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https://www.readbyqxmd.com/read/29161751/the-jellyfish-sign-a-new-sonographic-cervical-marker-to%C3%A2-predict-maternal-morbidity-in-abnormally-invasive-placenta-previa
#1
Emma Bertucci, Filomena Giulia Sileo, Giovanni Grandi, Valentina Fenu, Carlotta Cani, Luciano Mancini, Ema Mataca, Fabio Facchinetti
Purpose To investigate the value of a new cervical sonographic sign, called the jellyfish sign (JS), for predicting the risk of maternal morbidity in cases of abnormally invasive placenta (AIP) previa totalis. Materials and Methods Retrospective evaluation of transvaginal (TV) and transabdominal (TA) scans performed in all singleton pregnancies with placenta previa totalis. JS, i. e. the absence of the normal linear demarcation between the placenta previa and the cervix, was evaluated by TV scans. The presence/severity of AIP and outcomes of maternal morbidity were related to this sign...
November 21, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29158075/intermediate-care-unit-after-cardiac-surgery-impact-on-length-of-stay-and-outcomes
#2
Carlos Labata, Teresa Oliveras, Elisabet Berastegui, Xavier Ruyra, Bernat Romero, Maria-Luisa Camara, Maria-Soledad Just, Jordi Serra, Ferran Rueda, Marc Ferrer, Cosme García-García, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Current postoperative management of adult cardiac surgery often comprises transfer from the intensive care unit (ICU) to a conventional ward. Intermediate care units (IMCU) permit hospital resource optimization. We analyzed the impact of an IMCU on length of stay (both ICU and in-hospital) and outcomes (in-hospital mortality and 30-day readmissions) after adult cardiac surgery (IMCU-CS). METHODS: From November 2012 to April 2015, 1324 consecutive patients were admitted to a university hospital for cardiac surgery...
November 17, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29158058/regional-cerebral-oxygen-saturation-level-predicts-30-day-mortality-rate-after-left-ventricular-assist-device-surgery
#3
Soutik Ghosal, Jaimin Trivedi, James Chen, Michael P Rogers, Allen Cheng, Mark S Slaughter, Maiying Kong, Jiapeng Huang
OBJECTIVE: Left ventricular assist device (LVAD) surgery is complex, high risk, and expensive. The authors' hypothesis is baseline regional cerebral oxygen saturation (rSO2) might be a predictor of postoperative clinical outcomes. DESIGN: Retrospective review of 210 consecutive continuous flow LVAD patients between 2008 and 2014. The primary measure is 30-day mortality rate and secondary measures include modified major adverse cardiocerebral events (MACE), length of stay (LOS), and intensive care unit (ICU) stay...
August 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29153826/performance-evaluation-of-phase-angle-and-handgrip-strength-in-patients-undergoing-cardiac-surgery-prospective-cohort-study
#4
Taís Kereski da Silva, Ingrid Dalira Schweigert Perry, Janete Salles Brauner, Orlando Carlos Belmonte Weber, Gabriela Corrêa Souza, Sílvia Regina Rios Vieira
BACKGROUND AND AIMS: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#5
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#6
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#7
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#8
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29130231/-effect-of-postoperative-hyperglycemia-on-clinical-outcome-of-gastrointestinal-fistula-patients-undergoing-gastrointestinal-reconstruction
#9
Qiongyuan Hu, Jian'an Ren, Wenhao Tang, Jieshou Li
OBJECTIVE: To investigate the effect of hyperglycemia within postoperative 48 hours on gastrointestinal (GI) fistula patients without preoperative diagnosis of diabetes undergoing selective GI reconstruction. METHODS: Clinical data of GI fistula patients with age of 18 to 70 years and without diffuse peritonitis and systemic infection undergoing definitive GI reconstruction at Intestinal Fistula Center of Jinling Hospital from September 2012 to December 2015 were retrospectively analyzed...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29128046/preoperative-anemia-in-cardiac-operation-does-hemoglobin-tell-the-whole-story
#10
Lu Dai, Stephanie L Mick, Keith R McCrae, Penny L Houghtaling, Joseph F Sabik, Eugene H Blackstone, Colleen G Koch
BACKGROUND: Preoperative anemia, defined by hemoglobin level, is associated with elevated risk after cardiac operation. Better understanding of anemia requires characterization beyond this. This investigation focuses on red cell size and its association with patient characteristics and outcomes after cardiac operation. METHODS: From January 2010 to January 2014, 10,589 patients underwent elective cardiac operations at Cleveland Clinic. Anemia was characterized as normocytic, microcytic, or macrocytic based on mean corpuscular volume (MCV)...
November 8, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29118953/the-role-of-preoperative-sildenafil-therapy-in-controlling-of-postoperative-pulmonary-hypertension-in-children-with-ventricular-septal-defects
#11
Hamid Bigdelian, Mohsen Sedighi
Introduction: Most of the ventricular septal defects (VSD) are complicated with pulmonary arterial hypertension (PAH) which is the major cause of pulmonary hypertensive crisis and right ventricular failure. Methods: We reviewed clinical outcomes of 63 infants who underwent cardiac surgery and were divided into three groups. Control group (n=20) did not received sildenafil while group A (n = 22) received drug (0.3 mg/kg) before and after surgery. Group B (n=21) received drug at the initiation of surgery. Demographic data, preoperative and postoperative variables were compared among the patients...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#12
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29112468/the-effects-of-on-pump-and-off-pump-coronary-artery-bypass-surgery-on-respiratory-function-in-the-early-postoperative-period
#13
Federica Chiarenza, Theodoros Tsoutsouras, Cesare Cassisi, Cristina Santonocito, Stephen Gerry, Marinella Astuto, Shane George, Filippo Sanfilippo
BACKGROUND: Respiratory complications are common after cardiac surgery and the use of extracorporeal circulation is one of the main causes of lung injury. We hypothesized a better postoperative respiratory function in off-pump coronary artery bypass grafting (OPCABG) as compared with "on-pump coronary artery bypass grafting" (ONCABG). METHODS: This is a retrospective, single-center study at a cardiothoracic intensive care unit (ICU) in a tertiary university hospital...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29109631/comparative-evaluation-of-midazolam-dexmedetomidine-and-propofol-as-intensive-care-unit-sedatives-in-postoperative-electively-ventilated-eclamptic-patients
#14
Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
Background and Aims: Eclampsia is a common hypertensive disorder of pregnancy and treatment often includes termination of pregnancy with elective postoperative mechanical ventilation. The present study was aimed to compare midazolam, propofol, and dexmedetomidine for sedation and antihypertensive requirements of such patients admitted to Intensive Care Unit (ICU) after termination of pregnancy. Material and Methods: A total of ninety eclamptic patients administered general anesthesia for the termination of pregnancy through cesarean section and who also required postoperative ventilation were taken up for the study and were randomly allocated into three groups...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29109065/the-impact-of-chronic-kidney-disease-on-post-operative-outcomes-in-patients-undergoing-lumbar-decompression-and-fusion
#15
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D Vuong, Syed Khalid, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Little is known of the impact of pre-operative chronic kidney disease (CKD) on post-operative complications in patients undergoing lumbar arthrodesis. The aim of this study is to determine whether pre-operative CKD is associated with inferior peri-operative outcomes. METHODS: The medical records of 293 adult (≥18 years-old) spine deformity patients undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed...
November 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29098494/toxicity-of-inhaled-agents-after-prolonged-administration
#16
Panumart Manatpon, W Andrew Kofke
Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age...
November 2, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#17
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29096877/-comparison-of-postoperative-analgesia-with-methadone-versus-morphine-in-cardiac-surgery
#18
Ana Carolina Carvalho, Fábio Jean Goulart Sebold, Patrícia Mello Garcia Calegari, Benhur Heleno de Oliveira, Fabiana Schuelter-Trevisol
BACKGROUND AND OBJECTIVES: Pain is an aggravating factor of postoperative morbidity and mortality. The aim of this study was to compare the effects of methadone versus morphine using the numerical rating scale of pain and postoperative on-demand analgesia in patients undergoing myocardial revascularization. METHOD: A randomized, double-blind, parallel clinical trial was performed with patients undergoing coronary artery bypass grafting. The subjects were randomly divided into two groups: Morphine Group (MoG) and Methadone Group (MeG)...
October 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29090263/respiratory-events-with-sugammadex-vs-neostigmine-following-laparoscopic-sleeve-gastrectomy-a-prospective-pilot-study-assessing-neuromuscular-reversal-strategies
#19
Shmuel Evron, Yuri Abelansky, Tiberiu Ezri, Alexander Izakson
Abdominal surgery in obese patients may be associated with pulmonary morbidity, and mortality. Some patients may arrive in the PACU with residual paralysis. The purpose of this study was to find out if there was an association between the type of muscle relaxant reversal agent and the development of postoperative respiratory events in patients undergoing laparoscopic sleeve gastrectomy surgery. METHODS: From September 2012 to February 2013, in a prospective randomized pilot study, two different muscle relaxant reversal agents were administered at the end of surgery in 57 patients undergoing laparoscopic sleeve gastrectomy: sugammadex 2 mg/kg (32 patients) vs...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29089468/protective-effect-of-htk-solution-on-postoperative-pulmonary-function-in-infants-with-chd-and-pah
#20
Jindong Li, Yanhong Wu, Xudong Tian, Jiantang Wang, Mingfeng Dong, Anbiao Wang
Objective In this study, we aimed to investigate the effect of pulmonary arterial perfusion (PAP) with HTK on lung protection in infants with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH) after cardiopulmonary bypass (CPB). Methods Fifty infant patients with CHD and PAH at our hospital from January 2016 to February 2017 were randomly divided into control group and HTK group. The level of IL-6, MDA and ET-1 in serum were detected using ELISA Kit. Oxygen index (OI) and respiratory index (RI) were calculated at each time point...
October 31, 2017: Bioscience Reports
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