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Perioperative fluid

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https://www.readbyqxmd.com/read/28446926/are-we-ready-for-the-eras-protocol-in-colorectal-surgery
#1
Michał Kisielewski, Mateusz Rubinkiewicz, Michał Pędziwiatr, Magdalena Pisarska, Marcin Migaczewski, Marcin Dembiński, Piotr Major, Kazimierz Rembiasz, Andrzej Budzyński
INTRODUCTION: Modern perioperative care principles in elective colorectal surgery have already been established by international surgical authorities. Nevertheless, barriers to the introduction of routine evidence-based clinical care and changing dogmas still exist. One of the factors is the surgeon. AIM: To assess perioperative care trends in elective colorectal surgery among general surgery consultants in surgical departments in Malopolska Voivodeship, Poland...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28437812/infection-rate-in-1033-elective-neurosurgical-procedures-at-a-university-hospital-in-south-china
#2
Hongwei Zhu, Xiyao Liu, Zhanxiang Wang
Objective Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors. Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28436074/an-evaluation-of-the-mixed-pediatric-unit-for-blood-loss-replacement-in-pediatric-craniofacial-surgery
#3
Stefan Mogensen, Norbert Lubenow, Pelle Nilsson, Henrik Engquist, Folke Knutsson, Per Enblad, Daniel Nowinski, Peter Frykholm
BACKGROUND: Surgical correction for craniosynostosis is often associated with significant perioperative hemorrhage. We implemented a transfusion strategy with a strict protocol including transfusion triggers, frequent assessment of coagulation tests, and the use of a novel transfusion unit, the mixed pediatric unit. AIM: The aim of the study was to evaluate if the applied transfusion strategy could reduce total blood loss and number of blood donors. METHODS: Children <1 year old admitted for craniosynostosis surgery were included for the study...
April 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28431422/how-long-is-too-long-the-prespiked-intravenous-debate
#4
Jennifer L Stedman, Joel M Yarmush, Minal C Joshi, Sangeetha Kamath, Joseph Schianodicola
BACKGROUND: As the number of operative cases increases, there is a greater emphasis on reducing inefficiency while maintaining patient safety. Recently, the issue of prespiking intravenous (IV) bags was raised. No study has assessed whether the risk of infection is related to the length of time a sterile (IV) fluid bag has been spiked. After completion of a pilot study revealed no microbial growth within 24 hours of an IV spike, a larger formal study was undertaken to determine whether there was an increased infection risk within 4 hours of spiking an intravenous fluid bag...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430340/transurethral-contact-ureterolithotripsy-in-gas-%C3%B0-%C3%B0-2-medium
#5
Dmitry O Korolev, Peter V Glybochko, Leonid M Rapoport, Dmitry G Tsarichenko
BACKGROUND: Transurethral intracorporeal lithotripsy is the modality of choice for the endoscopic disintegration of large, long-standing, radiolucent or high-density stones. Despite several advantages and proven benefits of contact ureterolithotripsy/ureterolithoextraction (CULT), the application of irrigation carries significant risks of untoward perioperative events including retrograde stone migration and postoperative pyelonephritis. METHODS: We describe a new technique - endoscopic intracorporeal lithotripsy in the gas (СО2) medium...
April 14, 2017: Urologia
https://www.readbyqxmd.com/read/28429903/causes-of-interruptions-in-postoperative-enteral-nutrition-in-children-with-congenital-heart-disease
#6
Jirong Qi, Zhuo Li, Yueshuang Cun, Xiaonan Li
BACKGROUND AND OBJECTIVES: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. We, therefore, aimed to determine the causes of interruptions in postoperative EN in CHD patients and discuss clinical counter measures...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28428520/-prevention-of-spinal-cord-ischemia-during-thoracic-endovascular-aortic-repair
#7
Shinya Takahashi, Taijiro Sueda
Spinal cord ischemia(SCI) has been devastating complication of endovascular thoracic and thoracoabdominal aortic repair. Spinal cord blood supply arises from not only segmental artery, subclavian artery, hypogastric artery and these branches, but also perivertebral vasculature and paravertebral muscle and small arterial network, and risk factors of SCI were multifactorial. There are several adjuncts/strategies which are utilized to minimize the incidence of SCI: cerebrospinal fluid drainage, perioperative management of high mean arterial pressure, intraoperative evoked potential monitoring, and staged thoracoabdominal aortic repair...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28427121/-efficacy-and-safety-of-vertebrae-pedicle-subtraction-osteotomy-by-posterior-trans-apical-for-correction-of-severe-and-rigid-idiopathic-scoiiosis
#8
T Xu, Maimaiti Maierdan, H L Guo, Maimaiti Pulati, J Sheng, Q Deng, W B Sheng
Objective: To evaluate the efficacy and safety of pedicle subtraction osteotomy for correction of severe rigid idiopathic scoliosis. Methods: From January 2003 to December 2014, eighteen patients with severe rigid idiopathic scoliosis were treated by posterior wedge osteotomy in department of spinal surgery, the First Affiliated Hospital of Xinjiang Medical University. There were 5 males and 13 females, and the average age at was (16.9±9.1)years, and the average follow-up was 47.6 months. The coronal and sagittal Cobb's angles, sagittal trunk shifts, apical vertebral translation, height change and fusion segments were measured on standing AP and lateral radiographs before, after surgery and the final follow-up...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#9
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28413524/perioperative-complications-in-endovascular-neurosurgery-anesthesiologist-s-perspective
#10
Megha U Sharma, Pragati Ganjoo, Daljit Singh, Monica S Tandon, Jyotsna Agarwal, Durga P Sharma, Anita Jagetia
BACKGROUND: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. METHODS: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28397026/fistulojejunostomy-versus-distal-pancreatectomy-for-the-management-of-the-disconnected-pancreas-remnant-following-necrotizing-pancreatitis
#11
Vikrom K Dhar, Jeffrey M Sutton, Brent T Xia, Nick C Levinsky, Gregory C Wilson, Milton Smith, Kyuran A Choe, Jonathan Moulton, Doan Vu, Ross Ristagno, Jeffrey J Sussman, Michael J Edwards, Daniel E Abbott, Syed A Ahmad
BACKGROUND: A disconnected distal pancreas (DDP) remnant is a morbid sequela of necrotizing pancreatitis. Definitive surgical management can be accomplished by either fistulojejunostomy (FJ) or distal pancreatectomy (DP). It is unclear which operative approach is superior with regard to short- and long-term outcomes. METHODS: Between 2002 and 2014, patients undergoing either FJ or DP for DDP were retrospectively identified at a center specializing in pancreatic diseases...
April 10, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28396935/state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept-english-version
#12
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space...
April 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#13
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28390712/safe-intrathecal-fluorescein-use-for-identification-of-cerebrospinal-fluid-leaks-case-report-and-perioperative-algorithm-description
#14
M Á Rodríguez-Navarro, C Díaz-Alejo, M L Padilla-Del Rey, A B Alcaraz, P González-Pérez, M Benítez
Intrathecal injection of fluorescein is a method for repairing cerebrospinal fluid fistulas. The most frequent surgical procedure is endonasal endoscopy and the purpose of injecting this dye is to locate the fistula. The anaesthesiologists usually perform the puncture, therefore it is necessary to review this method and to specify some anaesthetic considerations such as correct dosing, safe management protocols and medical-legal aspects. In this case-report we describe the pre, intra and postoperative protocol of action implemented in our department that basically consists of: obtaining a specific consent, prior neurological/ophthalmologic assessment to rule out hypertension and brain damage, use of corticosteroids and previous antihistamines, choosing the correct dose and concentration of intrathecal sodium fluorescein (maximum 1ml at a concentration of 5% diluted in 9ml of cerebrospinal fluid) and close intra and postoperative monitoring...
April 5, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28387055/feasibility-of-laparoscopic-cholecystectomy-in-patients-with-cerebrospinal-fluid-shunt
#15
Terukazu Yoshihara, Yoshito Tomimaru, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Keizo Dono
INTRODUCTION: Previous reports of laparoscopic surgery in patients with cerebrospinal fluid (CSF) shunts for intracranial hypertension described shunt-related complications. Thus, the shunts have been considered a contraindication for laparoscopic procedures. However, with the implementation of recent improvements in surgical techniques, perioperative management, and shunt technology, laparoscopic surgery may now be safe in cases with shunts. The aim of the present study was to examine the safety of such procedures based on our own experiences with laparoscopic surgery in patients with CSF shunts...
April 7, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28377801/current-best-practice-in-the-management-of-patients-after-pituitary-surgery
#16
REVIEW
Alessandro Prete, Salvatore Maria Corsello, Roberto Salvatori
Sellar and parasellar masses are a common finding, and most of them are treated surgically via transsphenoidal approach. This type of surgery has revolutionized the approach to several hypothalamic-pituitary diseases and is usually effective, and well-tolerated by the patient. However, given the complex anatomy and high density of glandular, neurological and vascular structures in a confined space, transsphenoidal surgery harbors a substantial risk of complications. Hypopituitarism is one of the most frequent sequelae, with central adrenal insufficiency being the deficit that requires a timely diagnosis and treatment...
March 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28375472/enhanced-recovery-after-surgery-protocol-in-patients-undergoing-esophagectomy-for-cancer-a-single-center-experience
#17
S Giacopuzzi, J Weindelmayer, E Treppiedi, M Bencivenga, M Ceola, S Priolo, M Carlini, G de Manzoni
This article is about an emerging issue in esophageal surgery: enhanced recovery after surgery (ERAS) Few data are published in literature and its safety and feasibility is still debated. The focus of our paper is on the feasibility of an ERAS protocol for esophagectomy (including both the Ivor-Lewis and McKeown procedure) in a high volume center comparing to a standard perioperative protocol. We introduced a novelty item on this type of surgery: resume of oral feeding in the first postoperative day. We analyzed the dropout rate for each item and the postoperative morbidity...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28372955/colloids-in-cardiac-surgery-friend-or-foe
#18
Pia Katarina Ryhammer, Mariann Tang, Joachim Hoffmann-Petersen, Dovile Leonaviciute, Jacob Greisen, Marie Storebjerg Gissel, Carl-Johan Jakobsen
OBJECTIVE: The right choice of fluid replacement still is a matter of debate. Recently, two large-scale studies on the use of hydroxyethyl starches (HES) in the intensive care setting have been published, which have caused a huge shift in the daily practice of volume therapy. These results have been applied to patients outside intensive care. The aim of this study was to evaluate the impact this change has had on the outcomes in a large population of cardiac surgery patients, with a focus on the type of colloid infusion...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28372696/effectiveness-of-active-and-passive-warming-for-the-prevention-of-inadvertent-hypothermia-in-patients-receiving-neuraxial-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
Clarissa A Shaw, Victoria M Steelman, Jennifer DeBerg, Marin L Schweizer
OBJECTIVE: Perioperative hypothermia is a common complication of anesthesia that can result in negative outcomes. The purpose of this review is to answer the question: Does the type of warming intervention influence the frequency or severity of inadvertent perioperative hypothermia (IPH) in surgical patients receiving neuraxial anesthesia? DESIGN: Systematic review and meta-analysis. SETTING: Perioperative care areas. PATIENTS: Adults undergoing surgery with neuraxial anesthesia...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28364973/perioperative-fluid-therapy-recommendations-for-major-abdominal-surgery-via-rica-recommendations-revisited-part-i-physiological-background
#20
J Ripollés-Melchor, D Chappell, Á Espinosa, M G Mhyten, A Abad-Gurumeta, S D Bergese, R Casans-Francés, J M Calvo-Vecino
No abstract text is available yet for this article.
March 29, 2017: Revista Española de Anestesiología y Reanimación
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