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Fluids in anesthesia

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https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#1
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29768341/the-plethysmographic-variability-index-does-not-predict-fluid-responsiveness-estimated-by-esophageal-doppler-during-kidney-transplantation-a-controlled-study
#2
Morgan Le Guen, Arnaud Follin, Etienne Gayat, Marc Fischler
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation.To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard.Observational study.University hospital; study from May 2011 and May 2012.Forty-eight patients with end-renal function were included and 44 analyzed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29765015/reduction-of-blood-pressure-following-after-renal-artery-adventitia-stripping-during-total-nephroureterectomy-potential-effect-of-renal-sympathetic-denervation
#3
Keisuke Okamura, Shunsuke Satou, Keita Setojima, Shinjiro Shono, Shigero Miyajima, Tatsu Ishii, Kazuyuki Shirai, Hidenori Urata
BACKGROUND Catheter-based renal sympathetic denervation has been reported to be effective for treatment resistance hypertension in Australia and Europe. However, in the blinded SYMPLICITY HTN-3 trial, renal denervation did not achieve a significant decrease in blood pressure (BP) in comparison to sham controls. There have been various discussions on the factors that influenced this result. CASE REPORT Two men on antihypertensive therapy underwent unilateral radical nephroureterectomy for cancer of the renal pelvis...
May 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29757795/safe-labeling-practices-to-minimize-medication-errors-in-anesthesia-5-case-reports-and-review-of-the-literature
#4
Smita Prakash, Parul Mullick, Ajay Kumar, Mridula Pawar
Drug error is a significant hazard to patient health. Poor, incorrect, and inconsistent labeling of injectable medicines and fluids, and the devices used to deliver these, has been identified as a patient safety issue. We report 5 cases of medication error as a consequence of incorrect or inappropriate labeling and analyze their cause. Recommendations for safe and practical labeling practices in anesthesia based on a review of the literature are presented. Implementation of the recommended labeling practices can reduce the risk of medication error and contribute to the safe administration of drugs...
May 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29757794/delayed-post-caudal-catheter-placement-pseudomeningocele-a-case-report
#5
Victoria A Bradford, Ricardo J Falcon, Timothy R Petersen, Codruta N Soneru
We present a rare case of a 7-month-old infant who developed a pseudomeningocele 16 days after an uneventful caudal catheter placement. The patient did not exhibit neurological deficits or signs of infection, and the mass increased in size with Valsalva maneuver. Pseudomeningocele, an abnormal collection of cerebrospinal fluid around an opening in the dura mater, can be iatrogenic or traumatic. Regional anesthesia is rarely the cause. Recognizing diagnostic features such as the lack of infectious signs and mass compressibility can prevent misdiagnosis and inappropriate invasive treatment...
May 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29756696/preliminary-experience-with-epidural-and-perineural-catheter-localization-with-pulsed-wave-doppler-ultrasonography
#6
Hesham Elsharkawy, Theresa Barnes, Rovnat Babazade, Maria Huarte, Wael Ali Sakr Esa, Brian M Ilfeld
BACKGROUND: Various methods for peripheral nerve and epidural catheter location assessment exist, with varying degrees of ease of use, utility, and accuracy. Pulsed wave Doppler (PWD) evaluates the presence of fluid flow and is possible modality to assess the location of a percutaneously inserted perineural catheter. METHODS: A retrospective chart review was conducted in which PWD ultrasonography was used to confirm the position of nerve catheters for regional anesthesia...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29750688/feasibility-of-fully-automated-hypnosis-analgesia-and-fluid-management-using-2-independent-closed-loop-systems-during-major-vascular-surgery-a-pilot-study
#7
Alexandre Joosten, Vincent Jame, Brenton Alexander, Thierry Chazot, Ngai Liu, Maxime Cannesson, Joseph Rinehart, Luc Barvais
Automated titration of intravenous anesthesia and analgesia using processed electroencephalography monitoring is no longer a novel concept. Closed-loop control of fluid administration to provide goal-directed fluid therapy has also been increasingly described. However, simultaneously combining 2 independent closed-loop systems together in patients undergoing major vascular surgery has not been previously detailed. The aim of this pilot study was to evaluate the clinical performance of fully automated hypnosis, analgesia, and fluid management using 2 independent closed-loop controllers in patients undergoing major vascular surgery before implementation within a larger study evaluating true patient outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29746218/effect-of-an-innovative-technology-active-warming-and-passive-warming-on-unplanned-hypothermia-during-perioperative-period-a-clinical-trial
#8
Ganime Esra Soysal, Arzu İlçe, Mehmet Hayri Erkol
Patients are at risk for unplanned hypothermia during the perioperative period due to many reasons, including anesthesia, low room temperature, cold intravenous fluid, and blood transfusion. This study was conducted to examine the effect of active and passive warming methods applied in patients during the perioperative period on unplanned hypothermia. This study is a case-control type study. The population of this study is composed of the patients hospitalized in surgical clinic and undergone abdominal region-related operations...
May 10, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29745073/hemodynamic-stability-achievement-by-application-of-goal-directed-fluid-therapy-with-different-infusion-solutions-in-colorectal-surgery
#9
Ana Cvetkovic, Nevena Kalezic, Biljana Milicic, Srdjan Nikolic, Milan Zegarac, Dejan Stojiljkovic, Merima Goran, Marina Stojanovic
PURPOSE: To determine whether there was a correlation between the type of administered infusion solutions intraoperatively with the quantity of administered infusion solutions, differences in values of cardiac output (CO) and cardiac index (CI) and need to use vasopressors and inotropes, between control and research groups. METHODS: This randomized prospective study included 55 patients with colorectal cancer. Subjects in the control group received only crystalloid solutions intraoperatively and postoperatively...
March 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29742696/acute-starvation-ketoacidosis-in-pregnancy-with-severe-hypertriglyceridemia-a-case-report
#10
Li Hui, Li Shuying
RATIONALE: Pregnant women are more prone to ketosis due to the relative insulin resistance, accelerated lipolysis and increased free fatty acids. PATIENT CONCERNS: We report a pregnant woman with hyperlipidemia, who experienced severe metabolic acidosis after a short period of starvation. DIAGNOSES: Based on her clinical symptoms, exclusion diagnosis and therapeutic diagnosis, her condition was diagnosed as starvation ketoacidosis. INTERVENTIONS: An emergency caesarean section under general anesthesia was implemented 2 hours after her admission...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29742589/clinical-factors-associated-with-icu-specific-care-following-supratentoral-brain-tumor-resection-and-validation-of-a-risk-prediction-score
#11
Lynze R Franko, Todd Hollon, Joseph Linzey, Christopher Roark, Venkatakrishna Rajajee, Kyle Sheehan, Magnus Teig, Shawn Hervey-Jumper, Jason Heth, Daniel Orringer, Craig A Williamson
OBJECTIVES: The postoperative management of patients who undergo brain tumor resection frequently occurs in an ICU. However, the routine admission of all patients to an ICU following surgery is controversial. This study seeks to identify the frequency with which patients undergoing elective supratentorial tumor resection require care, aside from frequent neurologic checks, that is specific to an ICU and to determine the frequency of new complications during ICU admission. Additionally, clinical predictors of ICU-specific care are identified, and a scoring system to discriminate patients most likely to require ICU-specific treatment is validated...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29739181/accidental-intracerebral-injection-and-seizure-during-scalp-nerve-blocks-for-awake-craniotomy-in-a-previously-craniotomized-patient
#12
Woo Kyung Lee, Hyunzu Kim, Myung-Il Bae, Seung Ho Choi, Kyeong Tae Min
A 34-year-old man who previously underwent a craniotomy due to oligodendroglioma was admitted with a diagnosis of recurrent brain tumor. An awake craniotomy was planned. Approximately 15 minutes after completing the scalp nerve block, his upper torso suddenly moved and trembled for 10 seconds, suggesting a generalized clonic seizure. He recovered gradually and fully in 55 minutes without any neurological sequelae. The emergency computed tomography scan revealed a localized fluid collection and small intracerebral hemorrhage nearby in the temporoparietal cortex beneath the skull defect...
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29736769/world-health-organization-world-federation-of-societies-of-anaesthesiologists-who-wfsa-international-standards-for-a-safe-practice-of-anesthesia
#13
Adrian W Gelb, Wayne W Morriss, Walter Johnson, Alan F Merry
The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a non-profit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care...
May 7, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29736287/acute-parotitis-after-lower-limb-amputation-a-case-report-of-a-rare-complication
#14
Konstantinos Ioannis Avgerinos, Nikolaos Degermetzoglou, Sofia Theofanidou, Georgia Kritikou, Ioannis Bountouris
Background: Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report: An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee...
2018: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29734240/world-health-organization-world-federation-of-societies-of-anaesthesiologists-who-wfsa-international-standards-for-a-safe-practice-of-anesthesia
#15
Adrian W Gelb, Wayne W Morriss, Walter Johnson, Alan F Merry, Anuja Abayadeera, Natalia Belîi, Sorin J Brull, Aline Chibana, Faye Evans, Cyril Goddia, Carolina Haylock-Loor, Fauzia Khan, Sandra Leal, Nan Lin, Richard Merchant, Mark W Newton, Jackie S Rowles, Arinola Sanusi, Iain Wilson, Adriana Velazquez Berumen
The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a nonprofit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care...
June 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29728805/large-volume-crystalloid-fluid-is-associated-with-increased-hyaluronan-shedding-and-inflammation-in-a-canine-hemorrhagic-shock-model
#16
Lisa Smart, C J Boyd, M A Claus, E Bosio, G Hosgood, A Raisis
Shedding of the endothelial glycocalyx precedes leukocyte activation and adherence in acute inflammation. Rapid administration of crystalloid or colloid fluids for treating hemorrhagic shock may cause endothelial glycocalyx shedding, thereby increasing inflammation. This study aimed to compare the effect of different fluid treatments in a canine shock model on glycocalyx biomarker, hyaluronan, and inflammatory biomarkers. Greyhound dogs under general anesthesia subject to hemorrhage for 60 min were given 20 mL kg-1 of either fresh whole blood (FWB), hydroxyethyl starch (HES) 130/0...
May 4, 2018: Inflammation
https://www.readbyqxmd.com/read/29725381/soleus-muscle-h-reflex-monitoring-in-endoscopic-surgery-under-general-anesthesia-percutaneous-interlaminar-approach
#17
Huixue Wang, Yingji Gao, Lixin Ji, Wanshan Bai
The clinical value of soleus muscle H-reflex monitoring in general anesthesia percutaneous interlaminar approach was investigated. A total of 80 cases with unilateral L5-S1 disc herniation between January 2015 and October 2016 were randomly divided into control group (without soleus muscle H-reflex monitoring, n=40) and observation group (with soleus muscle H-reflex monitoring, n=40). Results showed that the operation time of the observation group was shorter than that of the control group (P<0.05), and the blood loss during the operation was less than that of the control group (P<0...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29721547/evaluation-of-the-pharyngeal-airway-using-computational-fluid-dynamics-in-patients-with-acromegaly
#18
Keika Mukaihara, Maiko Hasegawa-Moriyama, Tomonori Iwasaki, Youichi Yamasaki, Yuichi Kanmura
Objectives: Perioperative airway management may be particularly challenging in patients with acromegaly undergoing trans-sphenoidal pituitary surgery (TSS). Management for airway obstruction is required prior to pituitary surgery to minimize perioperative hypoxia. The purpose of this retrospective study was to evaluate airway obstruction by simulation of computational fluid dynamics (CFD) using computed tomography (CT) images in patients who had undergone TSS. Methods: CT images of the nasopharyngeal airways of patients with acromegaly (n = 5) or nonfunctional pituitary adenoma (n = 6) undergoing TSS from April 2012 to January 2017 were used to construct these airways in three dimensions...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29719401/a-restrictive-dose-of-crystalloids-in-patients-during-laparoscopic-cholecystectomy-is-safe-and-cost-effective-prospective-two-arm-parallel-randomized-controlled-trial
#19
Matija Belavić, Vlatka Sotošek Tokmadžić, Antonija Brozović Krijan, Ines Kvaternik, Kristina Matijaš, Nedjeljko Strikić, Josip Žunić
Purpose: There are no evidence-based guidelines for volume replacement during surgical procedures such as laparoscopic cholecystectomy. However, the administration of a restrictive volume of crystalloids could be more cost-effective and safe. This trial aimed to determine the effectiveness and safety of a restrictive regimen of crystalloids in patients during laparoscopic cholecystectomy by analyzing its cost-effectiveness and 1-year morbidity rate. Patients and methods: In this randomized, prospective study, patients were assigned to one of three groups based on the volume of fluid administered: the restrictive group received 1 mL/kg/hr, the low liberal group received 5 mL/kg/hr, and the high liberal group received 15 mL/kg/hr of Ringer's solution intraoperatively...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29708913/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#20
Boris D Heifets, Erin Crawford, Ethan Jackson, Jessica Brodt, Richard A Jaffe, Mark A Burbridge
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis...
May 1, 2018: A&A practice
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