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Perioperative blood management

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https://www.readbyqxmd.com/read/28092401/randomized-clinical-trial-of-preoperative-oral-versus-intravenous-iron-in-anaemic-patients-with-colorectal-cancer
#1
B D Keeler, J A Simpson, O Ng, H Padmanabhan, M J Brookes, A G Acheson
BACKGROUND: Treatment of preoperative anaemia is recommended as part of patient blood management, aiming to minimize perioperative allogeneic red blood cell transfusion. No clear evidence exists outlining which treatment modality should be used in patients with colorectal cancer. The study aimed to compare the efficacy of preoperative intravenous and oral iron in reducing blood transfusion use in anaemic patients undergoing elective colorectal cancer surgery. METHODS: Anaemic patients with non-metastatic colorectal adenocarcinoma were recruited at least 2 weeks before surgery and randomized to receive oral (ferrous sulphate) or intravenous (ferric carboxymaltose) iron...
January 16, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28091794/the-impact-of-liver-disorders-on-perioperative-management-of-reoperative-cardiac-surgery-a-retrospective-study-in-adult-congenital-heart-disease-patients
#2
Koko Adachi, Hiroaki Toyama, Yu Kaiho, Osamu Adachi, Hiroto Hudeta, Masanori Yamauchi
PURPOSE: We evaluated the preoperative prevalence of risk factors for liver disorders and the relationship between the liver disorders and perioperative outcomes in adult congenital heart disease (ACHD) patients. METHODS: This retrospective study included 32 ACHD patients who underwent reoperative cardiac surgery. RESULTS: Preoperatively, 38% of the study patients had risk factors, including congestive liver (CL) due to right heart failure (31%), chronic hepatitis C (HC) (22%), and both CL and HC (16%)...
January 16, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28086855/postoperative-fluid-overload-is-a-risk-factor-for-adverse-surgical-outcome-in-patients-undergoing-esophagectomy-for-esophageal-cancer-a-retrospective-study-in-335-patients
#3
Torben Glatz, Birte Kulemann, Goran Marjanovic, Svenja Bregenzer, Frank Makowiec, Jens Hoeppner
BACKGROUND: Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome. METHODS: We retrospectively examined 335 patients who had undergone esophagectomy for esophageal cancer at the University Hospital Freiburg between 1996 and 2014 to investigate the relation between intra- and postoperative fluid management and postoperative morbidity after esophagectomy...
January 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#4
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#5
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28032156/complex-truncal-masses-in-the-setting-of-cloves-syndrome-aesthetic-and-functional-implications
#6
Jason M Weissler, Valeriy Shubinets, Martin J Carney, David W Low
BACKGROUND: Congenital lipomatous overgrowth, vascular malformations, epidermal nevi, and skeletal abnormalities (CLOVES) is a complex overgrowth syndrome with dramatic aesthetic and functional implications. The truncal masses characteristic of CLOVES syndrome are described as vascular malformations or lipomatous lesions with variable vascular components. Herein, we describe our single-institution experience with surgical excision of CLOVES-related truncal masses and discuss future directions in treatment of these complex anomalies...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#7
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27999689/bradycardia-associated-with-steroid-use-for-laryngeal-edema-in-an-adult-a-case-report-and-literature-review
#8
Preeti R John, Ariana Khaladj-Ghom, Kimberly L Still
Steroids are used for specific indications in the perioperative period to reduce laryngeal or spinal cord edema, or for prophylaxis and treatment of postoperative nausea and vomiting. Given the other potential causes for hemodynamic alterations in the perioperative setting, it is important for physicians to be aware of cardiovascular side effects of short term steroids. Changes in blood pressure and heart rate, cardiac dysrhythmias, and even death have been described in patients receiving short term intravenous steroids...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#9
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27987219/relative-efficacy-of-tranexamic-acid-and-preoperative-anemia-treatment-for-reducing-transfusions-in-total-joint-arthroplasty
#10
Joseph F Styron, Alison K Klika, Caleb R Szubski, Deborah Tolich, Wael K Barsoum, Carlos A Higuera
BACKGROUND: This study aimed to evaluate the efficacy of a perioperative blood management (PBM) protocol at a large, tertiary hospital at reducing blood transfusions after total hip or knee arthroplasty (THA or TKA). STUDY DESIGN AND METHODS: A retrospective review of the PBM for patients undergoing THA or TKA was performed. Adjusted multiple logistic and Poisson regression models examined the effect of patient characteristics and preoperative, intraoperative, and postoperative factors on the likelihood of transfusion and units transfused...
December 17, 2016: Transfusion
https://www.readbyqxmd.com/read/27984342/strategies-to-prevent-periprosthetic-joint-infection-after-total-knee-arthroplasty-and-lessen-the-risk-of-readmission-for-the-patient
#11
Richard Iorio, Feroz A Osmani
There is yet to be a standardized total knee arthroplasty (TKA) surgical protocol that has been studied to a sufficient degree to offer evidence-based practices regarding infection and readmission prevention. Although high-level evidence is often sought to provide guidance concerning protocol- and process-level decisions, the literature is often confusing and nondefinitive in its conclusions and recommendations regarding periprosthetic joint infection and readmission prevention. Areas of study that require further investigation include the following: the role of patient optimization and preoperative mitigation of risk; perioperative antibiotics; operating room environment; blood management; operative techniques, implants, and infection prevention measures; wound care management; and post acute care...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27981865/healthcare-resource-utilization-in-patients-receiving-idarucizumab-for-reversal-of-dabigatran-anticoagulation-due-to-major-bleeding-urgent-surgery-or-procedural-interventions-interim-results-from-the-re-verse-ad-%C3%A2-study
#12
Charles V Pollack, Richard Bernstein, Robert Dubiel, Paul Reilly, Fredrik Gruenenfelder, Menno V Huisman, Chak-Wah Kam, Eva Kleine, Jerrold H Levy, Frank W Sellke, Thorsten Steiner, Anastasia Ustyugova, Jeffrey I Weitz
AIMS: Patients treated with anticoagulants may experience serious bleeding or require urgent surgery or intervention, and may benefit from rapid anticoagulant reversal. This exploratory analysis assessed healthcare resource utilization (HCRU) in patients treated with idarucizumab, a specific reversal agent for dabigatran etexilate. MATERIALS AND METHODS: RE-VERSE AD(™) (NCT02104947), a prospective, multicenter open-label study is evaluating idarucizumab for dabigatran reversal in patients with serious bleeding (Group A) or undergoing emergency surgery/procedures (Group B)...
December 16, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27977460/perioperative-outcomes-and-management-in-pediatric-complex-cranial-vault-reconstruction-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#13
Paul A Stricker, Susan M Goobie, Franklyn P Cladis, Charles M Haberkern, Petra M Meier, Srijaya K Reddy, Thanh T Nguyen, Lingyu Cai, Marcia Polansky, Peter Szmuk, John Fiadjoe, Codruta Soneru, Ricardo Falcon, Timothy Petersen, Courtney Kowalczyk-Derderian, Nicholas Dalesio, Stefan Budac, Neels Groenewald, Daniel Rubens, Douglas Thompson, Rheana Watts, Katherine Gentry, Iskra Ivanova, Mali Hetmaniuk, Vincent Hsieh, Michael Collins, Karen Wong, Wendy Binstock, Russell Reid, Kim Poteet-Schwartz, Heike Gries, Rebecca Hall, Jeffrey Koh, Carolyn Bannister, Wai Sung, Ranu Jain, Allison Fernandez, Gerald F Tuite, Ernesto Ruas, Oleg Drozhinin, Lisa Tetreault, Bridget Muldowney, Karene Ricketts, Patrick Fernandez, Lisa Sohn, John Hajduk, Brad Taicher, Jessica Burkhart, Allison Wright, Jane Kugler, Lea Barajas-DeLoa, Meera Gangadharan, Veronica Busso, Kayla Stallworth, Susan Staudt, Kristen L Labovsky, Chris D Glover, Henry Huang, Helena Karlberg-Hippard, Samantha Capehart, Cynthia Streckfus, Kim-Phuong T Nguyen, Peter Manyang, Jose Luis Martinez, Jennifer K Hansen, Heather Mitzel Levy, Alyssa Brzenski, Franklin Chiao, Pablo Ingelmo, Razaz Mujallid, Olutoyin A Olutoye, Tariq Syed, Hubert Benzon, Adrian Bosenberg
BACKGROUND: The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27975056/is-laparoendoscopic-single-site-adrenalectomy-a-feasible-alternative-in-treating-aldosterone-producing-adenoma
#14
Che-Hsiung Wu, Leay-Kiaw Er, Ya-Hui Hu, Chia Da Lin, Shih-Chieh Chueh, Yao-Chou Tsai
Objective. To compare laparoendoscopic single-site (LESS) and conventional multiport adrenalectomy in patients with aldosterone-producing adenoma (APA). Material and Methods. We retrospectively reviewed patients who had been clinically confirmed with unilateral APA and who underwent LESS or multiport adrenalectomy between 2009 and 2014. Perioperative data were obtained for all patients. Blood pressure and the levels of serum aldosterone, renin, and potassium were checked periodically. Results. We identified 45 APA patients in the LESS group and 71 in the multiport group...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27973934/patients-with-type-2-diabetes-anesthetic-management-in-the-ambulatory-setting-part-1-pathophysiology-and-associated-disease-states
#15
Bryant W Cornelius
The increasing prevalence of diabetes mellitus in the general population has many implications for the ambulatory anesthesia provider. Complications, particularly associated with poor glycemic control, can affect multiple organ systems and jeopardize the safety of any planned anesthetic. It is essential that anesthesiologists and sedation providers have in-depth knowledge of the pathophysiology of diabetes mellitus and the comorbid conditions that commonly accompany it. Anesthesiologists and sedation providers must also understand certain surgical and anesthetic considerations when planning an effective and safe anesthetic for diabetic patients...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27958191/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#16
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27955873/long-term-outcome-of-robotic-partial-nephrectomy-for-renal-angiomyolipoma
#17
Chia-Yen Lin, Cheng-Kuang Yang, Yen-Chuan Ou, Kun-Yuan Chiu, Chen-Li Cheng, Hao-Chung Ho, Shian-Shiang Wang, Chuan-Shu Chen, Jian-Ri Li
BACKGROUND/OBJECTIVE: To present the long-term result and efficacy of robotic partial nephrectomy (RPN) for renal angiomyolipomas (AMLs) with perioperative outcome and renal function preservation. METHODS: From September 2006 to October 2014, the database of a single medical center was reviewed and patients who underwent RPN for AMLs were enrolled. The patient demographics, perioperative complications, and postoperative outcomes were analyzed. RESULTS: We identified 23 patients who were treated with RPN for renal AMLs...
December 7, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27940453/perioperative-management-of-the-bleeding-patient
#18
K Ghadimi, J H Levy, I J Welsby
Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, the nature of the operation itself, or acquired coagulation abnormalities secondary to haemorrhage, haemodilution, or haemostatic factor consumption. In the bleeding patient, standard therapeutic approaches include allogeneic blood product administration, concomitant pharmacologic agents, and increasing application of purified and recombinant haemostatic factors...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27939898/portomesenteric-vein-thrombosis-after-excision-of-parasitic-peritoneal-myomas
#19
Akihiro Takeda, Shotaro Hayashi, Yoshie Teranishi, Sanae Imoto, Hiromi Nakamura
The enlargement of multiple asymptomatic pelvic masses was detected during a regular check-up of a 39-year-old woman. Twelve years previously, she had undergone laparoscopic-assisted myomectomy, at which time the uncontained manual extraction of a posterior intramural myoma had been performed. This was followed by two uneventful cesarean deliveries, which were performed after spontaneous conception. Diagnostic imaging revealed at least three abdominal masses, one of which received its major blood supply from the inferior mesenteric artery...
December 7, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27935782/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#20
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
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