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Perioperative blood management

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https://www.readbyqxmd.com/read/29350594/determinants-of-perioperative-transfusion-risk-in-patients-with-adult-spinal-deformity
#1
Varun Puvanesarajah, Sandesh S Rao, Hamid Hassanzadeh, Khaled M Kebaish
OBJECTIVE To determine predictors of perioperative allogeneic packed red blood cell (pRBC) transfusion requirement (total units transfused) in patients with adult spinal deformity (ASD). METHODS The authors retrospectively analyzed records of patients aged 18 years or older who underwent surgical correction of ASD that involved 4 or more spinal levels by the same spine surgeon between 2010 and 2016. Data regarding patient characteristics, comorbidities, surgical factors, and perioperative transfusions (up to 10 days after surgery) were analyzed using a linear regression model...
January 19, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#2
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29337842/perioperative-coagulation-management-in-liver-transplant-recipients
#3
Dmitri Bezinover, Daniel Dirkmann, James Findlay, Cosmin Guta, Matthias Hartmann, Ramona Nicolau-Raducu, Ahmed M Mukhtar, Marina Moguilevitch, Evan Pivalizza, David Rosenfeld, Fuat Saner, Christopher Wray, Gebhardt Wagener, James West
We review contemporary coagulation management for patients undergoing liver transplantation. A better understanding of the complex physiologic changes that occur in patients with end-stage liver disease has resulted in significant advances in anesthetic and coagulation management. A group of internationally recognized experts have critically evaluated current approaches for coagulopathy detection and management. Strategies for blood component and factor replacement have been evaluated and recommended therapies proposed...
January 15, 2018: Transplantation
https://www.readbyqxmd.com/read/29332100/robot-assisted-radical-prostatectomy-is-more-beneficial-for-prostate-cancer-patients-a-system-review-and-meta-analysis
#4
Yuefeng Du, Qingzhi Long, Bin Guan, Lijun Mu, Juanhua Tian, Yumei Jiang, Xiaojing Bai, Dapeng Wu
BACKGROUND Robot-assisted radical prostatectomy (RARP) is increasingly used worldwide, but comparisons of perioperative, functional, and oncologic outcomes among RARP, laparoscopic radical prostatectomy (LRP), and open radical prostatectomy (ORP) remain inconsistent. MATERIAL AND METHODS Systematic literature searches were conducted using EMBASE, PubMed, the Cochrane Library, CNKI, and Science Direct/Elsevier up to April 2017. A meta-analysis was conducted using Review Manager and Stata software. RESULTS We included 33 studies...
January 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#5
Muhammad Saad Yousuf, Mohsin Nazir Butt, Fauzia Anis Khan
Nesidioblastosis is the most common cause of non-transient, recurrent and persistent hypoglycaemia in neonates and infants. It is a disorder of diffuse proliferation of beta cells of the pancreas leading to hyperinsulinemia and hypoglycaemia. The main aim is to prevent the severe episodes of hypoglycaemia which can cause damage to the brain and/or mental retardation. In this case report we present two cases of nesidioblastosis and their perioperative anaesthetic course for near-total pancreatectomy. First case was a 7 months old female who had repeated episodes of convulsions since birth...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29328753/a-critical-analysis-of-the-perioperative-management-of-patients-with-ehlers-danlos-type-iv-vascular-syndrome
#6
Justyna Martin
This article discusses the perioperative care needs of patients with Ehlers Danlos type IV (vascular) syndrome. Ehlers Danlos syndrome (EDS) is a heritable group of connective tissue disorders characterised by varying degrees of tissue, blood vessel and internal organ fragility as well as skin and joint hypermobility (De Paepe and Malfait 2012).
September 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29322515/current-practices-in-perioperative-blood-management-for-patients-undergoing-liver-resection-a-survey-of-surgeons-and-anesthesiologists
#7
Sean Bennett, Abdul Ayoub, Alexandre Tran, Shane English, Alan Tinmouth, Daniel I McIsaac, Dean Fergusson, Guillaume Martel
BACKGROUND: Development of intraoperative techniques and blood management strategies in liver resection, and the multidisciplinary nature of perioperative transfusion decision making, creates an opportunity for practice variation. The aim of this study was to describe the current practices in perioperative blood management and explore differences between surgeons and anesthesiologists. STUDY DESIGN AND METHODS: A Web-based survey was developed, piloted, and circulated to Canadian liver surgeons and anesthesiologists...
January 10, 2018: Transfusion
https://www.readbyqxmd.com/read/29317965/perioperative-anesthetic-management-of-a-case-of-rare-ectopic-pheochromocytoma
#8
Aihua Jiang, Haiqiao Zhang, Xiaofei Liu, Huishan Zhao
We report an unusual case of pheochromacytoma and investigate the perioperative anesthetic management methods for giant abdominal aortic pheochromocytoma. We analyzed and summarized the recent clinical anesthetic management and experience in the hospital for a giant abdominal aortic pheochromocytoma, with the size of 20 × 14 × 5 cm. Under general anesthesia combined with TAPB, the resection of the giant abdominal aorta pheochromocytoma was successfully completed, and the patient was cured and discharged. Well planned and careful management resulted in patient with stable blood pressure, blood volume and cardiac functions, free from complications...
December 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29316890/risk-factors-of-postoperative-pulmonary-complications-in-patients-with-asthma-and-copd
#9
Takanori Numata, Katsutoshi Nakayama, Satoko Fujii, Yoko Yumino, Nayuta Saito, Masahiro Yoshida, Yusuke Kurita, Kenji Kobayashi, Saburo Ito, Hirofumi Utsumi, Haruhiko Yanagisawa, Mitsuo Hashimoto, Hiroshi Wakui, Shunsuke Minagawa, Takeo Ishikawa, Hiromichi Hara, Jun Araya, Yumi Kaneko, Kazuyoshi Kuwano
BACKGROUND: Postoperative pulmonary complications (PPC) in patients with pulmonary diseases remain to be resolved clinical issue. However, most evidence regarding PPC has been established more than 10 years ago. Therefore, it is necessary to evaluate perioperative management using new inhalant drugs in patients with obstructive pulmonary diseases. METHODS: April 2014 through March 2015, 346 adult patients with pulmonary diseases (257 asthma, 89 chronic obstructive pulmonary disease (COPD)) underwent non-pulmonary surgery except cataract surgery in our university hospital...
January 9, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29310400/clinical-analysis-of-hyperkalemia-after-esophagectomy-a-case-report
#10
Qiang Chen, Wei-Guo Zhang, Shu-Chang Chen
RATIONALE: The occurrence of hyperkalemia after esophagectomy is clinically rare. Patients who underwent esophagectomy often have a serum potassium level due to perioperative reduced intake, fluids loss, consumption and other reasons. These patients often require the artificial administration of potassium. Rapid fluid loss and physiological consumption lead to the deficiency of potassium, even hypokalemia. Patients often require the addition of a large amount of potassium after operation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#11
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#12
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29300713/the-important-role-for-intravenous-iron-in-perioperative-patient-blood-management-in-major-abdominal-surgery-a-randomized-controlled-trial
#13
Bernd Froessler, Peter Palm, Ingo Weber, Nicolette A Hodyl, Rajvinder Singh, Elizabeth M Murphy
No abstract text is available yet for this article.
February 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#14
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284885/anesthetic-management-for-prolonged-incidental-surgery-in-advanced-liver-disease
#15
Riddhi Kundu, Rajeshwari Subramaniam, Arijit Sardar
In spite of advances in perioperative management, operative procedures in patients with chronic liver disease pose a significant challenge for the anesthesiologist due to multisystem involvement, high risk of postoperative hepatic decompensation, and mortality. We describe the anesthetic management of an elderly patient with advanced liver disease (model for end-stage liver disease 16) for prolonged abdominal surgery. The use of invasive hemodynamic monitoring, point-of-care biochemical, and hematological surveillance coupled with prompt correction of all abnormalities was responsible for good outcome...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29283917/anesthetic-management-and-procedural-outcomes-of-patients-undergoing-off-pump-transapical-implantation-of-artificial-chordae-to-correct-mitral-regurgitation-case-series-of-76-patients
#16
Robertas Stasys Samalavicius, Ieva Norkiene, Agne Drasutiene, Arturas Lipnevicius, Vilius Janusauskas, Karolis Urbonas, Diana Zakarkaite, Audrius Aidietis, Kestutis Rucinskas
BACKGROUND: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure. METHODS: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29275965/restrictive-versus-liberal-transfusion-strategies-in-perioperative-blood-management-an-evidence-based-analysis
#17
REVIEW
Archer Kilbourne Martin, J Ross Renew, Harish Ramakrishna
No abstract text is available yet for this article.
December 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29274600/evidence-of-intimal-tear-in-type-a-intramural-hematoma-of-the-aorta-a-case-series
#18
Gianfranco Filippone, Giovanni Caruana, Claudia Calia, Violetta Moscaritolo, Vincenzo Argano
INTRODUCTION: Aortic intramural hematoma (IMH) is described as "dissection without intimal tear" due to rupture of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in patients with IMH and to suggest that this entity may represent a part of a disease and not a separate disease. PRESENTATION OF CASES: We report two patients admitted to our institution with sudden onset thoracic pain...
December 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29273350/the-association-of-age-with-perioperative-morbidity-and-mortality-among-men-undergoing-radical-prostatectomy
#19
Jorge F Pereira, Dragan Golijanin, Gyan Pareek, Ruiting Guo, Zheng Zhang, Joseph Renzulli, Boris Gershman M D
INTRODUCTION: Older age is considered a relative contraindication to radical prostatectomy (RP). However, data are limited regarding the impact of age on perioperative outcomes following RP. We examined the association of age with perioperative outcomes following RP to inform risk-stratification and management. MATERIALS AND METHODS: We identified 35,968 men aged 18 to 89 years who underwent RP from 2010 to 2015 in the National Surgical Quality Improvement Program (NSQIP) database...
December 19, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29262474/-clinical-application-of-electrical-velocimetry-in-monitoring-pediatric-blood-volume-after-cardiopulmonary-bypass
#20
J R Xue, B Li
Objective: To investigate the clinical applicability of electrical velocimetry (EV) in monitoring pediatric blood volume after cardiopulmonary bypass. Method: Between July 2016 and November 2016, 60 children with congenital heart disease were divided into EV group and traditional central venous pressure (CVP) group randomly. For EV group, the volume of fluid and vascular active medicine was adjusted according to the monitoring stroke volume variation (SVV) hemodynamic parameters. Whereas for CVP group empirical volume of fluid infusion was managed by the monitoring traditional hemodynamic parameters such as CVP, blood pressure, heart rate, urine volume and blood gas analysis...
December 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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