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Perioperative management

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https://www.readbyqxmd.com/read/29652895/complications-after-transcatheter-aortic-valve-implantation-using-transfemoral-and-transapical-approach-in-general-anaesthesia
#1
Fabian W├╝rschinger, Sigrid Wittmann, Sophia Goldfu├č, Nina Zech, Kurt Debl, Michael Hilker, Bernhard M Graf, York A Zausig
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat degenerative heart valve disease. The implantation requires a highly specific and interdisciplinary management approach. Currently, TAVI is performed with the patient under local or general anaesthesia. METHODS: This study was a retrospective analysis of all TAVI procedures performed at the University Hospital of Regensburg between January 2009 and July 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29652683/a-case-report-of-recurrent-severe-peripartum-cardiomyopathy-complicated-by-factor-v-leiden-and-multiple-endocrine-neoplasia-type-1-a-management-conundrum
#2
Amanda M Kleiman, Jessica L Sheeran, Mohamed Tiouririne
Cardiovascular disease is the leading cause of peripartum death in the United States during pregnancy. The presence of concomitant diagnoses may complicate or conflict with the management of the primary cardiovascular diagnosis and further complicate pregnancy and delivery. We describe the management of a 29-year-old, gravida 5, para 1 woman with severe peripartum cardiomyopathy during this and a previous pregnancy complicated by multiple endocrine neoplasia type and factor V Leiden thrombophilia, limiting therapeutic options and contributing to considerable perioperative management challenges...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29652291/whole-lung-lavage-in-a-patient-with-pulmonary-alveolar-proteinosis
#3
Lindsay R Hunter Guevara, Shane M Gillespie, Alan M Klompas, Norman E Torres, David W Barbara
Pulmonary alveolar proteinosis (PAP) is a rare syndrome in which phospholipoproteinaceous matter accumulates in the alveoli leading to compromised gas exchange. Whole-lung lavage is considered the gold standard for severe autoimmune PAP and offers favorable long-term outcomes. In this case report, we describe the perioperative management and procedural specifics of a patient undergoing WLL for PAP in which an anesthesiologist serves as the proceduralist and a separate anesthesiologist provides anesthesia care for the patient...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652282/perioperative-management-of-transcatheter-aortic-and-mitral-double-valve-in-valve-implantation-during-pregnancy-through-left-ventricular-apical-approach
#4
Suresh Chengode, Rahul Vijaykumar Shabadi, Ram Narayan Rao, Nasser Alkemyani, Hilal Alsabti
Pregnant women with stenotic degeneration of bioprosthetic cardiac valves may require another valve replacement procedure when their symptoms deteriorate with progression of pregnancy, but fetal mortality is higher with cardiac surgery done on cardiopulmonary bypass. Transcatheter valve-in-valve implantation may help to improve the fetal and maternal outcomes in these situations. Double valve-in-valve implantation is rare and has not been reported in a pregnant patient. We report, for the first time, the case of a pregnant woman with stenotic bioprosthetic valves in the mitral and aortic positions, who underwent a successful concomitant, transcatheter, double valve-in-valve implantation through the left ventricular apical route during the second trimester of her precious pregnancy...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652278/effects-of-glargine-insulin-on-glycemic-control-in-patients-with-diabetes-mellitus-type-ii-undergoing-off-pump-coronary-artery-bypass-graft
#5
Hemang Gandhi, Alpesh Sarvaia, Amber Malhotra, Himanshu Acharya, Komal Shah, Jeevraj Rajavat
Background: The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#6
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652270/pulmonary-hypertension-and-cardiac-anesthesia-anesthesiologist-s-perspective
#7
REVIEW
Manjula Sudeep Sarkar, Pushkar M Desai
Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650354/risk-factors-for-postoperative-delirium-in-patients-undergoing-free-flap-reconstruction-for-oral-cancer
#8
T Makiguchi, S Yokoo, J Kurihara
The aim of this study was to investigate risk factors for postoperative delirium in patients undergoing free flap reconstruction for defects after oral cancer resection. This was a non-randomized, retrospective cohort study involving 102 patients who underwent oral cancer resection and free flap reconstruction. Data were collected from the medical records. Postoperative delirium occurred in 34 patients (33.3%), of whom 27 were male and seven were female. High preoperative total protein and albumin, diabetes mellitus, history of smoking, use of hypnotics or antipsychotics, time until getting out of bed after surgery, and postoperative insomnia were significantly related to delirium in the univariate analysis (P<0...
April 10, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29650138/enhanced-recovery-after-surgery-pathways-role-and-outcomes-in-the-management-of-muscle-invasive-bladder-cancer
#9
REVIEW
Daniel Zainfeld, Ankeet Shah, Siamak Daneshmand
Radical cystectomy remains the gold standard therapy for the treatment of muscle-invasive urothelial carcinoma, yet is accompanied by significant rates of perioperative complications and readmission. Enhanced recovery protocols aim to apply evidence-based principles of care to ameliorate the morbidity of this procedure by enabling better tolerance of and recovery from radical cystectomy. Multiple patient series have demonstrated the capacity for enhanced-recovery-after-surgery (ERAS) principles to improve outcomes among patients undergoing radical cystectomy through decreased incidence of gastrointestinal complications and decreased length of hospitalization without increased readmissions or overall morbidity...
May 2018: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#10
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29644224/pharmacological-management-of-perioperative-bleeding-in-cardiac-surgery
#11
REVIEW
Hossam Walley, Magdi Yacoub, Hesham Saad
No abstract text is available yet for this article.
June 30, 2017: Global Cardiology Science & Practice
https://www.readbyqxmd.com/read/29644051/correction-to-american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-perioperative-fluid-management-within-an-enhanced-recovery-pathway-for-colorectal-surgery
#12
Robert H Thiele, Karthik Raghunathan, C S Brudney, Dileep N Lobo, Daniel Martin, Anthony Senagore, Maxime Cannesson, Tong Joo Gan, Michael Monty G Mythen, Andrew D Shaw, Timothy E Miller
[This corrects the article DOI: 10.1186/s13741-016-0049-9.].
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29643713/modified-conjunctival-flap-as-a-primary-procedure-for-nontraumatic-acute-corneal-perforation
#13
Yi-Chen Sun, Jason P Kam, Tueng T Shen
Objective: Appropriate management of nontraumatic acute corneal perforation is always a challenge even with the many advances in surgical materials and techniques. We reported the outcomes of a case series of acute corneal perforation repair using a newly modified conjunctival flap with amniotic membrane transplant (AMT), fibrin glue, and a bandage soft contact lens (BCL). Materials and Methods: A total of 13 consecutive referral cases with nontraumatic acute corneal perforation at the University of Washington were reviewed...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29643558/perioperative-concerns-and-management-of-pressurised-intraperitoneal-aerosolised-chemotherapy-report-of-two-cases
#14
Sohan Lal Solanki, Pooja P Kumar, Ashwin DeSouza, Avanish P Saklani
Pressurised intraperitoneal aerosolised chemotherapy (PIPAC) is a new, mostly supportive approach to help patients with advanced peritoneal metastasis to increase the lifespan. It carries occupational hazards to health-care workers and especially anaesthesiologist during the procedure. The aerosolised chemotherapy can also cause chemical peritonitis and organ dysfunction in the perioperative period. In this case report, we present the report of two cases and discuss the perioperative concerns and management related to PIPAC...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29643552/anaesthetic-management-and-perioperative-outcomes-of-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy-a-retrospective-analysis
#15
Kalpana P Balakrishnan, Sreedevi Survesan
Background and Aims: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming the standard treatment option for peritoneal carcinomatosis but is associated with high rates of morbidity and mortality. Our aim was to retrospectively analyse and evaluate intra-operative factors associated with morbidity and mortality of CRS and HIPEC. Methods: Intra-operative data were collected for cases done over 1 year (24 cases) and analysed for the primary outcome of post-operative ventilation >24 h, and secondary outcome of length of the Intensive Care Unit (ICU) stay >5 days...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29642961/preoperative-magnetic-resonance-imaging-diagnostic-features-of-uterine-leiomyosarcomas-a-systematic-review
#16
Helen Kaganov, Alex Ades, David Stuart Fraser
OBJECTIVES: There are no current established pathognomonic diagnostic features for uterine leiomyosarcomas in the pre- or perioperative setting. Recent inadvertent upstaging of this rare malignancy during laparoscopic morcellation of a presumed fibroid has prompted widespread debate among clinicians regarding the safety of current surgical techniques for management of fibroids. This study aims to conduct a systematic review investigating significant diagnostic features in magnetic resonance imaging (MRI) of uterine leiomyosarcomas...
April 12, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#17
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29629202/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-perioperative-analgesia-protocols
#18
REVIEW
Federico Piccioni, Matteo Segat, Stefano Falini, Marzia Umari, Olga Putina, Lucio Cavaliere, Riccardo Ragazzi, Domenico Massullo, Marco Taurchini, Carlo Del Naja, Andrea Droghetti
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#19
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29628848/wilm-s-tumor-with-intracardiac-extension-causing-dynamic-tricuspid-valve-obstruction-an-anesthetic-challenge
#20
Kamal Kajal, Ganesh Kumar Munirathinam, Banashree Mandal, Komal Gandhi, Harkant Singh, Ravi Kanojia
Wilms' tumor (WT) is the most common pediatric renal tumor that often spreads to inferior vena cava and sometimes up to right atrium (RA). We describe successful management of 3-year-old child diagnosed with WT having extension up to RA. He was operated under cardiopulmonary bypass and extubated on postoperative day 2 and discharged. Perioperative anesthesia concerns were shock from dynamic tricuspid valve obstruction, intraoperative massive blood loss, and a higher risk of pulmonary thromboembolism during tumor manipulation...
April 2018: Saudi Journal of Anaesthesia
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