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Perioperative fluid

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https://www.readbyqxmd.com/read/29452792/clinical-and-radiological-features-of-spinal-extradural-arachnoid-cysts-valve-like-mechanism-involving-the-nerve-root-fiber-as-a-possible-cause-of-cyst-expansion
#1
Kazuaki Morizane, Shunsuke Fujibayashi, Bungo Otsuki, Takeshi Sakamoto, Ryosuke Tsutsumi, Seiichi Odate, Akira Kusuba, Shuichi Matsuda
BACKGROUND: Although a valve-like mechanism has been proposed for expansion of spinal extradural arachnoid cysts (SEACs), the detailed mechanism remains unclear. Moreover, closure of the communication site is essential during surgery, but the method to identify the communication site remains unclear. The aim of this study was to determine the detailed mechanism of expanding SEACs through retrospective analysis of SEAC cases undergoing surgery and to elucidate the characteristics of the communication sites...
February 13, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#2
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29438158/intensive-care-unit-enhanced-recovery-pathway-for-patients-undergoing-orthotopic-liver-transplants-recipients-a-prospective-observational-study
#3
Adam B King, Clark D Kensinger, Yaping Shi, Matthew S Shotwell, Seth J Karp, Pratik P Pandharipande, J Kelly Wright, Liza M Weavind
BACKGROUND: Liver transplant recipients continue to have high perioperative resource utilization and prolonged length of stay despite improvements in perioperative care. Enhanced recovery pathways have been shown in other surgical populations to produce reductions in hospital resource utilization. METHODS: A prospective, observational study was performed to examine the effect of an enhanced recovery pathway for postoperative care after liver transplantation. Outcomes from patients undergoing liver transplantation from November 1, 2013, to October 31, 2014, managed by the pathway were compared to transplant recipients from the year before pathway implementation...
February 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29424017/perioperative-blood-management-strategies-for-total-knee-arthroplasty
#4
REVIEW
Qiang Lu, Hao Peng, Guan-Jin Zhou, Dong Yin
Total knee arthroplasty (TKA) often causes a significant amount of blood loss with an accompanying decline in hemoglobin and may increase the frequency of allogeneic blood transfusion rates. Unfortunately, allogeneic blood transfusions have associated risks including postoperative confusion, infection, cardiac arrhythmia, fluid overload, increased length of hospital stay, and increased mortality. Other than reducing the need for blood transfusions, reducing perioperative blood loss in TKA may also minimize intra-articular hemorrhage, limb swelling, and postoperative pain, and increase the range of motion during the early postoperative period...
February 9, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29416455/fluid-choice-during-perioperative-care-in-children-a-survey-of-present-day-proposing-practice-by-anesthesiologists-in-a-tertiary-care-hospital
#5
Muhammad Faisal Khan, Khalid Maudood Siddiqui, Muhammad Ali Asghar
Background: Perioperative fluid therapy in pediatrics has always been a challenging avenue for anesthesiologists. Inappropriate choice of fluid leads to multiple side effects, for instance iatrogenic hyponatremia. Our aim was to observe the current practice of perioperative fluid therapy in pediatric population undergoing surgery in a tertiary care hospital. Methods: After obtaining approval from the Departmental Research Review Committee, a survey form including questions was emailed to anesthesiologists from January 2015 to June 2015...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416252/perioperative-use-of-transthoracic-echocardiography-in-a-patient-with-congenitally-corrected-transposition-of-great-arteries-atrial-septal-defect-and-severe-pulmonary-stenosis-for-lower-segment-cesarean-section
#6
Vikas Saini, Tanvir Samra, Gurpreet Kaur
A 25-year-old female with congenitally corrected transposition of great arteries (CCTGAs), atrial septal defect, and severe pulmonary stenosis underwent lower segment cesarean section at 34 weeks of gestation using combined spinal epidural anesthesia (CSEA). We used transthoracic echocardiography (TTE) for intraoperative monitoring of the cardiovascular system because these patients are reported to have a high prevalence of myocardial perfusion defects, regional wall motion abnormalities, and impaired ventricular contractility...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29414017/a-validated-inductively-coupled-plasma-mass-spectrometry-icp-ms-method-for-the-quantification-of-total-platinum-content-in-plasma-plasma-ultrafiltrate-urine-and-peritoneal-fluid
#7
Lieselotte Lemoine, Elsy Thijssen, Jean-Paul Noben, Peter Adriaensens, Robert Carleer, Kurt Van der Speeten
Oxaliplatin is a platinum (Pt)1 containing antineoplastic agent that is applied in current clinical practice for the treatment of colon and appendiceal neoplasms. A fully validated, highly sensitive, high throughput inductively coupled plasma mass spectrometry (ICP-MS) method is provided to quantify the total Pt content in plasma, plasma ultrafiltrate, urine and peritoneal fluid. In this ICP-MS approach, the only step of sample preparation is a 1000-fold dilution in 0.5% nitric acid, allowing the analysis of 17 samples per hour...
January 29, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29406187/choice-of-fluid-type-physiological-concepts-and-perioperative-indications
#8
REVIEW
C Boer, S M Bossers, N J Koning
The consensus that i.v. resuscitation fluids should be considered as drugs with specific dose recommendations, contraindications, and side-effects has led to an increased attention for the choice of fluid during perioperative care. In particular, the debate concerning possible adverse effects of unbalanced fluids and hydroxyethyl starches resulted in a re-evaluation of the roles of different fluid types in the perioperative setting. This review provides a concise overview of the current knowledge regarding the efficacy and safety of distinct fluid types for perioperative use...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406186/current-concepts-of-fluid-management-in-enhanced-recovery-pathways
#9
REVIEW
R Makaryus, T E Miller, T J Gan
Perioperative fluid management impacts outcomes and plays a pivotal role in enhanced recovery pathways (ERPs). There have been major advances in understanding the effects of fluid therapy and administration during the perioperative period. Improving fluid management during this period leads to a decrease in complications, decrease in length of stay (LOS), and enhanced patient outcomes. It is important to consider preoperative and postoperative fluid management to be just as critical as intraoperative management given multiple associated benefits to the patients...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406177/could-patient-controlled-thirst-driven-fluid-administration-lead-to-more-rapid-rehydration-than-clinician-directed-fluid-management-an-early-feasibility-study
#10
F Hughes, S C Ng, M Mythen, H Montgomery
BACKGROUND: Fluid management is a major factor determining perioperative outcome, yet in reality, fluid administration practice is variable. Thirst however, is a highly sensitive and reliable indicator of fluid deficits. We explored the use of thirst sensation to trigger i.v. fluid boluses to guide individualized fluid management. METHODS: We performed a randomised double crossover trial on 16 healthy male volunteers, of mean age 31 yr and BMI 24.4 kg m-2. Twice, after administrations of oral furosemide (40 mg) and 12 h of oral fluid restriction, participants received a 4-h i...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406176/normal-saline-versus-a-balanced-crystalloid-for-goal-directed-perioperative-fluid-therapy-in-major-abdominal-surgery-a-double-blind-randomised-controlled-study
#11
C A Pfortmueller, G-C Funk, C Reiterer, A Schrott, O Zotti, B Kabon, E Fleischmann, G Lindner
BACKGROUND: This double-blind randomised controlled trial investigated whether normal saline or a balanced crystalloid has distinct effects on vasopressor use in patients undergoing major abdominal surgery. METHODS: Patients received either normal saline 0.9% or an acetate-buffered crystalloid for intraoperative volume replacement in a goal-directed fashion. The primary outcome was need for vasopressors; the secondary outcomes were the total dose of catecholamines, total perioperative fluid, and unplanned intensive care admissions...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29405885/risk-factors-for-intraoperative-and-postoperative-cerebrospinal-fluid-leaks-in-endoscopic-transsphenoidal-sellar-surgery
#12
Priyesh N Patel, Alicia M Stafford, James R Patrinely, Derek K Smith, Justin H Turner, Paul T Russell, Kyle D Weaver, Lola B Chambless, Rakesh K Chandra
Objective To determine the factors associated with intra- and postoperative cerebrospinal fluid (CSF) leaks in setting of endoscopic transsphenoidal sellar surgery. Study Design Retrospective cohort. Setting Tertiary referral center. Subjects and Methods This study included 806 patients who underwent endoscopic transsphenoidal sellar surgery between 2004 and 2016. The associations between CSF leaks (intra- and postoperative) and patient demographics, medical history, tumor characteristics, and intraoperative repair techniques were analyzed...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29404986/predictors-of-short-term-readmission-after-pancreaticoduodenectomy
#13
Rajesh Ramanathan, Travis Mason, Luke G Wolfe, Brian J Kaplan
BACKGROUND: Readmissions are a common complication after pancreaticoduodenectomy and are increasingly being used as a performance metric affecting quality assessment, public reporting, and reimbursement. This study aims to identify general and pancreatectomy-specific factors contributing to 30-day readmission after pancreaticoduodenectomy, and determine the additive value of incorporating pancreatectomy-specific factors into a large national dataset. METHODS: Prospective American College of Surgeons-National Surgical Quality Improvement Project (ACS-NSQIP) data were retrospectively analyzed for patients who underwent pancreaticoduodenectomy (PD) between 2011 and 2015...
February 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29394236/identification-of-factors-related-to-subfoveal-detachment-secondary-to-epiretinal-membrane
#14
Ilkay Kilic Muftuoglu, Tiezhu Lin, Eric Nudleman, Raouf Gaber, Dirk-Uwe Bartsch, William R Freeman
PURPOSE: To demonstrate factors related to the presence of subfoveal detachment (SD) secondary to epiretinal membrane (ERM) and to characterize the predictors for the resolution of SD after membrane peeling. METHODS: A retrospective chart review was conducted for the patients who underwent pars plana vitrectomy for the idiopathic ERM peeling. Preoperative spectral domain optical coherence tomography characteristics of the eyes including central foveal thickness, foveal center point thickness, presence of intraretinal cyst, continuity of the membrane, area of the membrane within fovea (1 mm), and entire macula (6 mm) were evaluated to find the best predictors for the presence of SD...
January 31, 2018: Retina
https://www.readbyqxmd.com/read/29390270/anesthetic-management-of-off-pump-simultaneous-coronary-artery-bypass-grafting-and-lobectomy-case-report-and-literature-review
#15
Xian Zhao, Yuhong Li, Hai-Ying Kong, Lin Zhang, Xiao-Hong Wen
RATIONALE: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. PATIENT CONCERNS: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383597/the-attenuation-value-of-preoperative-computed-tomography-as-a-novel-predictor-for-pancreatic-fistula-after-pancreaticoduodenectomy
#16
Takehiko Hanaki, Chihiro Uejima, Masataka Amisaki, Arai Yosuke, Naruo Tokuyasu, Soichiro Honjo, Teruhisa Sakamoto, Hiroaki Saito, Masahide Ikeguchi, Yoshiyuki Fujiwara
PURPOSE: Pancreatic fistula (PF) is the most serious complication following pancreaticoduodenectomy (PD). This study was performed to identify new clinical factors that may predict the development of PF after PD to improve perioperative management. METHODS: Seventy-five consecutive patients who underwent PD from 2012 to 2015 were evaluated. The patients' perioperative data including the computed tomography (CT) parameters were collected. The minimum, maximum, and mean CT attenuation values (HUmin, HUmax, and HUmean, respectively) were extracted from the pancreatic parenchyma (≥ 100 pixels), and the standard deviation of these values (HUSD) was determined from the slice in which the superior mesenteric and splenic veins were merged...
January 30, 2018: Surgery Today
https://www.readbyqxmd.com/read/29368625/perioperative-fluid-management-in-kidney-transplantation-a-black-box
#17
REVIEW
Maria Helena Calixto Fernandes, Thomas Schricker, Sheldon Magder, Roupen Hatzakorzian
The incidence of delayed graft function in patients undergoing kidney transplantation remains significant. Optimal fluid therapy has been shown to decrease delayed graft function after renal transplantation. Traditionally, the perioperative volume infusion regimen in this patient population has been guided by central venous pressure as an estimation of the patient's volume status and mean arterial pressure, but this is based on sparse evidence from mostly retrospective observational studies. Excessive volume infusion to the point of no further fluid responsiveness can damage the endothelial glycocalyx and is no longer considered to be the best approach...
January 25, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#18
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29335914/accuracy-and-trending-of-non-invasive-hemoglobin-measurement-during-different-volume-and-perfusion-statuses
#19
Abdelmoneim Adel, Wael Awada, Bassant Abdelhamid, Heba Omar, Omnia Abd El Dayem, Ahmed Hasanin, Ashraf Rady
The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation...
January 15, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29329510/the-predictive-value-of-hunger-score-on-gastric-evacuation-after-oral-intake-of-carbohydrate-solution
#20
Qiu Weiji, Li Shitong, Luo Yu, Hua Tianfang, Kong Ning, Zhang Lina
BACKGROUND: Surgical patients are asked to fast for a sufficient duration to ensure that the amount of residual liquid in the stomach is within the safe range, thereby reducing the risk of gastric reflux perioperatively. The authors hypothesized that subjective hunger numerical rating scale (NRS) score could also help assess the process of gastric emptying and determine the amount of fluid remaining in the stomach. METHODS: The current study consisted of healthy volunteers recruited by advertisement and mutual introduction...
January 12, 2018: BMC Anesthesiology
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