, neuromonitoring, management of paroxysmal sympathetic hyperactivity, neuroprotective strategies, prognostication, and communication with families about goals of care...
June 1, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28537567/intraoperative-neuromonitoring-of-hypogastric-plexus-branches-during-surgery-for-rectal-cancer-preliminary-report
#10
Piotr Wałęga, Michał Romaniszyn, Maciej Wałęga, Jarosław Szymon Świrta, Wojciech Nowak
AIM: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. MATERIALS AND METHODS: We qualified 4 patients (2 women, 2 men; age 42 - 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28506407/intraoperative-neuromonitoring-in-thyroid-surgery-is-the-two-staged-thyroidectomy-justified
#11
Pietro Giorgio Calò, Fabio Medas, Giovanni Conzo, Francesco Podda, Gian Luigi Canu, Claudio Gambardella, Giuseppe Pisano, Enrico Erdas, Angelo Nicolosi
BACKGROUND: The aim of this study was to evaluate the diagnostic accuracy of intraoperative neuromonitoring (IONM) in predicting postoperative nerve function during thyroid surgery and its consequent ability to assist the surgeon in intraoperative decision making. MATERIALS AND METHODS: A total of 2365 consecutive patients were submitted to thyroidectomy by the same surgical team. Group A included 1356 patients (2712 nerves at risk) in whom IONM was utilized, and Group B included 1009 patients (2018 nerves at risk) in whom IONM was not utilized...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28504930/extracorporeal-stimulation-of-sacral-nerve-roots-for-observation-of-pelvic-autonomic-nerve-integrity-description-of-a-novel-methodological-setup
#12
Tomasz Moszkowski, Daniel Kauff, Celine Wegner, Roman Ruff, Karin Somerlik-Fuchs, Thilo Krueger, Piotr Augustyniak, Klaus-Peter Hoffmann, Werner Kneist
INTRODUCTION: Neurophysiologic monitoring can improve autonomic nerve sparing during critical phases of rectal cancer surgery. OBJECTIVES: To develop a system for extracorporeal stimulation of sacral nerve roots. METHODS: Dedicated software controlled a ten-electrode stimulation array by switching between different electrode configurations and current levels. A built-in impedance and current level measurement assessed the effectiveness of current injection...
May 12, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28494900/perioperative-strokes-after-coronary-artery-bypass-grafting-with-staged-carotid-endarterectomy-a-nationwide-perspective
#13
Hannah Cheng, Reshmi Udesh, Amol Mehta, Parthasarathy D Thirumala
STUDY OBJECTIVE: To examine the risk of perioperative stroke on in-hospital morbidity and mortality in staged coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) procedures. DESIGN: The National Inpatient Sample (NIS) database was used to extract data on all patients who underwent staged CABG CEA procedures. They were identified using the ICD-9 (International Classification of Diseases, Ninth Revision-Clinical Modification) diagnosis and procedure codes...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28481390/multimodal-intraoperative-neurophysiologic-monitoring-in-the-neurosurgical-oncology
#14
Sema Brandmeier, Emine Taşkiran, Fatihhan Bölükbaşi, Ramazan Sari, İlhan Elmaci
AIM: Neurosurgical oncology that is performed for lesions located in critical areas like the sensorimotor area has additional risk because it may cause serious neurological deficiencies. Some intraoperative neuromonitoring (IONM) modalities can effectively help the surgeons to maximize resections of this kind of lesions with or without an acceptable neurological deficiency. Our aim was to share our IONM experiences with patients who underwent intracranial lesion surgery in critical areas between September 2013 and January 2015...
March 26, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28471443/the-role-of-near-infrared-spectroscopy-monitoring-in-preterm-infants
#15
P Korček, Z Straňák, J Širc, G Naulaers
Neurological morbidities such as peri/intraventricular hemorrhage and periventricular leukomalacia largely determine the neurodevelopmental outcome of vulnerable preterm infants and our aim should be to minimize their occurrence or severity. Bed-side neuromonitoring could provide valuable pieces of information about possible hemodynamic disturbances that are significantly associated with neurological morbidities and increased mortality. Near-infrared spectroscopy offers evaluation of regional cerebral oxygenation, which in conjunction with other non-invasive methods may give us a more complete picture about end-organ perfusion...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28466363/the-identification-preservation-and-classification-of-the-external-branch-of-the-superior-laryngeal-nerve-in-thyroidectomy
#16
Kun Wang, Huilan Cai, Deguang Kong, Qiuxia Cui, Dan Zhang, Gaosong Wu
BACKGROUND: Avoiding injury to the external branch of the superior laryngeal nerve is one of the major challenges during thyroid operation. The aim of this study was to propose a practical classification of the external branch of the superior laryngeal nerve. METHODS: A retrospective study of total thyroidectomy was performed. Totally 240 patients were included, with 480 external branches of the superior laryngeal nerves explored by intraoperative neuromonitoring...
May 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28452617/intradiploic-encephalocele-of-the-primary-motor-cortex-in-an-adult-patient-electrophysiological-implications-during-surgery
#17
Luca Valci, Martina Dalolio, Dominique Kuhlen, Emanuele Pravatà, Claudio Gobbi, Michael Reinert
Encephaloceles are herniations of brain parenchyma through congenital or acquired osseous-dural defects of the skull base or cranial vault. Different types of symptoms, due to CSF fistulas, meningitis, or seizures, are often associated with this condition. The authors present a rare case of spontaneous right frontal parasagittal encephalocele in a 70-year-old man who was experiencing a spastic progressive paresis of his left lower limb. Results of routine electrophysiological workup (motor evoked potentials, somatosensory evoked potentials, and electroneuromyography), as well as those of MRI of the spinal cord, were normal...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28451486/brachial-plexopathy-after-cervical-spine-surgery
#18
Khoi D Than, Praveen V Mummaneni, Zachary A Smith, Wellington K Hsu, Paul M Arnold, Michael G Fehlings, Thomas E Mroz, K Daniel Riew
STUDY DESIGN: Retrospective, multicenter case-series study and literature review. OBJECTIVES: To determine the prevalence of brachial plexopathy after cervical spine surgery and to review the literature to better understand the etiology and risk factors of brachial plexopathy after cervical spine surgery. METHODS: A retrospective case-series study of 12 903 patients at 21 different sites was performed to analyze the prevalence of several different complications, including brachial plexopathy...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28442068/intraoperative-nerve-monitoring-in-laryngotracheal-surgery
#19
Sergio Bolufer, María Dolores Coves, Carlos Gálvez, Gustavo Adolfo Villalona
Laryngotracheal surgery has an inherent risk of injury to the recurrent laryngeal nerves (RLN). These complications go from minor dysphonia to even bilateral vocal cord paralysis. The intraoperative neuromonitoring of the RLN was developed in the field of thyroid surgery, in order to preserve nerve and vocal cord function. However, tracheal surgery requires in-field intubation of the distal trachea, which limits the use of nerve monitoring using conventional endotracheal tube with surface electrodes. Given these challenges, we present an alternative method for nerve monitoring during laryngotracheal surgery through the insertion of electrodes within the endolaryngeal musculature by bilateral puncture...
April 23, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28439772/neuromonitoring-in-endoscopic-and-robotic-thyroidectomy
#20
REVIEW
Gianlorenzo Dionigi, Hoon Yub Kim, Che-Wei Wu, Matteo Lavazza, Gabriele Materazzi, Celestino Pio Lombardi, Angkoon Anuwong, Ralph P Tufano
Intraoperative neuromonitoring (IONM) has proven effective for intraoperative verification of RLN function in the conventional thyroid surgery. However, no studies have performed a systematic evidence-based assessment of this novel health technology in endoscopic and robotic thyroidectomy. Evidence-based criteria were used in a systematic review of relevant literature for years 2000-2015. Four electronic databases (CENTRAL, MEDLINE, Cochrane and EMBASE) were used to retrieve relevant reports published from January 1, 2000 to September 1, 2016...
April 24, 2017: Updates in Surgery
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