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Craniotomy AND mechanical ventilation

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https://www.readbyqxmd.com/read/28761526/a-study-of-partial-pressure-of-arterial-carbon-dioxide-and-end-tidal-carbon-dioxide-correlation-in-intraoperative-and-postoperative-period-in-neurosurgical-patients
#1
Pallavi Gaur, Minal Harde, Pinakin Gujjar, Devanand Deosarkar, Rakesh Bhadade
BACKGROUND AND AIM: Monitoring carbon dioxide (CO2) is of utmost importance in neurosurgical patients. It is measured by partial pressure of arterial CO2 (PaCO2) and end-tidal CO2 (ETCO2). We aimed to study the correlation between PaCO2 and ETCO2 in neurosurgical patients in the intraoperative and postoperative period on mechanical ventilation in Postanesthesia Care Unit (PACU). METHODOLOGY: This was prospective observational study done at tertiary care teaching public hospital over a period of 1 year...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28757912/lung-protective-ventilation-strategies-for-relief-from-ventilator-associated-lung-injury-in-patients-undergoing-craniotomy-a-bicenter-randomized-parallel-and-controlled-trial
#2
Chaoliang Tang, Juan Li, Shaoqing Lei, Bo Zhao, Zhetao Zhang, Wenting Huang, Si Shi, Xiaoqing Chai, Chaoshi Niu, Zhongyuan Xia
Current evidence indicates that conventional mechanical ventilation often leads to lung inflammatory response and oxidative stress, while lung-protective ventilation (LPV) minimizes the risk of ventilator-associated lung injury (VALI). This study evaluated the effects of LPV on relief of pulmonary injury, inflammatory response, and oxidative stress among patients undergoing craniotomy. Sixty patients undergoing craniotomy received either conventional mechanical (12 mL/kg tidal volume [VT] and 0 cm H2O positive end-expiratory pressure [PEEP]; CV group) or protective lung (6 mL/kg VT and 10 cm H2O PEEP; PV group) ventilation...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28338505/effects-of-hypertonic-saline-and-sodium-lactate-on-cortical-cerebral-microcirculation-and-brain-tissue-oxygenation
#3
Vlasta Dostalova, Jitka Schreiberova, Vlasta Dostalova, Jiri Paral, Jaroslav Kraus, Alena Ticha, Vera Radochova, Pavel Dostal
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model. METHODS: Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#4
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
May 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27857912/biomarkers-of-physiological-disturbances-for-predicting-mortality-in-decompressive-craniectomy
#5
Young Ha Jeong, So Hyun Kim, Eun Hee Choi, Kum Whang
OBJECTIVE: Of many critical care regimens, the management of physiological disturbances in serum is particularly drawing an attention in conjunction with patient outcome. The aim of this study was to assess the association of serum biochemical markers with mortality in head trauma patients with decompressive craniotomy. METHODS: Ninety six patients with acute subdural hematoma underwent decompressive craniectomy between January 2014 and December 2015. The clinical data and laboratory variables of these patients were recorded and analyzed retrospectively...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27466863/evaluation-of-the-efficacy-and-safety-of-short-course-deep-sedation-therapy-for-the-treatment-of-intracerebral-hemorrhage-after-surgery-a-non-randomized-control-study
#6
Dapeng Hou, Beibei Liu, Juan Zhang, Qiushi Wang, Wei Zheng
BACKGROUND While mild and moderate sedation have been widely used to reduce sudden agitation in intracerebral hemorrhage (ICH) patients after surgery, agitation is still a frequent problem, which may cause postoperative blood pressure fluctuation. The present study aimed to evaluate the efficacy and safety of short-course deep sedation for the treatment of ICH after surgery. MATERIAL AND METHODS A total of 41 ICH patients who received surgery, including traditional craniotomy hematoma removal and decompressive craniectomy, were including in this non-randomized control study...
July 28, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27399391/111%C3%A2-predictors-of-complications-after-clipping-of-unruptured-intracranial-aneurysms-a-national-surgical-quality-improvement-program-analysis
#7
Hormuzdiyar H Dasenbrock, Robert F Rudy, William B Gormley, Timothy R Smith, Kai U Frerichs, Mohammad Ali Aziz-Sultan, Rose Du
INTRODUCTION: While obliteration of unruptured aneurysms reduces the risk of subarachnoid hemorrhage, perioperative complications impact the risk-benefit ratio of aneurysm repair, and additional data are needed to optimally risk-stratify patients preoperatively. METHODS: Patients who underwent craniotomy for microsurgical clipping of an unruptured aneurysm were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry (2007-2014)...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27188111/-difficult-ventilation-requiring-emergency-endotracheal-intubation-during-awake-craniotomy-managed-by-laryngeal-mask-airway
#8
Asako Matsuda, Toshiyuki Mizota, Tomoharu Tanaka, Hajime Segawa, Kazuhiko Fukuda
We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased...
April 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27001425/effect-of-propofol-and-sevoflurane-on-the-inflammatory-response-of-patients-undergoing-craniotomy
#9
RANDOMIZED CONTROLLED TRIAL
Jasmina Markovic-Bozic, Blaz Karpe, Iztok Potocnik, Ales Jerin, Andrej Vranic, Vesna Novak-Jankovic
BACKGROUND: The purpose of this randomised, single-centre study was to prospectively investigate the impact of anaesthetic techniques for craniotomy on the release of cytokines IL-6, IL-8, IL-10, and to determine whether intravenous anaesthesia compared to inhalational anaesthesia attenuates the inflammatory response. METHODS: The study enroled 40 patients undergoing craniotomy, allocated into two equal groups to receive either sevoflurane (n = 20) or propofol (n = 20) in conjunction with remifentanil and rocuronium...
March 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/26426239/complications-of-neurosurgery
#10
REVIEW
Jennifer E Fugate
PURPOSE OF REVIEW: This article provides an overview of the major neurologic complications of common neurosurgical and endovascular procedures. RECENT FINDINGS: Brain edema, seizures, postoperative hemorrhage, and cerebral ischemia can complicate neurosurgical procedures and produce neurologic decline. The high variability of reporting, types of operations, patient characteristics, and acuity of cases make estimating the incidence and severity of complications difficult...
October 2015: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/26131257/negative-pressure-pulmonary-edema-after-craniotomy-through-the-endonasal-transsphenoidal-approach
#11
Mengchan Ou, Zhen Luo, Juan Liu, Yaoxin Yang, Yu Li
We describe a case of negative pressure pulmonary edema that occurred in the post-anesthesia care unit in a patient who had undergone transsphenoidal resection of a pituitary adenoma. Negative pressure pulmonary edema is an uncommon complication of general anesthesia. In this case, the patient's nasal cavity had been filled with surgical packs and she had not become accustomed to breathing through her mouth, in addition to her large tongue and small oropharyngeal cavity, residual effect of anesthetic may resulting in tongue falling which caused airway obstruction...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26055873/effects-of-hypertonic-saline-and-mannitol-on-cortical-cerebral-microcirculation-in-a-rabbit-craniotomy-model
#12
COMPARATIVE STUDY
Pavel Dostal, Jitka Schreiberova, Vlasta Dostalova, Vlasta Dostalova, Tomas Tyll, Jiri Paral, Islam Abdo, Miroslav Cihlo, David Astapenko, Zdenek Turek
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of mannitol and hypertonic saline (HTS) on cerebral cortical microcirculation in a rabbit craniotomy model. METHODS: Rabbits (weight, 2.0-3.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3...
2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/25397366/surgery-for-primary-supratentorial-brain-tumors-in-the-united-states-2000-2009-effect-of-provider-and-hospital-caseload-on-complication-rates
#13
Victoria T Trinh, Jason M Davies, Mitchel S Berger
OBJECT: The object of this study was to examine how procedural volume and patient demographics impact complication rates and value of care in those who underwent biopsy or craniotomy for supratentorial primary brain tumors. METHODS: The authors conducted a retrospective cohort study using data from the Nationwide Inpatient Sample (NIS) on 62,514 admissions for biopsy or resection of supratentorial primary brain tumors for the period from 2000 to 2009. The main outcome measures were in-hospital mortality, routine discharge proportion, length of hospital stay, and perioperative complications...
February 2015: Journal of Neurosurgery
https://www.readbyqxmd.com/read/25288505/perioperative-anesthetic-implications-of-epilepsy-surgery-a-retrospective-analysis
#14
Ashish Bindra, Rajendra S Chouhan, Hemanshu Prabhakar, P Sarat Chandra, Manjari Tripathi
PURPOSE: Drug-resistant epilepsy (DRE) occurs in about 30 % of individuals with epilepsy. For seizure control, a wide range of surgical procedures are performed, depending on the underlying pathology. To address the anesthetic and perioperative concerns in these patients, we analyzed the data of persons with DRE who underwent epilepsy surgery at our institute. METHODS: A retrospective analysis of patients who underwent epilepsy surgery from 2005-2010 was performed...
April 2015: Journal of Anesthesia
https://www.readbyqxmd.com/read/25051263/red-blood-cell-transfusion-in-neurosurgical-patients
#15
REVIEW
Shaun E Gruenbaum, Keith J Ruskin
PURPOSE OF REVIEW: Anemia is common in neurosurgical patients, and is associated with secondary brain injury. Although recent studies in critically ill patients have shifted practice toward more restrictive red blood cell (RBC) transfusion strategies, the evidence for restrictive versus liberal transfusion strategies in neurosurgical patients has been controversial. In this article, we review recent studies that highlight issues in RBC transfusion in neurosurgical patients. RECENT FINDINGS: Recent observational, retrospective studies in patients with traumatic brain injury, subarachnoid hemorrhage, and intracranial hemorrhage have demonstrated that prolonged anemia and RBC transfusions were associated with worsened outcomes...
October 2014: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/23933960/infratentorial-neurosurgery-is-an-independent-risk-factor-for-respiratory-failure-and-death-in-patients-undergoing-intracranial-tumor-resection
#16
Alana M Flexman, Bradley Merriman, Donald E Griesdale, Kelly Mayson, Peter T Choi, Christopher J Ryerson
BACKGROUND: Respiratory failure and death are devastating outcomes in the postoperative period. Patients undergoing neurosurgical procedures experience a greater frequency of respiratory failure compared with other surgical specialties. Resection of infratentorial mass lesions may be associated with an even higher risk because of several unique factors. Our objectives were: (1) to determine the incidence of postoperative respiratory failure and death in the neurosurgical population; and (2) to determine whether infratentorial procedures are associated with a higher risk compared with supratentorial procedures...
July 2014: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/23168208/-early-treatment-of-atelectasis-by-bronchoscopy-in-craniotomy-patients
#17
Yan-ping Qiu, Yong-ju Chen, Rong-rong Song, Gang Wang, Jian-jun Guan, Hao-liang Ni, Yong Ji
OBJECTIVE: To investigate the safety and effects of early bronchoscopy on atelectasis of the ventilation patients, whom had experienced craniotomy for severe cranial trauma and hemorrhage. METHODS: Fifty-five patients suffered from severe cranial trauma and hemorrhage with Glascow coma scores (GCS) less than 8 complicated by atelectasis after craniotomy were early given sputum suction by bronchoscope via extratracheal intubation and broncho-alveolar lavage (BAL) during tracheal intubation and mechanical ventilation...
December 2012: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
https://www.readbyqxmd.com/read/23103776/transmission-of-arterial-oxygen-partial-pressure-oscillations-to-the-cerebral-microcirculation-in-a-porcine-model-of-acute-lung-injury-caused-by-cyclic-recruitment-and-derecruitment
#18
K U Klein, S Boehme, E K Hartmann, M Szczyrba, L Heylen, T Liu, M David, C Werner, K Markstaller, K Engelhard
BACKGROUND: Cyclic recruitment and derecruitment (R/D) play a key role in the pathomechanism of acute lung injury (ALI) leading to respiration-dependent oscillations of arterial partial pressure of oxygen (Pa(O(2))). These Pa(O(2)) oscillations could also be forwarded to the cerebral microcirculation. METHODS: In 12 pigs, partial pressure of oxygen was measured in the thoracic aorta (Pa(O(2))) and subcortical cerebral tissue (Pbr(O(2))). Cerebral cortical haemoglobin oxygen saturation (Sbr(O(2))), cerebral blood flow (CBF), and peripheral haemoglobin saturation (Sp(O(2))) were assessed by spectroscopy and laser Doppler flowmetry...
February 2013: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/23099846/factors-associated-with-the-withdrawal-of-life-sustaining-therapies-in-patients-with-severe-traumatic-brain-injury-a-multicenter-cohort-study
#19
MULTICENTER STUDY
Nicolas Côte, Alexis F Turgeon, François Lauzier, Lynne Moore, Damon C Scales, Francis Bernard, Ryan Zarychanski, Karen E A Burns, Maureen O Meade, David Zygun, Jean-François Simard, Amélie Boutin, Jacques G Brochu, Dean A Fergusson
PURPOSE: To identify factors associated with decisions to withdraw life-sustaining therapies in patients with severe traumatic brain injury (TBI). MATERIALS AND METHODS: We conducted a 2-year multicenter retrospective cohort study (2005-2006) in mechanically ventilated patients aged 16 years and older admitted to the intensive care units (ICUs) of six Canadian level I trauma centers following severe TBI. One hundred and twenty charts were randomly selected at each center (n = 720)...
February 2013: Neurocritical Care
https://www.readbyqxmd.com/read/22462506/cranial-decompression-for-the-treatment-of-malignant-intracranial-hypertension-after-ischemic-cerebral-infarction-decompressive-craniectomy-and-hinge-craniotomy
#20
COMPARATIVE STUDY
Tyler J Kenning, M Reid Gooch, Ravi H Gandhi, M Parvez Shaikh, Alan S Boulos, John W German
OBJECT: Recent randomized trials have demonstrated a positive role (improved survival) in patients treated with cranial decompression for malignant cerebral infarction. However, many variables regarding operative decompression in this setting remain to be determined. Hinge craniotomy is an alternative to decompressive craniectomy, but its role in space-occupying cerebral infarctions has not been delineated. The objective of this study was to compare the authors' experiences with these 2 procedures in the management of space-occupying cerebral infarctions to determine the efficacy of each...
June 2012: Journal of Neurosurgery
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