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Perioperative anemia

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https://www.readbyqxmd.com/read/28538534/enhanced-recovery-after-surgery-for-hip-and-knee-replacements
#1
David P Gwynne-Jones, Ginny Martin, Chris Crane
BACKGROUND: Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. PURPOSE: To compare outcomes following the introduction of an ERAS program for hip and knee replacements developed at our institution with a historical cohort of patients. METHODS: ERAS protocols were developed at our institution for patients undergoing hip and knee joint replacements...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538406/dexmedetomidine-based-intravenous-anesthesia-of-a-pediatric-patient-with-glucose-6-phosphate-dehydrogenase-g6pd-deficiency-a-case-report
#2
Nanae Takahashi, Takashi Ogawa, Zen'ichiro Wajima, Akibumi Omi
RATIONALE: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect, resulting in deficits in nicotinamide adenine dinucleotide phosphate production, an important intracellular antioxidant enzyme. G6PD-deficient subjects present with a susceptibility of erythrocytes to oxidative stress and hemolysis, and should avoid drugs or stressors that have oxidative actions. Dexmedetomidine is an anesthetic agent with antioxidant actions. PATIENT CONCERNS AND DIAGNOSES: A 5-year-old boy with G6PD deficiency...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28534070/total-abdominal-colectomy-vs-restorative-total-proctocolectomy-as-the-initial-approach-to-medically-refractory-ulcerative-colitis
#3
Jinyu Gu, Luca Stocchi, Jeanie Ashburn, Feza H Remzi
PURPOSE: There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS: Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 were identified from an IRB-approved database. Demographics, treatment variables, and perioperative outcomes were assessed. RESULTS: Out of 521 patients, 322 (62%) underwent initial total abdominal colectomy before restorative proctectomy...
May 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28529107/is-there-a-role-for-preoperative-iron-supplementation-in-patients-preparing-for-a-total-hip-or-total-knee-arthroplasty
#4
Stephen M Petis, Brent A Lanting, Edward M Vasarhelyi, Douglas D R Naudie, Fiona E Ralley, James L Howard
BACKGROUND: Several treatment modalities exist for the treatment of perioperative anemia. We determined the effect of oral iron supplementation on preoperative anemia, and the use of blood-conserving interventions before total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: A total of 3435 total joint arthroplasties (1461 THAs and 1974 TKAs) were analyzed during 2 phases of a blood conservation program. The first phase used erythropoietin alfa (EPO) or intravenous (IV) iron for patients at risk for perioperative anemia...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28507883/risk-factors-for-medical-and-surgical-complications-following-single-level-alif
#5
Winward Choy, Nikki Barrington, Roxanna M Garcia, Robert B Kim, Heron Rodriguez, Sandi Lam, Nader Dahdaleh, Zachary A Smith
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of the study was to determine rates of medical and surgical postoperative complications following anterior lumbar interbody fusion (ALIF) along with their associated predictors. METHODS: Using the American College of Surgeons National Surgical Quality Improvement database, patients who underwent single-level ALIF surgery from 2006 to 2013 were identified. The 30-day rate of postoperative medical and surgical complications along with associated risk factors were evaluated by multivariable logistic regression...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#6
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28416180/revision-of-sleeve-gastrectomy-to-roux-en-y-gastric-bypass-a-canadian-experience
#7
Ekua Yorke, Caroline Sheppard, Noah J Switzer, David Kim, Christopher de Gara, Shahzeer Karmali, Aliyah Kanji, Daniel Birch
INTRODUCTION: Sleeve gastrectomy (SG) can be associated with inadequate weight loss, insufficient resolution of co-morbidities and severe reflux. Conversion to Roux-en-Y Gastric Bypass (RYGB) is a potential solution. The aim of this study was to determine the common indications for conversion from SG to RYGB at our centre, and evaluate patient outcomes with respect to weight loss and co-morbidity resolution. METHODS: A retrospective review of patients who underwent conversion from SG to RYGB between 2008 and 2015...
April 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28387620/reoperation-and-readmission-after-clipping-of-an-unruptured-intracranial-aneurysm-a-national-surgical-quality-improvement-program-analysis
#8
Hormuzdiyar H Dasenbrock, Timothy R Smith, Robert F Rudy, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured aneurysm electively were extracted from the prospective National Surgical Quality Improvement Program registry (2011-2014). Multivariable logistic regression and recursive partitioning analysis evaluated the independent predictors of nonroutine hospital discharge, unplanned 30-day reoperation, and readmission...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28377861/outpatient-anterior-cervical-discectomy-and-fusion-an-analysis-of-readmissions-from-the-new-jersey-state-ambulatory-services-database
#9
Shearwood McClelland, Peter G Passias, Thomas J Errico, R Shay Bess, Themistocles S Protopsaltis
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) performed as an outpatient has become increasingly common for treating cervical spine pathology. Few reports have attempted to assess readmissions following outpatient ACDF. This study was performed to address this issue using population-based databases. METHODS: The State Ambulatory Services Database (SASD) for New Jersey (NJ) from 2003-2012 was used for analysis. Patients receiving ACDF (defined as anterior cervical fusion (ICD-0 code=81...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28366762/still-a-role-for-surgery-as-first-line-therapy-of-splenic-marginal-zone-lymphoma-results-of-a-prospective-observational-study
#10
Giacomo Pata, Michele Bartoli, Enrico Damiani, Stefano Solari, Antonella Anastasia, Chiara Pagani, Alessandra Tucci
AIM: Assessment of hematologic improvement, survival and peri-operative morbidity after first-line splenectomy for splenic marginal zone lymphoma (SMZL). METHODS: Forty-three patients undergoing open splenectomy were prospectively analyzed. Perioperative clinical course, overall and progression-free survival (OS-PFS) were evaluated. Risk factors analyzed were gender, age, ASA-grade, ECOG performance status, presence of B-symptoms, body mass index, steroidal treatment, serum albumin concentration, IIL-score, operative time, spleen size and weight...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#11
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28315018/influence-of-pelvic-volume-on-surgical-outcome-after-low-anterior-resection-for-rectal-cancer
#12
G Zur Hausen, J Gröne, D Kaufmann, S M Niehues, K Aschenbrenner, A Stroux, B Hamm, M E Kreis, Johannes C Lauscher
BACKGROUND: Low anterior resection (LAR) for rectal cancer is a potentially challenging operation due to limited space in the pelvis. CT pelvimetry allows to quantify pelvic space, so that its relationship with outcome after LAR may be assessed. Studies investigating this, however, yielded conflicting results. We hypothesized that a small pelvis is associated with a higher rate of incomplete mesorectal excision, anastomotic leakages, and increased rate of urinary dysfunction in patients operated for rectal cancer...
March 18, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28299184/revisiting-blood-transfusion-and-predictors-of-outcome-in-cardiac-surgery-patients-a-concise-perspective
#13
REVIEW
Carlos E Arias-Morales, Nicoleta Stoicea, Alicia A Gonzalez-Zacarias, Diana Slawski, Sujatha P Bhandary, Theodosios Saranteas, Eva Kaminiotis, Thomas J Papadimos
In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement...
2017: F1000Research
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#14
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
June 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28277473/clinical-utility-of-hemoglobin-testing-after-minimally-invasive-sacrocolpopexy
#15
Erin Seifert Lavelle, Lauren Giugale, Sears Sarah, Charelle M Carter-Brooks, Jonathan P Shepherd
OBJECTIVE: To determine the clinical utility of routine postoperative hemoglobin screening after minimally invasive sacrocolpopexy. METHODS: This is a retrospective chart review of women undergoing minimally invasive sacrocolpopexy between 2009 and 2015 at a large academic center where postoperative hemoglobin assessment is performed as routine practice. Demographic and perioperative data, pre- and postoperative hemoglobin values, and clinical signs and symptoms of potential postoperative anemia were extracted...
March 9, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28259602/perioperative-strokes-and-early-outcomes-in-mitral-valve-surgery-a-nationwide-analysis
#16
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...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28259372/-gas-tamponade-following-intraoperative-pneumothorax-on-a-single-lung-a-case-study
#17
S D El Jaouhari, O Mamane Nassirou, M Meziane, M Bensghir, C Haimeur
Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation...
April 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28242402/hypoalbuminemia-predicts-perioperative-morbidity-and-mortality-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#18
Matthew R Peacock, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
BACKGROUND: Poor nutritional status has been associated with a higher risk of morbidity and mortality in general surgery patients; however, outcomes in vascular surgery patients are unclear. Our goal was to determine the effect of poor nutritional status on perioperative morbidity and mortality after lower extremity bypass (LEB). METHODS: The 2005-2012 National Surgical Quality Improvement Program was analyzed to determine associated complications, mortality, length of stay (LOS), and readmissions for patients with hypoalbuminemia (serum albumin <3...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28225801/perioperative-hemoglobin-area-under-the-curve-is-an-independent-predictor-of-renal-failure-after-cardiac-surgery-results-from-a-spanish-multicenter-retrospective-cohort-study
#19
Paula Duque-Sosa, Diego Martínez-Urbistondo, Gemma Echarri, Raquel Callejas, María Josefa Iribarren, Gregorio Rábago, Pablo Monedero
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28215514/robotic-single-site-myomectomy-clinical-analysis-of-61-consecutive-cases
#20
Eun Ji Choi, A Mi Rho, Sa Ra Lee, Kyungah Jeong, Hye-Sung Moon
STUDY OBJECTIVES: To report 61 consecutive cases of successful robotic single-site myomectomy (RSSM), and to evaluate the feasibility and safety of RSSM. DESIGN: Retrospective analysis of 61 cases involving RSSM (Canadian Task Force classification III). SETTING: Department of Obstetrics and Gynecology, College of Medicine, Robot Surgery Center, Ewha Womans University, Seoul, Republic of Korea. PATIENTS: Sixty-one patients who underwent RSSM performed by 3 gynecologic surgeons at Ewha Womans University between December 2014 and May 2016...
February 12, 2017: Journal of Minimally Invasive Gynecology
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