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https://www.readbyqxmd.com/read/27864870/hereditary-hemorrhagic-telangiectasia-to-transplant-or-not-to-transplant
#1
Sophie Dupuis-Girod, Elisabetta Buscarini
This report comments the case reported by Muller et al. which describes a combination of at least two different indications for orthotopic liver transplant (OLT) in a same patient: hepatocarcinoma and HHT complicated with severe liver involvement and high output cardiac failure. This case report highlighted that the clear time for OLT in HHT can be difficult to determine. In HHT, if intensive medical approach is not efficient, OLT, has to be considered. In the case of Muller et al., the patient was correctly listed for OLT for a single hepatocellular carcinoma, however, he did not receive a sufficient priority so as to avoid worsening of liver vascular malformations complications...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#2
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27676415/impact-of-opening-hours-of-the-post-anaesthetic-care-unit-on-fast-track-success-in-cardiac-surgery
#3
Christian Graß, Federica Stretti, Waseem Zakhary, Edwin Turton, Sophia Sgouoropoulou, Meinhard Mende, Joerg Ender
BACKGROUND: Fast track (FT) treatment in cardiac anaesthesia is state of the art. Aim of our study was to compare FT treatment in a post anaesthetic care unit (PACU) with limited opening hours with a PACU opened for unlimited hours. Primary endpoints were extubation time (ET), length of stay (LOS) in PACU and LOS in intermediate care unit (IMC). Secondary endpoints were FT success/failure, hospital LOS, re- intubation and in hospital mortality. METHODS: At our institution, FT is usually managed in a PACU with limited opening hours from 10am to 10pm, Monday to Friday (PACU12)...
September 27, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27616189/fast-track-cardiac-care-for-adult-cardiac-surgical-patients
#4
REVIEW
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27555146/ultrashort-acting-remifentanil-is-not-superior-to-long-acting-sufentanil-in-preserving-cognitive-function-a-randomized-study
#5
Linda A Rasmussen, Pia K Ryhammer, Jacob Greisen, Rajesh R Bhavsar, Anne-Grethe Lorentzen, Carl-Johan Jakobsen
STUDY OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27554238/independent-risk-factors-for-fast-track-failure-using-a-predefined-fast-track-protocol-in-preselected-cardiac-surgery-patients-j-cardiothorac-vasc-anesth-29-1461-1465-2015
#6
Waseem Zakhary, Jacob Lindner, Sophia Sgouropoulou, Sarah Eibel, Stefan Probst, Markus Scholz, Joerg Ender
No abstract text is available yet for this article.
August 20, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27542901/use-of-postoperative-peak-arterial-lactate-level-to-predict-outcome-after-cardiac-surgery
#7
Marco C Haanschoten, Herman G Kreeftenberg, R Arthur Bouwman, Albert H M van Straten, Wolfgang F Buhre, Mohamed A Soliman Hamad
OBJECTIVES: In the present study, the authors investigated the predictive value of postoperative peak arterial lactate levels for early and late mortality after cardiac surgery. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Single-center study in an academic hospital. PARTICIPANTS: Adult patients who underwent cardiac surgery between 2004 and 2014 (n = 16,376). INTERVENTIONS: Different cardiac surgical procedures...
April 22, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27471314/clonidine-and-ketamine-for-stable-hemodynamics-in-off-pump-coronary-artery-bypass
#8
Jigar Patel, Rajesh Thosani, Jignesh Kothari, Pankaj Garg, Himani Pandya
BACKGROUND: The current era of fast-track extubation and faster recovery after cardiac surgery requires agents that provide perioperative sedation, suppress sympathetic response, reduce opioid requirement, and maintain hemodynamic stability. METHODS: In a prospective randomized double-blind study, 75 off-pump coronary artery bypass patients were divided into 3 groups of 25 each: group A had clonidine 1 µg·kg(-1), group B had clonidine 1 µg·kg(-1) and ketamine 1 mg·kg(-1), and group C had a saline placebo...
September 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27397447/anesthetic-implications-of-subxiphoid-coronary-artery-bypass-surgery
#9
Murali Chakravarthy, Muralimanohar Veerappa, Vivek Jawali, Nischal Pandya, Jayaprakash Krishnamoorthy, Geetha Muniraju, Antony George, Jitumoni Baishya
BACKGROUND: Minimal invasive surgeries are carried out to benefit the patient with less pain, blood loss, mechanical ventilation and hospital stay; a smaller scar is not the aim. Minimal invasive cardiac surgeries are carried out via small sternotomy, small thoracotomy and via robotic arms. Subxiphoid route is a novel method and avoids sternotomy. AIM: This case series is an attempt to understand the anesthetic modifications required. Secondly, whether it is feasible to carry out subxiphoid coronary artery bypass surgery...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27397446/hemodynamic-challenge-to-early-mobilization-after-cardiac-surgery-a-pilot-study
#10
Tiziano Cassina, Alessandro Putzu, Luisa Santambrogio, Michele Villa, Marc Joseph Licker
BACKGROUND: Active mobilization is a key component in fast-track surgical strategies. Following major surgery, clinicians are often reluctant to mobilize patients arguing that circulatory homeostasis would be impaired as a result of myocardial stunning, fluid shift, and autonomic dysfunction. AIMS: We examined the feasibility and safety of a mobilization protocol 12-24 h after elective cardiac surgery. SETTING AND DESIGN: This observational study was performed in a tertiary nonacademic cardiovascular Intensive Care Unit...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27293525/sporadic-multicentric-right-atrial-and-right-ventricular-myxoma-presenting-as-acute-pulmonary-thromboembolism
#11
Satyajit Singh, Mahendra Prasad Tripathy, Bipin Bihari Mohanty, Sutapa Biswas
Multicentric cardiac myxoma is a rare syndrome; usually it is familial. We report a rare case of sporadic right atrium (RA) and right ventricle (RV) myxoma in a 26-year-old female presenting to our hospital for the evaluation of sudden onset of dyspnea and left precordial pain attributed to the embolization of degenerating tumor fragments to the pulmonary artery (PA). The exact incidence of sporadic multicentric RA and RV myxoma presenting as acute pulmonary embolism is unknown as multicentric RA and RV myxoma are very rare...
January 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27163419/evaluation-of-the-influence-of-pulmonary-hypertension-in-ultra-fast-track-anesthesia-technique-in-adult-patients-undergoing-cardiac-surgery
#12
Paulo Sérgio da Silva, Márcio Portugal Trindade Cartacho, Casimiro Cardoso de Castro, Marcello Fonseca Salgado Filho, Antônio Carlos Aguiar Brandão
OBJECTIVE: To evaluate the influence of pulmonary hypertension in the ultra-fast-track anesthesia technique in adult cardiac surgery. METHODS: A retrospective study. They were included 40 patients divided into two groups: GI (without pulmonary hypertension) and GII (with pulmonary hypertension). Based on data obtained by transthoracic echocardiography. We considered as the absence of pulmonary hypertension: a pulmonary artery systolic pressure (sPAP) <36 mmHg, with tricuspid regurgitation velocity <2...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
https://www.readbyqxmd.com/read/27162650/comparison-of-the-single-lumen-endotracheal-tube-and-double-lumen-endobronchial-tube-used-in-minimally-invasive-cardiac-surgery-for-the-fast-track-protocol
#13
Hee Young Kim, Seung-Hoon Baek, Hyung Gon Je, Tae Kyun Kim, Hye Jin Kim, Ji Hye Ahn, Soon Ji Park
BACKGROUND: Minimally invasive cardiac surgery (MICS) has been more commonly performed due to the reduced amount of bleeding and transfusion and length of hospital stay. We investigated the feasibility of performing MICS using single-lumen endotracheal tube (SLT). METHODS: We conducted a retrospective review of clinical data of 112 patients who underwent MICS between July 2012 and March 2015. The patients underwent MICS using a SLT or a double lumen endotracheal tube (DLT)...
May 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27021174/remifentanil-compared-with-sufentanil-does-not-enhance-fast-track-possibilities-in-cardiac-surgery-a-randomized-study
#14
Rajesh Bhavsar, Pia Katerina Ryhammer, Jacob Greisen, Linda A Rasmussen, Carl-Johan Jakobsen
OBJECTIVE: Progressive cost containment has resulted in a growing interest for fast-track cardiac surgery. Ventilation time and length of stay (LOS) in the intensive care unit (ICU) are important factors in patient turnover, a more efficient use of resources, and early patient mobilization. However, LOS in ICU is not an objective measure because, in addition to medical factors, patient discharge may be guided by logistics and policy, and thus more objective measures are warranted. The authors hypothesized that remifentanil compared with sufentanil would reduce ventilation time and LOS in the ICU and that remifentanil would have beneficial effects on the overall quality of recovery...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/26936365/postoperative-awake-paralysis-in-the-intensive-care-unit-after-cardiac-surgery-due-to-residual-neuromuscular-blockade-a-case-report-and-prospective-observational-study
#15
Maxim Roy, Nathalie Morissette, Martin Girard, Nicholas Robillard, Pierre Beaulieu
PURPOSE: We report a case of awake paralysis due to residual neuromuscular blockade (NMB) in the intensive care unit (ICU) in a patient following fast-track cardiac surgery. As a result of this case, we performed a prospective quality assurance audit to investigate the incidence of residual paralysis in the ICU in a similar population of cardiac surgery patients. CLINICAL FEATURES AND AUDIT METHODS: A 73-yr-old woman (69 kg) underwent coronary artery bypass surgery under anesthesia induced with intravenous sufentanil 25 µg, midazolam 5 mg, ketamine 25 mg, and rocuronium 100 mg (followed by two additional 50-mg doses during surgery) and maintained with sevoflurane...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26902132/intraoperative-monitoring-of-stroke-volume-variation-versus-central-venous-pressure-in-laparoscopic-liver-surgery-a-randomized-prospective-comparative-trial
#16
Francesca Ratti, Federica Cipriani, Raffaella Reineke, Marco Catena, Michele Paganelli, Laura Comotti, Luigi Beretta, Luca Aldrighetti
BACKGROUND: Central venous pressure (CVP) is used as a marker of cardiac preload to control intraoperative blood loss in open hepatectomies, while its reliability in laparoscopy is less certain. The aim of this randomized prospective trial was to evaluate the outcome of laparoscopic resections performed with stroke volume variation (SVV) or CVP monitoring. METHODS: All candidates for laparoscopic liver resection were assigned randomly to SVV or to CVP groups. Outcome was evaluated included conversion rate, cause of conversion, intraoperative blood loss, need for transfusions, length of surgery and postoperative results...
February 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/26739112/improving-on-fast-track-protocol-for-post-cardiac-surgery-patients
#17
Yi C Tham, Zhihui Tan, Anna Lw Tam, Shah S Sharad, Kenny Yk Sin, Shaw Y Chia, Kim K Ong
No abstract text is available yet for this article.
December 16, 2015: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/26380654/fast-track-anesthesia-for-liver-transplantation-review-of-the-current-practice
#18
REVIEW
Stephen Aniskevich, Sher-Lu Pai
Historically, patients undergoing liver transplantation were left intubated and extubated in the intensive care unit (ICU) after a period of recovery. Proponents of this practice argued that these patients were critically ill and need time to be properly optimized from a physiological and pain standpoint prior to extubation. Recently, there has been a growing movement toward early extubation in transplant centers worldwide. Initially fueled by research into early extubation following cardiac surgery, extubation in the operating room or soon after arrival to the ICU, has been shown to be safe with proper patient selection...
September 18, 2015: World Journal of Hepatology
https://www.readbyqxmd.com/read/26342271/independent-risk-factors-for-fast-track-failure-using-a-predefined-fast-track-protocol-in-preselected-cardiac-surgery-patients
#19
Zakhary Waseem, Jacob Lindner, Sophia Sgouropoulou, Sarah Eibel, Stefan Probst, Markus Scholz, Joerg Ender
OBJECTISVES: The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. DESIGN: A retrospective analysis. SETTING: A university-affiliated heart center. PARTICIPANTS: In a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU)...
December 2015: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/26241543/mucosolvan-serves-to-optimize-perioperative-airway-management-for-nsclc-patients-in-fast-track-surgery-a-randomized-placebo-controlled-study
#20
RANDOMIZED CONTROLLED TRIAL
J-Y Wang, X Hong, G-H Chen, Q-C Li, Z-M Liu
OBJECTIVE: This study is conducted to investigate whether mucosolvan may offer therapy optimization initiatives for airway perioperative management of patients with non-small cell lung cancer (NSCLC) in fast track surgery (FTS). PATIENTS AND METHODS: The patients in FTS were treated with and without aerosol (90 mg/day) of mucosolvan in combination of intravenous administration of the agent (180 mg/day) for 8 consecutive days. Postoperative complications and length of time of hospital stay were examined in the patients treated with and without mucosolvan...
August 2015: European Review for Medical and Pharmacological Sciences
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