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Perioperative fluid

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https://www.readbyqxmd.com/read/28650680/transurethral-resection-of-prostate-and-bleeding-a-prospective-randomized-double-blind-placebo-controlled-trial-to-see-the-efficacy-of-short-term-use-of-finasteride-and-dutasteride-on-operative-blood-loss-and-prostatic-microvessel-density
#1
Ankur Bansal, Aditi Arora
OBJECTIVE: The aim of this study was to determine the efficacy of short-duration use of finasteride and dutasteride before transurethral resection of the prostate (TURP) on intraoperative blood loss and microvessel density (MVD) of prostate stroma and suburethral tissues in benign prostatic hyperplasia (BPH). METHODS: This study includes 450 patients who were planned for TURP. They were prospectively randomized into three groups (150 patients each). Group 1 received placebo, group 2 received finasteride, 5 mg per day, and group 3 patients received dutasteride, 0...
June 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28648412/renal-outcome-after-radical-cystectomy-and-urinary-diversion-performed-with-restrictive-hydration-and-vasopressor-administration-in-the-frame-of-an-enhanced-recovery-program-a-follow-up-study-of-a-randomized-clinical-trial
#2
Fiona Mei Wen Wu, Fiona Burkhard, Filippo Turri, Marc Furrer, Lukas Loeffel, George Thalmann, Patrick Wuethrich
OBJECTIVE: To determine whether a restrictive perioperative fluid management in the context of an enhanced recovery after surgery program for radical cystectomy and urinary diversion affects renal function, as fluid restriction and the use of vasopressors have been linked to impaired tissue perfusion, potentially resulting in renal dysfunction. METHODS: We followed 166 patients initially included in a randomized clinical trial and equally allocated to receive a continuous norepinephrine administration combined with 1ml/kg/h initially, and after cystectomy 3ml/kg/h crystalloid infusion (intervention group, n = 83), or a standard crystalloid infusion of 6ml/kg/h throughout surgery (control group, n = 83)...
June 22, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28645586/venous-sinus-stenting-in-the-management-of-patients-with-intracranial-hypertension-manifesting-with-skull-base-cerebrospinal-fluid-leaks
#3
Rajiv R Iyer, David Solomon, Abhay Moghekar, C Rory Goodwin, Charles M Stewart, Masaru Ishii, Philippe Gailloud, Gary L Gallia
BACKGROUND: A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak as well as postoperative leak recurrences. Current strategies for post-operative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks due to elevated ICP...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28643098/-importance-of-wound-irrigation-solutions-and-fluids-with-antiseptic-effects-in-therapy-and-prophylaxis-update-2017
#4
REVIEW
Christian Willy, Catharina Scheuermann-Poley, Marcus Stichling, Thomas von Stein, Axel Kramer
INTRODUCTION: Despite the use of modern antibiotics as well as complex perioperative, intraoperative and postoperative prophylactic measures, the rate of surgical site infections (SSI) could not be significantly reduced. The introduction of biocompatible antiseptic drugs with a high microbiocidal effect provided a successful alternative for infection prevention and therapy, particularly in a time of increasing occurrence of multi-drug resistant pathogens. Hence, questions about the risk-benefit ratio of antiseptic wound irrigation solutions, the prophylactic use of wound irrigation solutions for the reduction of SSI and the effect of negative pressure wound therapy combined with instillation (NPWTi) need to be answered...
June 22, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28625451/is-perioperative-administration-of-5-dextrose-effective-in-reducing-the-incidence-of-ponv-in-laparoscopic-cholecystectomy-a-randomized-control-trial
#5
Ankita Mishra, Ravinder Kumar Pandey, Ankur Sharma, Vanlalnghaka Darlong, Jyotsna Punj, Devalina Goswami, Renu Sinha, Vimi Rewari, Chandralekha Chandralekha, Virinder Kumar Bansal
STUDY OBJECTIVE: To compare the incidence of postoperative nausea and vomiting (PONV) during perioperative administration of 5% dextrose and normal saline in laparoscopic cholecystectomy. DESIGN: Prospective, randomized, double-blind trial. SETTING: Operating rooms in a tertiary care hospital of Northern India. PATIENTS: One hundred patients with American Society of Anesthesiologists status I to II undergoing laparoscopic cholecystectomy were enrolled in this study...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28620807/predictive-factors-of-maternal-hypothermia-during-cesarean-delivery-a-prospective-cohort-study
#6
François-Pierrick Desgranges, Lionel Bapteste, Céline Riffard, Marius Pop, Bérengère Cogniat, Anne-Charlotte Gagey, Pierre Boucher, Corinne Bonnard, Brigitte Paturel, Christine Mullet, Dominique Chassard, Lionel Bouvet
PURPOSE: Although perioperative hypothermia may increase maternal morbidity, active warming is infrequently performed to maintain normothermia during Cesarean delivery (CD). The aim of this prospective observational study was to determine the factors associated with maternal hypothermia in this setting. METHODS: Women scheduled for elective or emergency CD were consecutively included in this study from November 2014 to October 2015. Maternal temperature was measured using an infrared tympanic thermometer on the patient's arrival in the operating room, at skin incision, and at the end of skin suture...
June 15, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28616733/clinical-fluid-therapy-in-the-perioperative-setting-robert-g-hahn-editor-cambridge-university-press-2017-isbn-13-9781107119550
#7
Victor Tran
No abstract text is available yet for this article.
June 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28616213/postoperative-goal-directed-therapy-and-development-of-acute-kidney-injury-following-major-elective-noncardiac-surgery-post-hoc-analysis-of-pom-o-randomized-controlled-trial
#8
Amour Patel, John R Prowle, Gareth L Ackland
Background: The role of goal-directed therapy (GDT) in preventing creatinine rise following noncardiac surgery is unclear. We performed a post-hoc analysis of a randomized controlled trial to assess the relationship between postoperative optimization of oxygen delivery and development of acute kidney injury (AKI)/creatinine rise following noncardiac surgery. Methods: Patients were randomly assigned immediately postoperatively to receive either fluid and/or dobutamine therapy to maintain/restore their preoperative oxygen delivery, or protocolized standard care (oxygen delivery only recorded)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28614595/perioperative-cox-2-inhibitors-may-increase-the-risk-of-post-operative-acute-kidney-injury
#9
A Abrahamsson, J Oras, J Snygg, L Block
BACKGROUND: In enhanced recovery protocols (ERP), a restrictive fluid regimen is proposed. Patients who undergo major surgery have an increased risk of post-operative acute kidney injury (AKI). This combination may pose difficulties when ERP is used for patients undergoing major surgery. The aim of this study was to evaluate whether patients undergoing pancreatic surgery and treated with a restrictive fluid regimen are at greater risk of post-operative AKI. Furthermore, if there was an increased risk of AKI, we aimed to identify its cause...
June 14, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28605474/digital-innovations-and-emerging-technologies-for-enhanced-recovery-programmes
#10
F Michard, T J Gan, H Kehlet
Enhanced recovery programmes (ERPs) are increasingly used to improve post-surgical recovery. However, compliance to various components of ERPs-a key determinant of success-remains sub-optimal. Emerging technologies have the potential to help patients and caregivers to improve compliance with ERPs.Preoperative physical condition, a major determinant of postoperative outcome, could be optimized with the use of text messages (SMS) or digital applications (Apps) designed to facilitate smoking cessation, modify physical activity, and better manage hypertension and diabetes...
June 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28605442/perioperative-goal-directed-therapy-with-uncalibrated-pulse-contour-methods-impact-on-fluid-management-and-postoperative-outcome
#11
F Michard, M T Giglio, N Brienza
Previous meta-analyses suggest that perioperative goal-directed therapy (GDT) is useful to decrease postoperative morbidity. Most GDT studies analysed were done with pulmonary artery catheters, oesophageal Doppler and calibrated pulse contour methods. Uncalibrated pulse contour (uPC) techniques are an appealing alternative but their accuracy has been questioned. The effects of GDT on fluid management (volumes and volume variability) remain unclear. We performed a meta-analysis of randomized controlled trials investigating the effects of GDT with uPC methods on postoperative outcome...
June 11, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28604404/perioperative-care-of-head-and-neck-free-flap-patients
#12
Michael R Kinzinger, Arnaud F Bewley
PURPOSE OF REVIEW: This article reviews the recent literature on the perioperative care of head and neck surgical patients undergoing free tissue transfer. RECENT FINDINGS: As the overall success of head and neck free flaps has plateaued above 95%, recent literature on perioperative flap management has focused on minimizing complications, length of stay, and cost of treatment. Current areas of research include preoperative risk stratification, preoperative and postoperative nutrition, intraoperative fluid management, postoperative level of care, postoperative antibiotic prophylaxis, defining the impact of comorbidities, and developing comprehensive evidence-based perioperative care protocols...
June 9, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28602158/effect-of-perioperative-goal-directed-hemodynamic-therapy-on-postoperative-recovery-following-major-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
Yanxia Sun, Fang Chai, Chuxiong Pan, Jamie Lee Romeiser, Tong J Gan
BACKGROUND: Goal-directed hemodynamic therapy (GDHT) has been used in the clinical setting for years. However, the evidence for the beneficial effect of GDHT on postoperative recovery remains inconsistent. The aim of this systematic review and meta-analysis was to evaluate the effect of perioperative GDHT in comparison with conventional fluid therapy on postoperative recovery in adults undergoing major abdominal surgery. METHODS: Randomized controlled trials (RCTs) in which researchers evaluated the effect of perioperative use of GDHT on postoperative recovery in comparison with conventional fluid therapy following abdominal surgery in adults (i...
June 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#14
Shannon Fraser, Paul A Gardner, Maria Koutourousiou, Mark Kubik, Juan C Fernandez-Miranda, Carl H Snyderman, Eric W Wang
OBJECTIVE The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors. METHODS A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes. RESULTS Of the 615 patients studied, 103 developed a postoperative CSF leak (16...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28597121/current-research-priorities-in-perioperative-intensive-care-medicine
#15
REVIEW
Michael A Gillies, Michael Sander, Andrew Shaw, Duminda N Wijeysundera, John Myburgh, Cesar Aldecoa, Ib Jammer, Suzana M Lobo, Naomi Pritchard, Michael P W Grocott, Marcus J Schultz, Rupert M Pearse
INTRODUCTION: Surgical treatments are offered to more patients than ever before, and increasingly to older patients with chronic disease. High-risk patients frequently require critical care either in the immediate postoperative period or after developing complications. The purpose of this review was to identify and prioritise themes for future research in perioperative intensive care medicine. METHODS: We undertook a priority setting process (PSP). A panel was convened, drawn from experts representing a wide geographical area, plus a patient representative...
June 8, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28593749/impact-of-atrial-fibrillation-on-long-term-survival-following-oesophagectomy-a-21-year-observational-study
#16
Cameron I Wells, Jason P Robertson, Sandra Campbell, Fadhel Al-Herz, Bruce Rhind, Mike Young
BACKGROUND: Post-operative atrial fibrillation (AF) is a common complication of oesophagectomy and thought to signal a complicated post-operative course. AF is associated with prolonged admissions, increased healthcare costs and inpatient mortality. However, the impact of post-operative AF on long-term outcomes remains uncertain. METHODS: Patients undergoing open Ivor-Lewis oesophagectomy from 1994 to 2014 at Palmerston North Hospital, New Zealand, were retrospectively evaluated...
June 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28585750/effects-of-intraoperative-liberal-fluid-therapy-on-postoperative-nausea-and-vomiting-in-children-a-randomized-controlled-trial
#17
Vighnesh Ashok, Indu Bala, Neerja Bharti, Divya Jain, Ram Samujh
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most distressing complications following surgery. Supplemental perioperative fluid therapy might be an effective strategy to reduce PONV in children. OBJECTIVES: The study was conducted to evaluate the effects of intraoperative liberal fluid therapy with crystalloids on PONV in children. METHODS: In this randomized trial, a total of 150 children of 3-7 years undergoing lower abdominal and penile surgery under general anesthesia were randomly assigned into two groups...
June 6, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28582287/does-cleft-palate-width-correlate-with-veau-classification-and-outcome
#18
Robin Wu, Shayan Cheraghlou, Yassmin Parsaei, Roberto Travieso, Derek M Steinbacher
PURPOSE: Wider cleft palates are thought to be associated with increased complications and poorer outcomes following cleft palate repair. Objective cleft palate photographic measurement and assessment of complications have not been previously performed. The purpose of this study is to quantitatively characterize a series of cleft palate dimensions and to investigate possible correlations with Veau classification and intra-, peri-, and postoperative outcomes. METHODS: The analytic sample included primary cleft palate repairs performed by the senior author over a 2-year period...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28576354/does-the-addition-of-active-body-warming-to-in-line-intravenous-fluid-warming-prevent-maternal-hypothermia-during-elective-caesarean-section-a-randomised-controlled-trial
#19
R Chebbout, R S Newton, M Walters, I J Wrench, M Woolnough
INTRODUCTION: Inadvertent perioperative hypothermia occurs frequently during elective caesarean section but perioperative active body warming is not widely used. There is a paucity of evidence of its use in the obstetric population, and no applicable guidelines. We set out to identify a superior active warming method for preventing inadvertent perioperative hypothermia. METHODS: Following ethical approval, 132 women presenting for uncomplicated elective caesarean section with spinal anaesthesia were recruited...
April 27, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28562540/excess-intraoperative-fluid-volume-administration-is-associated-with-pancreatic-fistula-after-pancreaticoduodenectomy-a-retrospective-multicenter-study
#20
MULTICENTER STUDY
In Woong Han, Hongbeom Kim, JinSeok Heo, Min Gu Oh, Yoo Shin Choi, Seung Eun Lee, Chang-Sup Lim
Recent studies on perioperative fluid administration in patients undergoing pancreaticoduodenectomy (PD) have suggested that increased fluid loads are associated with worse perioperative outcomes. The purpose of this study was to investigate the relationship between intraoperative fluid (IOF) administration and postoperative pancreatic fistula (POPF), and to determine additional risk factors affecting pancreatic fistula in patients undergoing PD.From 2005 to 2014, a total of 182 patients with various periampullary diseases after PD were reviewed retrospectively at Dongguk University Ilsan Hospital, Chung-Ang University Hospital, and Dongnam Institute of Radiological and Medical Sciences...
June 2017: Medicine (Baltimore)
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