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Postoperative ICU

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https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#1
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#2
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#3
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28717904/a-description-of-deaths-following-emergency-abdominal-surgery
#4
Henrik Wolsted, Ann Merete Møller, Mai-Britt Tolstrup, Morten Vester-Andersen
OBJECTIVE: Emergency major abdominal surgery carries a high mortality rate. The aim of this present study was to characterize a population of deceased abdominal surgical patients, to examine how many died unexpectedly and how many were subject to treatment limitations. MATERIALS AND METHODS: We included adult emergency abdominal surgical patients who died within 30 days postoperatively. We collected data from January 1, 2013, to December 31, 2014, in a Danish tertiary care hospital (Herlev)...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#5
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28707741/randomized-clinical-trial-of-psychological-support-and-sleep-adjuvant-measures-for-postoperative-sleep-disturbance-in-patients-undergoing-oesophagectomy
#6
M Scarpa, E Pinto, E Saraceni, F Cavallin, M Parotto, R Alfieri, M T Nardi, M R Marchi, M Cagol, C Castoro
BACKGROUND: Major surgery such as oesophagectomy requires a postoperative stay in intensive care. Painful stimuli lead to sleep disturbance and impairment in quality of life. The aim of this study was to evaluate the effect of psychological counselling and sleep adjuvant measures on postoperative quality of sleep and quality of life. METHODS: This RCT was performed between January 2013 and October 2015. Patients undergoing oesophagectomy for cancer were randomized into one of four groups receiving: psychological counselling plus sleep adjuvant measures during the ICU stay; psychological counselling alone; sleep adjuvant measures alone during the ICU stay; or standard care...
July 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28704503/role-of-biomarkers-in-early-infectious-complications-after-lung-transplantation
#7
Borja Suberviola, Luzdivina Rellan, Jordi Riera, Reyes Iranzo, Ascension Garcia Campos, Juan Carlos Robles, Rosario Vicente, Eduardo Miñambres, Miguel Santibanez
BACKGROUND: Infections and primary graft dysfunction are devastating complications in the immediate postoperative period following lung transplantation. Nowadays, reliable diagnostic tools are not available. Biomarkers could improve early infection diagnosis. METHODS: Multicentre prospective observational study that included all centres authorized to perform lung transplantation in Spain. Lung infection and/or primary graft dysfunction presentation during study period (first postoperative week) was determined...
2017: PloS One
https://www.readbyqxmd.com/read/28701597/randomized-comparative-study-of-intravenous-infusion-of-three-different-fixed-doses-of-milrinone-in-pediatric-patients-with-pulmonary-hypertension-undergoing-open-heart-surgery
#8
Neeraj Kumar Barnwal, Sanjeeta Rajendra Umbarkar, Manjula Sudeep Sarkar, Raylene J Dias
BACKGROUND: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone. METHODOLOGY: Patients were randomized into three groups...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#9
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701197/a-case-of-bowel-perforation-due-to-traumatic-hernia-at-a-pelvic-fracture-site-a-case-report-and-review-of-the-literature
#10
Ryota Tanaka, Hisashi Nagahara, Kiyoshi Maeda, Hiroshi Ohtani, Masatsune Shibutani, Tatsuro Tamura, Tetsuro Ikeya, Kenji Sugano, Yasuhito Iseki, Katsunobu Sakurai, Sadaaki Yamazoe, Kenjiro Kimura, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: Common complications of pelvic fractures include visceral injury, large-volume hemorrhage, genitourinary injury, rectal injury, and pulmonary embolism. On the other hand, traumatic hernia is a rare complication, especially in association with pelvic fractures. We report a case of bowel perforation due to traumatic hernia at a pelvic fracture site. CASE PRESENTATION: A 65-year-old female was presented at our hospital for further examination and treatment of ileus...
July 12, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28700473/diagnostic-value-of-plasma-ngal-and-intraoperative-diuresis-for-aki-after-major-gynecological-surgery-in-patients-treated-within-an-intraoperative-goal-directed-hemodynamic-algorithm-a-substudy-of-a-randomized-controlled-trial
#11
Oliver Hunsicker, Aarne Feldheiser, Andreas Weimann, David Liehre, Jalid Sehouli, Klaus-Dieter Wernecke, Claudia Spies
Data on early markers for acute kidney injury (AKI) after noncardiovascular surgery are still limited. This study aimed to determine the diagnostic value of plasma neutrophil-gelatinase-associated lipocalin (pNGAL) and intraoperative diuresis for AKI in patients undergoing major abdominal surgery treated within a goal-directed hemodynamic algorithm.This study is a post-hoc analysis of a randomized controlled pilot trial comparing intravenous solutions within a hemodynamic goal-directed algorithm based on the esophageal Doppler in patients undergoing epithelial ovarian cancer surgery...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28699136/intrawound-application-of-vancomycin-changes-the-responsible-germ-in-elective-spine-surgery-without-significant-effect-on-the-rate-of-infection-a-randomized-prospective-study
#12
B Mirzashahi, M Chehrassan, S M J Mortazavi
PURPOSE: Surgical site infection (SSI) is a costly complication associated with spine surgery. The impact of intrawound vancomycin has not been strongly postulated to decrease the risk of surgical site infection. We designed study to determine whether intrawound vancomycin application reduces the risk of SSI in patients after spine surgery. METHODS: A prospective randomized control trial study to evaluate the patients with elective spine surgery in a period of 15 month was designed...
July 11, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28697572/delayed-recall-and-working-memory-mmse-domains-predict-delirium-following-cardiac-surgery
#13
Catherine C Price, Cynthia Garvan, Loren Hizel, Marcos G Lopez, Frederic T Billings
BACKGROUND: Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. OBJECTIVE: Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. METHODS: Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery...
July 4, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28682828/criteria-for-intensive-care-admission-and-monitoring-after-elective-craniotomy
#14
Rafael Badenes, Lara Prisco, Armando Maruenda, Fabio S Taccone
PURPOSE OF REVIEW: The current article revises the recent evidence on ICU admission criteria and postoperative neuromonitoring for patients undergoing elective craniotomy. RECENT FINDINGS: Only a small proportion of elective postoperative neurosurgical patients require specific medical interventions and invasive monitoring. Among these, patients undergoing elective craniotomy are frequently admitted to neuro-ICU, specialist postanaesthesia care units or intermediate-level care unit in the postoperative period...
July 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681751/assessment-of-surgical-risk-factors-in-the-development-of-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients-alarming-observations
#15
Deepashu Sachdeva, Daljit Singh, Poonam Loomba, Amandeep Kaur, Monica Tandon, Ishu Bishnoi
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in patients receiving mechanical ventilation (MV) and contributes to a longer intensive care unit (ICU) stay, duration of MV, and a high morbidity and mortality. OBJECTIVE: The purpose of study was to determine the incidence of VAP in neurosurgery ICU patients and to assess the probable contributing neurosurgical risk factors like the site and nature of the lesion in the brain, the duration of surgery, blood loss during surgery, and infection elsewhere in the body, in the development of VAP...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28671866/application-of-autologous-blood-cell-salvage-in-off-pump-coronary-artery-bypass-graft-operation
#16
Hui Zhao, Huimin Ma, Li Meng, Ziniu Zhao, Xiaoqiang Quan, Zhaoyun Cheng
To analyze whether application of autologous blood cell salvage can reduce the transfusion volume of allogeneic blood and complications of blood transfusion in off-pump coronary artery bypass operations. Methods: We randomly divided 120 patients into autologous blood cell salvage group (experimental group, n = 60) and non-autologous blood cell salvage group (control group, n = 60). Volume of perioperative allogeneic blood transfusion of each patient was recorded. Moreover, complications and ICU retention times (H) of each patient were also recorded...
June 22, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28659919/the-%C3%AE-d-endoglucuronidase-heparanase-is-a-danger-molecule-that-drives-systemic-inflammation-and-correlates-with-clinical-course-after-open-and-endovascular-thoracoabdominal-aortic-aneurysm-repair-lessons-learnt-from-mice-and-men
#17
Lukas Martin, Alexander Gombert, Jianmin Chen, Julia Liebens, Julia Verleger, Johannes Kalder, Gernot Marx, Michael Jacobs, Christoph Thiemermann, Tobias Schuerholz
Thoracoabdominal aortic aneurysm (TAAA) is a highly lethal disorder requiring open or endovascular TAAA repair, both of which are rare, but extensive and complex surgical procedures associated with a significant systemic inflammatory response and high post-operative morbidity and mortality. Heparanase is a β-d-endoglucuronidase that remodels the endothelial glycocalyx by degrading heparan sulfate in many diseases/conditions associated with systemic inflammation including sepsis, trauma, and major surgery. We hypothesized that (a) perioperative serum levels of heparanase and heparan sulfate are associated with the clinical course after open or endovascular TAAA repair and (b) induce a systemic inflammatory response and renal injury/dysfunction in mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28658904/elective-tracheostomy-in-head-and-neck-surgery-our-experience
#18
Venkatesh S Anehosur, Pallavi Karadiguddi, Vajendra K Joshi, Basavraj C Lakkundi, Rajarshi Ghosh, Gopalkrishnan Krishnan
INTRODUCTION: Tracheostomy is commonly used to secure the airway during the immediate postoperative period in maxillofacial oncological operations. We conducted a study to review the utility of elective tracheostomy in head and neck surgery. AIM: To review the incidence of intraoperative, perioperative and postoperative complications and its management in elective tracheostomy and to analyse its utility in head and neck surgery. MATERIALS AND METHODS: The study included review of 50 patients, who were treated for head and neck cancers in the Department of Oral And Maxillofacial Surgery of our centre between January 2011 to December 2014...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28655695/influences-of-prophylactic-implantation-iabp-and-passive-emergency-placement-iabp-in-clinical-prognosis-of-high-risk-of-coronary-bypass-patients
#19
Ying Zhang
This paper aims to study the influences of prophylactic placement of intra-aortic balloon pump (IABP) and passive emergency placement of IABP on the prognosis of patients with high risk of coronary bypass. In this study, 70 patients with high-risk coronary artery bypass IABP admitted to our hospital from August 2012 to August 2015 were selected and retrospectively analyzed. These patients were divided into two groups based on the timing of IABP placement, namely prophylactic placement of IABP group (group A, n=35) and passive emergency placement of IABP group (group B, n=35)...
May 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28652590/the-incidence-risk-factors-and-outcomes-of-postoperative-acute-kidney-injury-in-neurosurgical-critically-ill-patients
#20
Yujun Deng, Jie Yuan, Ruibin Chi, Heng Ye, Dong Zhou, Sheng Wang, Cong Mai, Zhiqiang Nie, Lin Wang, Yiling Zhai, Lu Gao, Danqing Zhang, Linhui Hu, Yiyu Deng, Chunbo Chen
We investigated the incidence, perioperative risk factors, and outcomes of postoperative acute kidney injury (AKI) in neurosurgical critically ill patients. A prospective multicenter cohort study was conducted, enrolling adult patients who underwent neurosurgical procedure and admitted to the neurosurgical intensive care units (ICU). Postoperative AKI was diagnosed within 7 days after surgery based on the Kidney Disease Improving Global Outcomes criteria. Of 624 enrolled patients, postoperative AKI occurred in 84 patients...
June 26, 2017: Scientific Reports
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