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https://www.readbyqxmd.com/read/29924662/current-state-of-enhanced-recovery-after-surgery-in-hepatopancreatobiliary-surgery
#1
William C Buhrman, William B Lyman, Russell C Kirks, Michael Passeri, Dionisios Vrochides
For over two decades, enhanced recovery pathways have been implemented in many surgical disciplines, most notably in colorectal surgery. Since 2001, the Enhanced Recovery After Surgery (ERAS® ) Study Group has developed a main protocol comprising 24 evidence-based core items. While these core items unite similar preoperative, intraoperative, and postoperative principles across surgical subspecialties, variations and modifications exist to these core items based on unique considerations for each surgical subspecialty...
June 20, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29921231/effects-of-preoperative-plasma-exchange-therapy-with-albumin-replacement-fluid-on-blood-coagulation-in-patients-undergoing-abo-incompatible-living-donor-kidney-transplantation-using-rotational-thromboelastometry
#2
Kazuhiro Shirozu, Naoyuki Fujimura, Yuji Karashima, Mizuko Ikeda, Hidehisa Kitada, Yasuhiro Okabe, Kei Kurihara, Tomoko Henzan, Sumio Hoka
BACKGROUND: ABO-incompatible living-donor kidney transplantation (LDKT) requires immunotherapy and plasma exchange therapy (PEX). PEX with albumin replacement fluid reportedly decreases fibrinogen levels. However, no reports have described the effects of PEX with albumin replacement fluid on blood coagulation parameters and blood loss during the perioperative period. Therefore, we investigated the effects of preoperative PEX on blood coagulation parameters and blood loss during the perioperative period in patients undergoing ABO-incompatible LDKT as measured by rotational thromboelastometry (ROTEM®)...
June 19, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29920872/perioperative-outcomes-and-management-in-midface-advancement-surgery-a-multicenter-observational-descriptive-study-from-the-pediatric-craniofacial-collaborative-group
#3
Chris D Glover, Allison M Fernandez, Henry Huang, Christopher Derderian, Wendy Binstock, Russell Reid, Nicholas M Dalesio, John Zhong, Paul A Stricker
BACKGROUND/AIMS: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. METHODS: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016...
June 19, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29912723/balanced-crystalloids-versus-saline-for-perioperative-intravenous-fluid-administration-in-children-undergoing-neurosurgery-a-randomized-clinical-trial
#4
Mariana F Lima, Iuri S Neville, Sergio Cavalheiro, Dafne C Bourguignon, Paolo Pelosi, Luiz M S Malbouisson
BACKGROUND: Balanced crystalloid solutions induce less hyperchloremia than normal saline, but their role as primary fluid replacement for children undergoing surgery is unestablished. We hypothesized that balanced crystalloids induce less chloride and metabolic derangements than 0.9% saline solutions in children undergoing brain tumor resection. METHODS: In total, 53 patients (age range, 6 mo to 12 y) were randomized to receive balanced crystalloid (balanced group) or 0...
June 15, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29910494/evaluation-of-the-effect-of-pre-operative-over-fasting-on-post-operative-vomiting-in-children-undergoing-bone-marrow-aspiration-at-a-tertiary-care-setting-in-sri-lanka-a-prospective-cohort-study
#5
Vidura Jayasinghe, Pk Buddhika Mahesh, Cmd Sooriaarachchi, Jimutha Jayalath, Weranga Karunarathne, S N Liyanage
Background and Aims: Non-adherence to standard fasting guidelines may result in perioperative complications. We aimed to determine the association between pre-operative over-fasting and post-operative vomiting amongst children undergoing bone marrow aspiration under general anaesthesia. Methods: A prospective cohort study was conducted from May 2015 to April 2016 in children undergoing bone marrow aspiration under general anaesthesia and their caregivers. Children fasted for ≥3 hours from last clear fluid intake constituted the exposed group ( n = 202) while children fasting for <3 h constituted the non-exposed group ( n = 202)...
May 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29894342/severe-disruption-of-water-and-electrolyte-balance-after-appendectomy-a-case-report
#6
Olga Bossong, Christoph Rudin, Gabor Szinnai, Thomas O Erb, Jens Moll
Perioperative derangements of fluid and electrolyte homeostasis are rare complications in healthy children. Nonetheless, early diagnosis and treatment are mandatory to avoid a potentially life-threatening situation. However, the variety of underlying pathologies may prove to make accurate diagnosis challenging. This case report presents the management of an unexpected occurrence of a perioperative partial diabetes insipidus with massive fluid loss. Diagnostic and therapeutic procedures are discussed in the context of laboratory findings, and an overview of the existing literature is given...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29890807/-eestablishment-of-the-model-of-goat-lumbar-spinal-fusion-by-3d-printing-technology-and-experimental-perioperative-management
#7
Feng Zhang, Jian-Tao Liu, Rui Wang, Teng Lu, Bin-Bin Niu, Jie Qie, Xuan Cai, Ting Zhang, Peng-Rong Ouyang, Xi-Jing He
OBJECTIVE: To explore the feasibility and the attention of perioperative management of goat lumbar fusion model for individualized 3D printing technology. METHODS: According to preoperative X-ray and CT three dimensional reconstruction data of 10 males Boer goat's lumbar(1-2 years old, weight 35-45 kg), the preoperative open height were determined, meanwhile, according to the theoretical entry point of nails, the length of steel plate, arc, and setting position, screw length for reference were determined, the lumbar lateral anterior plate was designed and 3D-printed...
May 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29889743/perioperative-management-and-implementation-of-enhanced-recovery-programs-in-gynecologic-surgery-for-benign-indications
#8
Erin T Carey, Janelle K Moulder
Enhanced recovery after surgery (ERAS) programs are a multimodal approach to optimize the surgical experience. Intraoperative and postoperative pain management is essential because the stress of surgery results in significant neurohormonal and metabolic shifts that can influence patient analgesia. Enhanced recovery after surgery programs address the physiologic and psychological factors that contribute to pain outcomes and overall satisfaction scores. A multimodal approach to recovery throughout the perioperative surgical experience is representative of successful pathways...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29885944/cold-agglutinin-disease-complicating-management-of-aortic-dissection
#9
James Bras, Kelsey Uminski, Arjuna Ponnampalam
BACKGROUND: Cold agglutinin disease is characterized by acrocyanosis, hemolytic anemia, and occasionally, frank hemoglobinuria. Although cold agglutinins are commonly detected, they are rarely clinically significant due to subphysiologic temperatures at which agglutination occurs. Cardiovascular surgical procedures requiring hypothermia present a unique challenge for these patients, requiring modification of the conduct of cardiopulmonary bypass and cardioplegia. CASE REPORT: Herein we report a case of a patient with a prior history of symptomatic cold agglutinin disease and type A aortic dissection, presenting with dilation of his known diseased ascending aorta, requiring semi-urgent repair...
April 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29880358/comparison-of-perioperative-renal-function-between-epidural-and-intravenous-patient-controlled-analgesia-after-living-donor-hepatectomy-a-retrospective-study
#10
S Y Ham, E J Kim, T H Kim, B-N Koo
BACKGROUND: Sympathetic blockade associated with epidural analgesia was reported to be a risk factor for acute kidney injury (AKI) following liver resection. The purpose of this study was to compare the incidence of AKI after living-donor hepatectomies according to the type of patient-controlled analgesia (PCA). METHODS: A total of 316 patients after living-donor hepatectomy were retrospectively analyzed; 148 patients in the epidural PCA group and 168 patients in the intravenous (IV) PCA group were evaluated...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29869090/perioperative-net-fluid-balance-predicts-pancreatic-fistula-after-pancreaticoduodenectomy
#11
Leah K Winer, Vikrom K Dhar, Koffi Wima, Tiffany C Lee, Mackenzie C Morris, Shimul A Shah, Syed A Ahmad, Sameer H Patel
BACKGROUND: Our goal was to evaluate the relationship between perioperative fluid administration and the development of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD). METHODS: Retrospectively, we analyzed fluid balance over the first 72 h in 104 consecutive patients who underwent PD between 2013 and 2017. Patients were categorized into tertiles (low, medium, and high) by net fluid balance. RESULTS: POPF was identified in 17...
June 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29868596/improving-perioperative-outcomes-through-minimally-invasive-and-non-invasive-hemodynamic-monitoring-techniques
#12
REVIEW
Takashige Yamada, Susana Vacas, Yann Gricourt, Maxime Cannesson
An increasing number of patients require precise intraoperative hemodynamic monitoring due to aging and comorbidities. To prevent undesirable outcomes from intraoperative hypotension or hypoperfusion, appropriate threshold settings are required. These setting can vary widely from patient to patient. Goal-directed therapy techniques allow for flow monitoring as the standard for perioperative fluid management. Based on the concept of personalized medicine, individual assessment and treatment are more advantageous than conventional or uniform interventions...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29868327/surgical-outcomes-and-postoperative-management-in-spontaneous-cerebrospinal-fluid-rhinorrhea
#13
Zi Yang Jiang, Caitlin McLean, Carlos Perez, Samuel Barnett, Deborah Friedman, Bobby A Tajudeen, Pete S Batra
Background  The etiology of spontaneous cerebrospinal fluid (CSF) rhinorrhea remains unknown, though emerging evidence suggests that this likely represents a variant of idiopathic intracranial hypertension. Long-term success rates for repair and postoperative management strategies remain variable. Methods  Retrospective review of patients undergoing surgical management of spontaneous CSF rhinorrhea was conducted over a 5-year period. Analysis was performed to correlate recurrence with demographics and perioperative variables...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29864262/functional-significance-and-risk-factors-for-lymphocele-formation-after-renal-transplantation
#14
Munish K Heer, David Clark, Paul R Trevillian, Philip Sprott, Kerrin Palazzi, Adrian D Hibberd
BACKGROUND: Lymphocele development following renal transplantation is a significant adverse event. It may cause acute graft dysfunction or venous obstruction. There are no consistent risk factors reported in literature. Perioperative fluid balance may lead to increased lymphocele formation and has never been studied. We aimed to analyse incidence and risk factors for lymphocele formation. We hypothesized that overhydration in perioperative period is a risk factor. METHODS: We analysed 250 consecutive renal transplant recipients from 2006 to 2014...
June 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#15
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29844947/surgical-technical-evidence-review-of-hip-fracture-surgery-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#16
REVIEW
Anaar Siletz, Christopher P Childers, Claire Faltermeier, Emily S Singer, Q Lina Hu, Clifford Y Ko, Stephen L Kates, Melinda Maggard-Gibbons, Elizabeth Wick
Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or "bins." For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29804566/-perioperative-fluid-therapy-influences-coagulation-blood-loss-and-post-operative-complications
#17
Kirsten Cleemann Rasmussen, Tom Pedersen, Niels H Secher
Literature on fluid therapy for surgery is updated in regard to coagulation, blood loss and post-operative complications. Haemorrhage depends on the surgical intervention but also on the chosen fluid therapy with artificial colloids affecting coagulation competence and in turn the blood loss. Furthermore, a stable central blood volume as indicated by plasma pro-atrial natriuretic peptide requires a calculated fluid surplus by approximately 2.5 l. Randomized controlled trials recommend haemorrhage to be treated by administration of a crystalloid; however, if the calculated excess of fluid approaches 2 l, albumin may be added...
May 21, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29798580/-clinical-research-on-perioperative-restrictive-fluid-therapy-combined-with-preoperative-urination-training-in-total-hip-arthroplasty
#18
Yiting Lei, Qiang Huang, Shaoyun Zhang, Guo Chen, Guorui Cao, Fuxing Pei
Objective: To evaluate the effectiveness and safety of restrictive fluid therapy combined with preoperative urination training during perioperative period in an enhanced recovery after surgery (ERAS) program for primary total hip arthroplasty (THA). Methods: A retrospective study were conducted in 73 patients who underwent unilateral THA with liberal intravenous fluid therapy on the day of surgery between April 2015 and March 2016 (control group) and in 70 patients with restrictive fluid therapy and preoperative urination training between November 2016 and April 2017 (trial group)...
November 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29798253/-effects-of-perioperative-thermoregulation-on-patients-body-temperature-peripheral-circulation-and-blood-coagulation-time-in-patients-undergoing-elective-vertical-hemi-laryngectomy
#19
X Zheng, D Sun, F Zhou, Y J Zhang
Objective: To compare the effects of different thermal insulation measures on perioperative body temperature, peripheral circulation and blood coagulation time in patients undergoing vertical hemi laryngectomy. Method: Sixty eligible patients with elective vertical hemi laryngectomy were randomly divided into 3 groups: preoperative inflatable heating blanket group (A group, n=20), warmed irrigation group (B group, n=20), and control group (C group, n=20). The core temperature were recorded after entering the operating room, before induction, 20th minute during operation, entering PACU and 2nd hour after operation respectively...
July 20, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29794728/acute-noncardiogenic-pulmonary-edema-after-neostigmine-administration-during-the-recovery-period-of-general-anesthesia-a-case-report
#20
Wenjing Zhang, Cong Ning, Guoqing Zhao, Zhenbo Su
RATIONALE: Acute non-cardiogenic pulmonary edema (ANPE) is a rare but challenging complication which occurs during the perioperative period, mainly before and after the extubation in the course of the recovery period of general anesthesia. It is characterized by increased fluid in extravascular pulmonary spaces, preventing gas exchange and further resulting in respiratory failure. PATIENT CONCERNS: A 12-year-old boy who had undergone island skin flap in the right upper limb and who developed a unilateral pulmonary edema after the administration of neostigmine during the recovery period of general anesthesia...
May 2018: Medicine (Baltimore)
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