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Postoperative care

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https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#1
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte(®) ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg(-1) . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29150418/immune-enhancing-formulas-for-patients-with-cancer-undergoing-esophagectomy-systematic-review-protocol
#2
Astrid Naranjo, Elizabeth Isenring, Laisa Teleni
BACKGROUND: Adult patients with an esophageal cancer can potentially be compromised with postoperative leaks or fistulae if patients' nutritional status is in a vulnerable stage. Currently in Australia, there is a growing need for clinicians to know whether use of immune-enhancing formulas (IEFs) containing Arg, omega-3, and RNA are a cost-effective approach compared with isonitrogenous-isocaloric formulas to reduce postoperative infectious complications in esophagectomy patients. Since IEFs may carry higher costs, this has led to inconsistencies in practice among clinicians and hospitals...
November 17, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29150034/lung-resection-in-the-postpneumonectomy-patient
#3
REVIEW
Megumi Asai, Walter J Scott
Pulmonary resection after pneumonectomy is a reasonable option in selected patients. Wedge resection for single peripheral metachronous disease has the best outcome with 5-year survival as high as 63%. Current and predicted postoperative cardiopulmonary reserve should be evaluated carefully. Stereotactic body radiotherapy is a promising alternative for inoperable patients.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#4
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#5
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29149429/population-analysis-of-predictors-of-difficult-intubation-with-direct-laryngoscopy-in-pediatric-patients-with-and-without-thyroid-disease
#6
Aalap C Shah, William C K Ng, Sean Sinnott, Joseph P Cravero
PURPOSE: There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3) evaluates the effect of DI on postoperative care and length-of-stay. METHODS: A single-center retrospective cohort analysis of procedures in patients assigned with an ICD-9 code for thyroid disease between June 2012 and February 2016...
November 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#7
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29149147/hypothalamic-pituitary-adrenocortical-axis-suppression-following-a-single-epidural-injection-of-methylprednisolone-acetate
#8
Aleem Jameel Abdul, Babita Ghai, Dipika Bansal, Naresh Sachdeva, Anil Bhansali, Saravdeep Singh Dhatt
BACKGROUND: Epidural injections (EIs) are the most commonly performed minimally invasive intervention in managing chronic low back pain (CLBP). There is inconsistency in data to accurately predict the degree of hypothalamic-piuitary-adrenal (HPA) axis suppression in patients receiving exogenous steroid therapy, especially in the form of epidural steroid injections (ESIs). OBJECTIVE: We aim to quantify the degree and duration of HPA axis suppression after a single ESI of 80 mg methyl prednisolone acetate in patients with CLBP...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149145/endoscopic-epidural-laser-decompression-versus-transforaminal-epiduroscopic-laser-annuloplasty-for-lumbar-disc-herniation-a-prospective-randomized-trial
#9
Chang Hong Park, Sang Ho Lee
BACKGROUND: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleo-annuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. OBJECTIVE: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148256/toward-standardization-of-care-the-feeding-readiness-assessment-after-congenital-cardiac-surgery
#10
Daniel E Ehrmann, Matthew Mulvahill, Shaunda Harendt, Jessica Church, Amy Stimmler, Piyagarnt Vichayavilas, Sanja Batz, Jennifer Rodgers, Michael DiMaria, James Jaggers, Cindy Barrett, Jon Kaufman
BACKGROUND: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care. METHODS: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center...
November 17, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29148019/a-prospective-randomised-comparison-of-2-skin-closure-techniques-in-primary-total-hip-arthroplasty-surgery
#11
Min Rui, Xin Zheng, Shao-Song Sun, Cheng-Yu Li, Xing-Chen Zhang, Kai-Jin Guo, Feng-Chao Zhao, Yong Pang
INTRODUCTION: As an essential step of total hip arthroplasty (THA), an effective and secure skin closure technique after primary THA is important. Metallic staples closure and subcuticular suture are the 2 common techniques for skin closure. However, which closure technique is the optimal skin-closure method remains unclear. The purpose of this prospective randomised clinical study was to compare the clinical outcomes and costs between staples and subcuticular suture techniques. METHODS: In this clinical study, 165 patients who underwent primary unilateral THA through a posterolateral approach from August 2014 to May 2015 were included...
November 13, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#12
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29146536/analysis-of-an-integral-care-programme-for-hip-fracture-patients-aged-over-65-years
#13
J Franch Parella
OBJECTIVE: To analyse the results of a comprehensive care programme in elderly patients with hip fracture. METHODS: Non-randomised intervention study with patients undergoing hip fracture in Althaia Hospital (Manresa). The care model of the control group was the traditional, with the orthopaedist centralising decisions. By contrast, in the intervention group, a multidisciplinary model was used with the active collaboration, among other professionals, of orthopaedic surgeons and geriatricians...
November 13, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29146391/small-diameter-hysteroscopic-metroplasty-for-a-septate-uterus-after-open-assisted-laparoscopic-radical-trachelectomy
#14
Akimasa Takahashi, Hiroyuki Kanao, Nobuhiro Takeshima
STUDY OBJECTIVE: To describe a two-step fertility preservation technique for early-stage cervical cancer of a patient with a complete septate uterus. DESIGN: A step-by-step demonstration and explanation of the technique in a surgical video (Canadian Task Force Classification III). SETTING: Center for cancer, a tertiary referral center. The patient provided informed consent to use images and videos of the procedure. Institutional Review Board approval was not required for this kind of procedure...
November 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29146229/evaluating-the-projected-surgical-impact-of-reclassifying-noninvasive-encapsulated-follicular-variant-of-papillary-thyroid-cancer-as-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features
#15
Rajshri Mainthia, Heather Wachtel, Yufei Chen, Elizabeth Mort, Sareh Parangi, Peter M Sadow, Carrie C Lubitz
BACKGROUND: The reclassification of noninvasive encapsulated follicular variant of papillary thyroid cancer to noninvasive follicular thyroid neoplasm with papillary-like nuclear features will reduce nonefficacious and potentially harmful care. Reclassification is estimated in 18.6% of patients with papillary thyroid carcinoma; we aimed to quantify the implications of this change. METHODS: Pathology reports from April 2006 to April 2016 were reviewed to isolate cases that would have been designated as neoplasm with papillary-like nuclear features...
November 13, 2017: Surgery
https://www.readbyqxmd.com/read/29145987/outpatient-total-knee-arthroplasty-are-we-there-yet-part-2
#16
REVIEW
Andrew Krause, Zain Sayeed, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The method by which surgeons conduct outpatient total knee procedures has yet to be fully elucidated. Literature demonstrates different experiences from various care protocols in place across the nation. This article reviews current recommendations for implementing successful total knee arthroplasty (TKA) and unicompartmental knee arthroplasty outpatient protocols. Specifically, information regarding anesthesia and analgesia modalities, perioperative care, operative technique, and postoperative care within outpatient TKA pathways is discussed...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145982/impact-of-outpatient-total-joint-replacement-on-postoperative-outcomes
#17
REVIEW
Danielle Lovett-Carter, Zain Sayeed, Leila Abaab, Vinay Pallekonda, William Mihalko, Khaled J Saleh
Total joint arthroplasty (TJA) has demonstrated tremendous benefits to patients with osteoarthritis. Health care reform has influenced surgeons to optimize TJA care pathways as well as playing a role in the formation of outpatient TJA protocols. Understanding the outcomes of outpatient TJA is imperative to surgical predicate decision making. The aim of this review is to compare outcomes of outpatient TJA patients to standard-stay inpatients. Postoperative outcomes assessed include pain, complications, readmissions, reoperation, patient satisfaction, and cost...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145981/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-2
#18
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The intra- and postoperative phases of outpatient total hip arthroplasty (THA) vary by institution and surgeon. An understanding of an evidence-based approach to enhancing the intra- and postoperative phases of the care continuum is warranted to offer high-value care to outpatient candidates. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding anesthesia and analgesia modalities, intraoperative considerations, and postoperative rehabilitation amenable to outpatient THA...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145966/outcome-evaluation-of-staged-treatment-for-bicondylar-tibial-plateau-fractures
#19
Vincenzo Giordano, Ney Pecegueiro do Amaral, Hilton A Koch, Rodrigo Pires E Albuquerque, Felipe Serrão de Souza, José Félix Dos Santos Neto
BACKGROUND: The universal accepted strategy for treating high-energy tibial plateau fractures remains a topic of ongoing debate. The challenge for the practicing orthopaedic trauma surgeon is to provide anatomical articular fracture reduction, with successfully managing the complex soft-tissue injury that is commonly present at patient admission. The primary aim of the actual study was to evaluate the results of a staged protocol for the treatment of high-energy bicondylar tibial plateau fractures...
October 2017: Injury
https://www.readbyqxmd.com/read/29143893/the-role-of-systemic-therapy-in-resectable-gastric-and-gastro-oesophageal-junction-cancer
#20
REVIEW
Elizabeth Cartwright, David Cunningham
Approximately 20% of patients with cancer of the stomach or gastro-oesophageal junction (GOJ) present with resectable disease. Long-term outcome after surgery alone in these patients is poor, and a combined treatment approach is the standard of care. The two approaches to managing patients with cancer of the GOJ are perioperative chemotherapy or preoperative chemoradiotherapy. Based upon the most recent evidence, patients treated with a perioperative approach and deemed suitable for a triplet regimen should be considered for pre- and post-operative FLOT (5-fluorouracil [5-FU], leucovorin, oxaliplatin and docetaxel) and those suitable for a doublet regimen should be considered for a fluoropyrimidine/platinum combination such as capecitabine and oxaliplatin...
November 16, 2017: Current Treatment Options in Oncology
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