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https://www.readbyqxmd.com/read/28341919/intraoperative-hydroxyethyl-starch-70-0-5-administration-may-increase-postoperative-bleeding-a-retrospective-cohort-study
#1
Toko Fukushima, Shigehiko Uchino, Tomoko Fujii, Masanori Takinami, Shoichi Uezono
PURPOSE: Studies evaluating the safety of hydroxyethyl starch with a molecular weight of 70 kDa and a molar substitution ratio of 0.5 (HES 70/0.5) are scarce in the literature. In this study, we investigated the relationship between intraoperative HES 70/0.5 administration and postoperative bleeding. METHODS: This is a single-center, retrospective cohort study. Subjects were postoperative adult patients who stayed in the intensive care unit (ICU) for more than 24 h during the period from January 1, 2010 to December 31, 2012...
March 24, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28341469/long-term-survival-after-the-fontan-operation-twenty-years-of-experience-at-a-single-center
#2
Tacy E Downing, Kiona Y Allen, Andrew C Glatz, Lindsay S Rogers, Chitra Ravishankar, Jack Rychik, Jennifer A Faerber, Stephanie Fuller, Lisa M Montenegro, James M Steven, Thomas L Spray, Susan C Nicolson, J William Gaynor, David J Goldberg
OBJECTIVE: Existing studies of patients palliated with the Fontan operation are limited by heterogeneous patient populations and incomplete follow-up. This study aimed to describe long-term post-Fontan survival in a modern patient cohort. METHODS: All 773 patients who underwent a first Fontan operation at our institution between 1992 and 2009 were reviewed. The primary outcome was the composite endpoint of Fontan takedown, heart transplantation, or death before 2013...
March 6, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28340840/short-term-results-of-heartmate-3-ventricular-assist-device-implantation-for-end-stage-heart-failure
#3
P Ozturk, S Ertugay, C Sahutoglu, C Engin, S Nalbantgil, T Yagdi, M Ozbaran
OBJECTIVE: To report our initial experience with Heartmate 3 ventricular assist device (HM3) in cases with end-stage heart failure (ESHF). METHODS: Charts of 8 ESHF patients who underwent HM3 implantation in our clinic from January to June 2016 (group 1) and 16 patients who underwent HM2 implantation during 2015 (group 2) were reviewed retrospectively. Demographics as well as pre- and early postoperative medical data were noted and statistically analyzed between the 2 groups...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340494/postoperative-care-of-patients-with-high-grade-glioma-is-there-a-real-need-for-the-neurocritical-icu-and-early-ct-scan
#4
Roberto Altieri, Fabio Cofano, Alessandro Agnoletti, Riccardo Fornaro, Marco Ajello, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Background Pressure on economic resources now requires a careful rationalization of services. For adult patients with supratentorial gliomas, there is no consensus on the real need for care in a postoperative neurocritical intensive care unit (NICU) and on the timing of a postsurgical computed tomography (CT) scan. In this retrospective nonrandomized study, we assessed if and when there is a real need for NICU and if an early CT scan could be justified in the absence of neurologic worsening. Methods Of 264 patients, 21 were admitted to the NICU after the procedure as planned before the surgery for their clinical features (Karnofsky performance status < 70, American Society of Anesthesiologists score > 2, or Charlson Comorbidity Index > 5)...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28338592/open-abdomen-with-vacuum-assisted-wound-closure-and-mesh-mediated-fascial-traction-in-patients-with-complicated-diffuse-secondary-peritonitis-a-single-center-8-year-experience
#5
Matti Tolonen, Panu Mentula, Ville Sallinen, Suvi Rasilainen, Minna Bäcklund, Ari Leppäniemi
BACKGROUND: Open abdomen (OA) treatment in patients with peritonitis is increasing worldwide. Various temporary abdominal closure devices are being used. This study included patients with complicated diffuse secondary peritonitis, OA, and vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). The aim of this study was to describe mortality and major morbidity in terms of delayed primary fascial closure (DPFC) and enteroatmospheric fistula rates. METHODS: This was a single academic center retrospective study of consecutive patients with diffuse peritonitis, OA, and VAWCM between years 2008-2016...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338185/a-structured-blood-conservation-program-in-pediatric-cardiac-surgery
#6
A B Budak, K McCusker, S Gunaydin
OBJECTIVE: The limitation of alternative transfusion practices in infants increases the benefits of blood conservation. We analyzed the efficacy of a structured program to reduce transfusions and transfusion-associated complications in cardiac surgery PATIENTS AND METHODS: Our pediatric surgery database was reviewed retrospectively, comparing outcomes from two different time periods, after the implementation of an effective blood conservation program beginning in March 2014. A total of 214 infants (8...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28335987/community-health-indicators-associated-with-outcomes-of-pancreatectomy
#7
Lauren Slakey Pointer, Zaid Al-Qurayshi, David Taylor Pointer, Emad Kandil, Douglas Philip Slakey
PURPOSE: This study evaluates the association of environmental, social and health risk factors in relation to outcomes of pancreatic surgery. METHODS: Patients who underwent pancreatectomy with a 30 day postoperative follow up in Florida, New York and Washington states were identified using the State Inpatient Databases (SID) from 2010 to 2011. This data was merged with community health indicators complied from the County Health Ranking database. Fourteen community health indicators were used to determine higher risk communities...
March 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#8
Sharon Orbach-Zinger, Carolyn F Weiniger, Amir Aviram, Alexander Balla, S Fein, L A Eidelman, A Ioscovich
PURPOSE: Placenta previa (PP) is a major cause of obstetric hemorrhage. Clinical diagnosis of complete versus incomplete PP has a significant impact on the peripartum outcome. Our study objective is to examine whether distinction between PP classifications effect anesthetic management. METHODS AND MATERIALS: This multi center, retrospective, cohort study was performed in two tertiary university-affiliated medical centers between the years 2005- 2013. Electronic delivery databases were reviewed for demographic, anesthetic, obstetric hemorrhage, and postoperative outcomes for all cases...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28330804/cardiac-arrest-attributable-to-dysfunction-of-the-autonomic-nervous-system-after-traumatic-cervical-spinal-cord-injury
#9
Sei Won Kim, Chan Joo Park, Kyungil Kim, Yoon-Chung Kim
Bradycardia is the most common form of dysrhythmia developing after disruption of the sympathetic pathway by a spinal cord injury (SCI), and it can have fatal consequences, including cardiac arrest. Here, we report a case of cardiac arrest developing after cervical SCI attributable to sympathetic hypoactivity. A 26-year-old male pedestrian was admitted after a traffic accident. Radiologically, fractures were apparent at the C6-7 bilateral articular facets, and cord contusion with hemorrhage was evident at C4-7...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#10
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#11
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322416/effect-of-intensive-vs-moderate-alveolar-recruitment-strategies-added-to-lung-protective-ventilation-on-postoperative-pulmonary-complications-a-randomized-clinical-trial
#12
Alcino Costa Leme, Ludhmila Abrahao Hajjar, Marcia S Volpe, Julia Tizue Fukushima, Roberta Ribeiro De Santis Santiago, Eduardo A Osawa, Juliano Pinheiro de Almeida, Aline Muller Gerent, Rafael Alves Franco, Maria Ignez Zanetti Feltrim, Emília Nozawa, Vera Regina de Moraes Coimbra, Rafael de Moraes Ianotti, Clarice Shiguemi Hashizume, Roberto Kalil Filho, Jose Otavio Costa Auler, Fabio Biscegli Jatene, Filomena Regina Barbosa Gomes Galas, Marcelo Britto Passos Amato
Importance: Perioperative lung-protective ventilation has been recommended to reduce pulmonary complications after cardiac surgery. The protective role of a small tidal volume (VT) has been established, whereas the added protection afforded by alveolar recruiting strategies remains controversial. Objective: To determine whether an intensive alveolar recruitment strategy could reduce postoperative pulmonary complications, when added to a protective ventilation with small VT...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28320386/delayed-gastric-emptying-following-pancreatoduodenectomy-with-alimentary-reconstruction-according-to-roux-en-y-or-billroth-ii
#13
Tim R Glowka, Markus Webler, Hanno Matthaei, Nico Schäfer, Volker Schmitz, Jörg C Kalff, Jens Standop, Steffen Manekeller
BACKGROUND: Delayed gastric emptying (DGE) remains the most frequent complication following pancreatoduodenectomy (PD) with published incidences as high as 61%. The present study investigates the impact of bowel reconstruction techniques on DGE following classic PD (Whipple-Kausch procedure) with pancreatogastrostomy (PG). METHODS: We included 168 consecutive patients who underwent PD with PG with either Billroth II type (BII, n = 78) or Roux-en-Y type reconstruction (ReY, n = 90) between 2004 and 2015...
March 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28318531/national-survey-on-postoperative-care-and-treatment-circuits-in-neurosurgery
#14
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28298034/a-protocol-for-postoperative-admission-of-elective-craniotomy-patients-to-a-non-icu-or-step-down-setting
#15
Jeffrey E Florman, Deborah Cushing, Lynne A Keller, Anand I Rughani
OBJECTIVE Selecting the appropriate patients undergoing craniotomy who can safely forgo postoperative intensive care unit (ICU) monitoring remains a source of debate. Through a multidisciplinary work group, the authors redefined their institutional care process for postoperative monitoring of patients undergoing elective craniotomy to include transfer from the postanesthesia care unit (PACU) to the neurosurgical floor. The hypothesis was that an appropriately selected group of patients undergoing craniotomy could be safely managed outside the ICU in the postoperative period...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28292587/diagnosis-of-perioperative-myocardial-infarction-after-heart-valve-surgery-with-new-cut-off-point-of-high-sensitivity-troponin-t-and-new-electrocardiogram-or-echocardiogram-changes
#16
Héctor Cubero-Gallego, Mario Lorenzo, María Heredia, Itziar Gómez, Eduardo Tamayo
OBJECTIVE: Criteria for diagnosing myocardial infarction (MI) after heart valve surgery are not collected in the Third Universal Definition of MI. We aimed to define cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) for the diagnosis of perioperative MI after heart valve surgery according to perioperative MI determined by new alterations in electrocardiogram (ECG) and/or transthoracic echocardiogram (TTE). Secondary endpoints were incidence of perioperative MI, postoperative complications, 30-day mortality, and 2-year survival...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28292572/effects-of-hypertonic-saline-vs-normal-saline-in-lactate-depuration-after-cardiovascular-surgery
#17
Luis Horacio Atehortúa-López, Ray Mendoza-Franco, José Fernando Escobar-Serna, Luis Alejandro Urrego, Fernando Alzate, Fabian Jaimes
BACKGROUND: The postoperative care of patients exposed to cardiac surgery frequently require a thorough reanimation with intravenous fluids but crystalloid solutions like normal saline may increase the interstitial edema, and also it is well known that fluid overload increases mortality. OBJECTIVE: To compare the effect of 7.5% hypertonic saline (HS) with 0.9% normal saline (NS) in the lactate depuration and the hemodynamic response of patients during the first day after on-pump cardiovascular surgery...
March 11, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28291303/thoracic-endovascular-aortic-repair-for-traumatic-type-b-aortic-dissection-a-five-year-experience-from-a-single-center
#18
Shuang Li, Wenwu Cai, Xin Li, Jian Qiu, Quanming Li, Chang Shu
BACKGROUND: to share our experience and demonstrate the feasibility, safety and efficacy of Thoracic endovascular aortic repair (TEVAR) for traumatic Type B Aortic Dissection (TTBAD). METHODS: Between October 2010 and October 2015, 36 patients, who have been diagnosed as TTBAD, were included. A computed tomography angiography (CTA) scan was performed to confirm the diagnosis and to localize the aortic entry. The clinical data and outcomes of these patients were retrospectively reviewed and collected for further analysis...
March 14, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28290849/-factors-affecting-duration-of-stay-in-intensivecare-unit-after-coronary-artery-bypass-surgery
#19
N D Sveshnikova, F N Paleev
We studied predictors of prolonged stay in intensive care unit (ICU) after coronary surgery without cardiopulmonary bypass. Factors significantly associated with duration of ICU stay were elevated levels of glucose and lactate in venous blood, types of conduits used, and type of bypass surgery. Results of this study can be used for elaboration of a quantitative scale for prediction of duration of postoperative treatment in ICU.
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#20
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
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