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https://www.readbyqxmd.com/read/29780973/case-report-transection-of-radial-arterial-catheter-requiring-surgical-intervention
#1
Luis Tollinche, Jacob Jackson, Melvin La, Dawn Desiderio, Cindy Yeoh
We report a case in which a radial arterial line was placed prior to induction of general anaesthesia in a 76 year old male with prostate cancer and multiple co-morbidities who presented for thoracoscopic resection of a right lower lobe carcinoid lung tumor. The patient's intra-operative course was complicated by acute blood loss requiring conversion to an open procedure. A subsequent injury to the superior vena cava resulted in the need for immediate re-exploration at the conclusion of surgery. While the arterial line was still indicated in this patient's postoperative course in the ICU, malfunction on post-operative day one resulted in removal of the catheter...
2018: Journal of Intensive and Critical Care
https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#2
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29779314/-impact-of-psoas-muscle-index-on-early-postoperative-mortality-and-complications-after-liver-transplantation
#3
J C Hou, H Zheng, Z Qiang, Y M Zhang, W T Jiang, W Gao, J Z Cai, J J Zhang, Z Y Shen
Objective: To investigate the relationship between psoas muscle index (PMI) and early postoperative survival rate and the incidence of complications after liver transplantation in adults. Methods: The clinical data of 225 patients (male, n =184; female, n =41) underwent liver transplantation at the Organ Transplantation Department of First Central Clinic Institute of Tianjin Medical University from January 2014 to December 2016 were analyzed, retrospectively.Original disease: hepatitis B liver cirrhosis(44 cases), hepatitis C cirrhosis(10 cases), autoimmune liver cirrhosis(29 cases), other benign liver diseases(24 cases), liver cirrhosis with liver cancer(116 cases), hilar cholangiocarcinoma(1 case) and hepatic vascular sarcoma(1 case)...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29778750/our-modified-technique-of-combined-antegrade-vein-graft-cardioplegia-infusion-versus-conventional-antegrade-method-in-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#4
Mehrzad Sharifi, Seyed Reza Mousavi, Mohammad Rafiei
BACKGROUND: To determine the efficacy of antegrade cardioplegia supplemented with venous graft perfusion in patients scheduled for coronary artery bypass grafting (CABG). METHODS: 223 consecutive patients scheduled for isolated CABG were randomized to receive either continuous crystalloid cardioplegia via vein grafts on completion of each distal anastomosis plus intermittent blood cardioplegia through aortic root (group 1, n = 110) or antegrade blood cardioplegia alone (group 2, n = 113)...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29777769/a-combined-approach-for-the-early-recognition-of-acute-kidney-injury-after-adult-cardiac-surgery
#5
Cédrick Zaouter, Julien Potvin, Marie-Lise Bats, Marie-Christine Beauvieux, Alain Remy, Alexandre Ouattara
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent complication. The current criteria to detect CSA-AKI rise only when organic dysfunction has occurred. The Doppler Renal Resistive Index (RRI) and the urinary G1 cell cycle arrest proteins (TIMP-2 and IGFBP7) have been advocated to predict CSA-AKI at an early stage after cardiac surgery. The primary objective was to determine the predictive value of these new markers to detect CSA-AKI after elective heart surgery in patients at risk to develop AKI...
May 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#6
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29771744/sleep-quality-during-and-after-cardiothoracic-intensive-care-and-psychological-health-during-recovery
#7
Nittaya Caruana, Sharon McKinley, Rosalind Elliott, Leila Gholizadeh
BACKGROUND: Intensive care patients experience poor sleep quality. Psychological distress and diminished health-related quality of life (HRQOL) are also common among former intensive care unit (ICU) patients. Coronary artery bypass graft (CABG) surgery is a frequent reason adults require treatment in ICU. The effect of on- versus off-pump surgery on sleep and recovery has not been reported. OBJECTIVE: The aim of this study was to assess sleep quality of CABG patients during and after ICU, psychological well-being, HRQOL during recovery, and whether on- versus off-pump surgery affects sleep and recovery...
May 16, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#8
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29754733/assessing-the-benefits-of-preoperative-thoracic-epidural-placement-for-lung-transplantation
#9
Sean R McLean, Peter von Homeyer, Aaron Cheng, Michael L Hall, Michael S Mulligan, Kevin Cain, Kei Togashi
OBJECTIVE: The authors investigated the effect of preoperative thoracic epidural (PreTE) catheter placement versus not placing a preoperative thoracic epidural catheter (NoPreTE) on the duration of postoperative ventilation time, time to become coherent (measured as time to become Confusion Assessment Method-intensive care unit [ICU] negative), opioid consumption, ICU length of stay (LOS), and hospital LOS. DESIGN: Retrospective cohort design. SETTING: Single institution, university hospital...
April 3, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29753821/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery
#10
Sirisha Emani, Lynn A Sleeper, David Faraoni, Michelle Mulone, Fatoumata Diallo, James A DiNardo, Juan Ibla, Sitaram M Emani
BACKGROUND: Perioperative bleeding is a common complication in pediatric patients undergoing cardiac surgery. Although thromboelastography (TEG) has been utilized in patients undergoing adult cardiac surgery, limited data are available in pediatric patients. We hypothesize that TEG parameters may be associated with surrogate endpoints for postoperative bleeding in pediatric patients undergoing complex cardiac surgery. METHODS: In a retrospective study, TEG was obtained after protamine administration and upon intensive care unit (ICU) admission in pediatric patients (≤ 18yrs) undergoing cardiac surgery requiring cardiopulmonary bypass...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#11
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29745099/incidence-and-risk-assessment-of-venous-thromboembolism-in-cancer-patients-admitted-to-intensive-care-unit-for-postoperative-care
#12
Jia-Xuan Xu, Jun Dong, Hong Ren, Xiao-Jie Chen, Yong Yang, Ren-Xiong Chen, Guo-Dong Wang, Hong-Zhi Wang
PURPOSE: Cancer patients undergoing surgery are at high risk of venous thromboembolism (VTE). The occurrence of VTE in Chinese cancer patients admitted to intensive care unit (ICU) for postoperative care is poorly characterized. This study was designed to investigate the incidence of VTE in this population and to evaluate the utility of the Caprini score in risk stratification. METHODS: 2127 consecutive adult patients admitted to a 10-bed surgical ICU (SICU) in a tertiary care academic hospital during a 4-year period (January 1, 2013 - December 31, 2016) were enrolled...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29742589/clinical-factors-associated-with-icu-specific-care-following-supratentoral-brain-tumor-resection-and-validation-of-a-risk-prediction-score
#13
Lynze R Franko, Todd Hollon, Joseph Linzey, Christopher Roark, Venkatakrishna Rajajee, Kyle Sheehan, Magnus Teig, Shawn Hervey-Jumper, Jason Heth, Daniel Orringer, Craig A Williamson
OBJECTIVES: The postoperative management of patients who undergo brain tumor resection frequently occurs in an ICU. However, the routine admission of all patients to an ICU following surgery is controversial. This study seeks to identify the frequency with which patients undergoing elective supratentorial tumor resection require care, aside from frequent neurologic checks, that is specific to an ICU and to determine the frequency of new complications during ICU admission. Additionally, clinical predictors of ICU-specific care are identified, and a scoring system to discriminate patients most likely to require ICU-specific treatment is validated...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29736359/clinical-significance-of-candida-in-an-intraoperative-peritoneal-specimen-with-perforation-peritonitis-an-institutional-perspective
#14
Jagannath Pramod, Chellappa Vijayakumar, Krishnamachari Srinivasan, Nanda Kishore Maroju, Nagarajan Raj Kumar, Gopal Balasubramaniyan
Introduction Fungal infection of the peritoneum has become more common in recent years, the most common cause of which is Candida. Candida peritonitis is considered as a severe disease and is regarded as an independent risk factor for mortality in postoperative peritonitis. This study was planned to find out the clinical significance of Candida isolation on the outcome of the patients with peritonitis in terms of morbidity and mortality. Methods This prospective study included consecutive patients admitted and operated for secondary peritonitis over a two-year period in a tertiary care hospital in South India...
March 5, 2018: Curēus
https://www.readbyqxmd.com/read/29729522/relaparotomy-following-cesarean-section-a-single-center-study
#15
Hubert Huras, Malgorzata Radon-Pokracka, Magdalena Nowak
INTRODUCTION: Relaparotomy is a serious complication of caesarean section. The aim of this study was to investigate its risk factors and postoperative outcome. METHODS: We conducted a retrospective case-control study examining 48 reoperations between January 2013 and June 2017 at the Obstetrics and Perinatology Department, Jagiellonian University Hospital in Cracow, Poland. This is tertiary referral center, in that time 8421 cesarean section were performed. The control group was randomly matched from all CS in a 1 to 2 ratio...
April 26, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29726418/improving-fluid-management-in-critical-care-towards-the-icu-of-the-future
#16
Katharina Bergmoser, Lucas Pflanzl-Knizacek, Matthias Hafner, Gernot Schilcher, Christian Baumgartner
BACKGROUND: The calculation of daily fluid balances is essential in perioperative and postoperative fluid management in order to prevent severe hypervolemia or hypovolemia in critically ill patients. In this context, modern health information technology has the potential to reduce the workload for health care professionals by not only automating data collection but also providing appropriate decision support. OBJECTIVES: Within this work, current problems and barriers regarding fluid balancing in cardiac intensive care patients are outlined and improvement activities are specified...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29724988/total-gastric-necrosis-due-to-mucormycosis-a-rare-case-of-gastric-perforation
#17
Salah Termos, Feras Othman, Mohammad Alali, Bader M S Al Bader, Talal Alkhadher, Wael Fathi Hassanaiah, Ali Taqi, Abhijit Sapkal
BACKGROUND Spontaneous gastric perforation is usually a complication of peptic ulcer disease, or a postoperative complication resulting from gastric torsion. Mucormycosis (or zygomycosis) is an uncommon opportunistic fungal infection that is usually seen in immunocompromised patients and is associated with significant morbidity and mortality. This report is of a rare case of spontaneous gastric perforation due to mucormycosis infection. CASE REPORT A 52-year-old woman, with a past medical history of heroin abuse, diabetes mellitus, hypertension, and chronic kidney disease treated by dialysis, presented to the emergency department with cellulitis of the arms...
May 4, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29718883/the-american-society-of-anesthesiologists-score-influences-on-postoperative-complications-and-total-hospital-charges-after-laparoscopic-colorectal-cancer-surgery
#18
Jae-Hyun Park, Dong-Hyun Kim, Bo-Ra Kim, Young-Wan Kim
The aim of this study was to investigate the influence of American Society of Anesthesiologists (ASA) scores on postoperative complication rates and total hospital charges following laparoscopic surgery for colorectal cancer.All patients (n = 664) underwent laparoscopic colorectal cancer surgery. A group of patients with an ASA score of 1 or 2 (n = 575) and a group of patients with an ASA score of 3 (n = 89) were compared.The mean age was higher in the group of patients with an ASA score of 3 than in the group of patients with an ASA score of 1 or 2 (70 vs 67 years)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29716763/expanding-eligibility-for-the-ross-procedure-a-reasonable-proposition
#19
Aly Ghoneim, Ismail Bouhout, Katie Losenno, Nancy Poirier, Raymond Cartier, Philippe Demers, Michael Tousch, Linruo Guo, Michael W A Chu, Ismail El-Hamamsy
BACKGROUND: Although the Ross procedure offers potential benefits in young adults, technical complexity represents a significant limitation. Therefore, the safety of expanding its use in more complex settings is uncertain. The aim of this study was to compare early outcomes of standard isolated Ross procedures vs expanding elgibility to higher-risk clinical settings. METHODS: From 2011 to 2016, 261 patients (46 ± 12 years) underwent Ross procedures in 2 centres...
January 31, 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#20
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
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