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Perioperative fluid

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https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#1
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28299589/respiratory-variation-in-peak-aortic-velocity-accurately-predicts-fluid-responsiveness-in-children-undergoing-neurosurgery-under-general-anesthesia
#2
Kavita G Morparia, Srijaya K Reddy, Laura J Olivieri, Michael C Spaeder, Jennifer J Schuette
The determination of fluid responsiveness in the critically ill child is of vital importance, more so as fluid overload becomes increasingly associated with worse outcomes. Dynamic markers of volume responsiveness have shown some promise in the pediatric population, but more research is needed before they can be adopted for widespread use. Our aim was to investigate effectiveness of respiratory variation in peak aortic velocity and pulse pressure variation to predict fluid responsiveness, and determine their optimal cutoff values...
March 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28289972/impact-of-laparoscopy-on-adherence-to-an-enhanced-recovery-pathway-and-readiness-for-discharge-in-elective-colorectal-surgery-results-from-the-perioperative-italian-society-registry
#3
Marco Braga, Felice Borghi, Marco Scatizzi, Giancarlo Missana, Marco Azzola Guicciardi, Stefano Bona, Ferdinando Ficari, Marianna Maspero, Nicolò Pecorelli
INTRODUCTION: Previous studies reported that laparoscopic surgery (LPS) improved postoperative outcomes in patients undergoing colorectal surgery within an enhanced recovery program (ERP). However, the effect of minimally invasive surgery on each ERP item has not been clarified, yet. The aim of this study is to assess the impact of LPS on adherence to ERP items and recovery as measured by time to readiness for discharge (TRD). METHODS: Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed...
March 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28289542/complications-after-pancreaticoduodenectomy-are-associated-with-higher-amounts-of-intra-and-postoperative-fluid-therapy-a-single-center-retrospective-cohort-study
#4
Birte Kulemann, Marianne Fritz, Torben Glatz, Goran Marjanovic, Olivia Sick, Ulrich T Hopt, Jens Hoeppner, Frank Makowiec
BACKGROUND: Perioperative mortality after pancreaticoduodenectomy has decreased significantly in high-volume centers, but morbidity remains high. Restrictive perioperative fluid management may contribute to reduced complication rates after various surgical procedures. The aim of this study was to determine whether there is a correlation between the amount of fluid administered and postoperative complications. We hypothesized that higher amounts of intra- and total fluid is associated with greater postoperative morbidity...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28287012/low-sensitivity-of-implant-sonication-when-screening-for-infection-in-revision-surgery
#5
Floor M Van Diek, Christiaan G M Albers, Miranda L Van Hooff, Jacques F Meis, Jon H M Goosen
Background and purpose - Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods - 252 consecutive revision arthroplasty cases were enrolled. These cases were determined as being suspected or unsuspected of having infection according to standard criteria...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28285959/impact-of-perioperative-fluid-administration-on-early-outcomes-after-pancreatoduodenectomy-a-meta-analysis
#6
REVIEW
Yeqian Huang, Terence C Chua, Anthony J Gill, Jaswinder S Samra
BACKGROUND: Pancreatoduodenectomy (PD) remains a technically challenging surgical procedure with morbidity rates ranging between 30 and 50%. It is suggested that the liberal use of fluids is associated with a poor perioperative outcome. This review examines the impact of fluid administration on outcomes after PD. METHODS: A literature search was conducted using the MEDLINE, EMBASE and PubMed database (June 1966-June 2016). Studies identified were appraised with standard selection criteria...
February 28, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28283245/effect-of-tranexamic-acid-on-intraoperative-blood-loss-and-transfusion-requirements-in-patients-undergoing-excision-of-intracranial-meningioma
#7
Bhavna Hooda, Rajendra Singh Chouhan, Girija Prasad Rath, Parmod Kumar Bithal, Ashish Suri, Ritesh Lamsal
Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery...
March 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28282425/administration-of-tranexamic-acid-to-patients-undergoing-surgery-for-adolescent-idiopathic-scoliosis-evokes-pain-and-increases-the-infusion-rate-of-remifentanil-during-the-surgery
#8
Nobuko Ohashi, Masayuki Ohashi, Naoto Endo, Tatsuro Kohno
BACKGROUND: We recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS)...
2017: PloS One
https://www.readbyqxmd.com/read/28282010/complications-and-mortality-associated-with-temporary-abdominal-closure-techniques-a-systematic-review-and-meta-analysis
#9
Adam Cristaudo, Scott Jennings, Ronny Gunnarsson, Alan DeCosta
Temporary abdominal closure (TAC) techniques are routinely used in the open abdomen. Ideally, they should prevent evisceration, aid in removal of unwanted fluid from the peritoneal cavity, facilitate in achieving safe definitive fascial closure, as well as prevent the development of intra-abdominal complications. TAC techniques used in the open abdomen were compared with negative pressure wound therapy (NPWT) to identify which was superior. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines involving Medline, Excerpta Medica, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and <ext-link ext-link-type="uri" xlink:href="http://Clinicaltrials...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28270914/sepsis-induced-cardiac-dysfunction-and-%C3%AE-adrenergic-blockade-therapy-for-sepsis
#10
REVIEW
Takeshi Suzuki, Yuta Suzuki, Jun Okuda, Takuya Kurazumi, Tomohiro Suhara, Tomomi Ueda, Hiromasa Nagata, Hiroshi Morisaki
Despite recent advances in medical care, mortality due to sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains high. Fluid resuscitation and vasopressors are the first-line treatment for sepsis in order to optimize hemodynamic instability caused by vasodilation and increased vascular permeability. However, these therapies, aimed at maintaining blood pressure and blood flow to vital organs, could have deleterious cardiac effects, as cardiomyocyte damage occurs in the early stages of sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28259855/restrictive-versus-liberal-fluid-therapy-in-major-abdominal-surgery-relief-rationale-and-design-for-a-multicentre-randomised-trial
#11
Paul Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Sophie Wallace, Philip Peyton, Chris Christophi, David Story, Kate Leslie, Jonathan Serpell, Shay McGuinness, Rachel Parke
INTRODUCTION: The optimal intravenous fluid regimen for patients undergoing major abdominal surgery is unclear. However, results from many small studies suggest a restrictive regimen may lead to better outcomes. A large, definitive clinical trial evaluating perioperative fluid replacement in major abdominal surgery, therefore, is required. METHODS/ANALYSIS: We designed a pragmatic, multicentre, randomised, controlled trial (the RELIEF trial). A total of 3000 patients were enrolled in this study and randomly allocated to a restrictive or liberal fluid regimen in a 1:1 ratio, stratified by centre and planned critical care admission...
March 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28259602/perioperative-strokes-and-early-outcomes-in-mitral-valve-surgery-a-nationwide-analysis
#12
Reshmi Udesh, Amol Mehta, Thomas G Gleason, Lawrence Wechsler, Parthasarathy D Thirumala
OBJECTIVE: To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade. DESIGN: Using data from the National Inpatient Sample database for analysis, all patients who underwent isolated mitral valve procedures were identified using International Classification of Diseases-Ninth Revision codes...
December 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28248863/comparison-of-bedside-assessed-arm-and-leg-fluid-filtration-determined-by-venous-congestion-plethysmography-in-perioperative-cancer-patients-an-observational-study-investigating-agreement
#13
Oliver Hunsicker, Sandra Heinig, Jana-Jennifer Dathe, Alexander Krannich, Claudia Spies, Aarne Feldheiser
In recent years, pathophysiology and clinical impact of microvascular fluid filtration has regained interest. As the latest data in surgical patients have been published almost 20 years ago, there is need for further research to better understand fluid filtration during the perioperative period. Venous congestion plethysmography (VCP) provides a rapid and noninvasive method, which has been shown suitable for the assessment of fluid filtration in limbs. Fluid filtration assessed by VCP can be obtained from forearm and calf measurement sites, while in many clinical situations a reduced access to the patient often restricts the measurements to patient's forearm...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28248604/middle-ear-obliteration-with-blind-sac-closure-of-the-external-auditory-canal-for-spontaneous-csf-otorrhea
#14
Shawn M Stevens, Ryan Crane, Myles L Pensak, Ravi N Samy
Outcome Objectives To (1) identify unique features of patients who underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal for spontaneous cerebrospinal fluid (CSF) otorrhea and (2) explore outcomes. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods Adults treated for spontaneous cerebrospinal fluid otorrhea from 2007 through 2015 were reviewed and stratified into 2 groups based on the surgery performed: (1) 11 patients underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal and (2) 26 patients underwent other procedures...
March 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28243814/dna-diagnosis-of-peritoneal-fluid-cytology-test-by-cdo1-promoter-dna-hypermethylation-in-gastric-cancer
#15
Hideki Ushiku, Keishi Yamashita, Akira Ema, Naoko Minatani, Mariko Kikuchi, Ken Kojo, Keigo Yokoi, Toshimichi Tanaka, Nobuyuki Nishizawa, Satoru Ishii, Kei Hosoda, Hiromitsu Moriya, Hiroaki Mieno, Natsuya Katada, Shiro Kikuchi, Hiroshi Katoh, Masahiko Watanabe
BACKGROUND: Minimal residual disease of the peritoneum is challenging for early cancer detection in gastric cancer (GC). Utility of PCR amplification of cancer-derived DNA has been considered feasible due to its molecular stability, however such markers have never been available in GC clinics. We recently discovered cancer-specific methylation of CDO1 gene in GC, and investigated the clinical potential to detect the minimal residual disease. METHODS: One hundred and two GC patients were investigated for peritoneal fluid cytology test (CY), and detection level of the promoter DNA methylation of CDO1 gene was assessed by quantitative methylation specific PCR (Q-MSP) in the sediments (DNA CY)...
February 27, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28239944/pancreatoduodenectomy-and-the-risk-of-complications-from-perioperative-fluid-administration
#16
Preetjote Gill, Terence C Chua, Yeqian Huang, Shreya Mehta, Anubhav Mittal, Anthony J Gill, Jaswinder S Samra
BACKGROUND: The dogma of administering sufficient intravenous fluids aggressively to avoid under-resuscitation has recently been challenged. Evidence suggests that excessive perioperative fluid administration may be associated with negative clinical outcomes in gastrointestinal surgery. This study examines the impact of fluid administration on perioperative outcomes in patients undergoing pancreatoduodenectomy (PD). METHODS: A retrospective analysis of 202 patients undergoing PD between January 2004 and August 2015 was performed...
February 27, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28239802/anesthetic-management-of-patients-with-dilated-cardiomyopathy-for-noncardiac-surgery
#17
C-Q Chen, X Wang, J Zhang, S-M Zhu
Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesia considerations of patients with DCM undergoing non-cardiac surgery. Patient pathophysiology and clinical status, such as ventricular function, degree of myocardial fibrosis, resting heart rate and high-sensitivity C-reactive protein can affect survival rates...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28236867/medication-errors-in-anesthesia-unacceptable-or-unavoidable
#18
Ira Dhawan, Anurag Tewari, Sankalp Sehgal, Ashish Chandra Sinha
Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28228207/complications-and-mortality-associated-with-temporary-abdominal-closure-techniques-a-systematic-review-and-meta-analysis
#19
REVIEW
Adam Cristaudo, Scott Jennings, Ronny Gunnarsson, Alan DeCosta
Temporary abdominal closure (TAC) techniques are routinely used in the open abdomen. Ideally, they should prevent evisceration, aid in removal of unwanted fluid from the peritoneal cavity, facilitate in achieving safe definitive fascial closure, as well as prevent the development of intra-abdominal complications. TAC techniques used in the open abdomen were compared with negative pressure wound therapy (NPWT) to identify which was superior. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines involving Medline, Excerpta Medica, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and <ext-link ext-link-type="uri" xlink:href="http://Clinicaltrials...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28217157/emergency-anesthesia-for-evacuating-a-traumatic-acute-subdural-hemorrhage-in-a-child-overdosed-with-hypertonic-saline
#20
Chulananda Goonasekera, James Bedford, Sodhi Harpreet, Mariangela Giombini, Asme Sheikh
A previously healthy 1-year-old child with a traumatic acute subdural hemorrhage received 10 times higher dose of hypertonic saline inadvertently immediately before surgery. This case report describes deviations in fluid management needed to alleviate salt toxicity and its adverse effects during surgery under anesthesia perioperatively. The child made an uneventful recovery with no evident residual damage at follow-up.
October 2016: Journal of Pediatric Neurosciences
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