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Postoperative ICU

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https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#1
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28801404/systematic-review-of-preoperative-physical-activity-and-its-impact-on-postcardiac-surgical-outcomes
#2
D Scott Kehler, Andrew N Stammers, Navdeep Tangri, Brett Hiebert, Randy Fransoo, Annette S H Schultz, Kerry Macdonald, Nicholas Giacomontonio, Ansar Hassan, Jean-Francois Légaré, Rakesh C Arora, Todd A Duhamel
OBJECTIVES: The objective of this systematic review was to study the impact of preoperative physical activity levels on adult cardiac surgical patients' postoperative: (1) major adverse cardiac and cerebrovascular events (MACCEs), (2) adverse events within 30 days, (3) hospital length of stay (HLOS), (4) intensive care unit length of stay (ICU LOS), (5) activities of daily living (ADLs), (6) quality of life, (7) cardiac rehabilitation attendance and (8) physical activity behaviour. METHODS: A systematic search of MEDLINE, Embase, AgeLine and Cochrane library for cohort studies was conducted...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28796646/defining-benchmarks-for-transthoracic-esophagectomy-a-multicenter-analysis-of-total-minimally-invasive-esophagectomy-in-low-risk-patients
#3
Henner M Schmidt, Susanne S Gisbertz, Johnny Moons, Ioannis Rouvelas, Juha Kauppi, Andrew Brown, Emanuele Asti, Misha Luyer, Sjoerd M Lagarde, Felix Berlth, Annouck Philippron, Christiane Bruns, Arnulf Hölscher, Paul M Schneider, Dimitri A Raptis, Mark I van Berge Henegouwen, Philippe Nafteux, Magnus Nilsson, Jari Räsanen, Francesco Palazzo, Ernest Rosato, Stuart Mercer, Luigi Bonavina, Grard Nieuwenhuijzen, Bas P L Wijnhoven, Wolfgang Schröder, Piet Pattyn, Peter P Grimminger, Christian A Gutschow
OBJECTIVE: To define "best possible" outcomes in total minimally invasive transthoracic esophagectomy (ttMIE). BACKGROUND: TtMIE, performed by experts in patients with low comorbidity, may serve as a benchmark procedure for esophagectomy. PATIENTS AND METHODS: From a cohort of 1057 ttMIE, performed over a 5-year period in 13 high-volume centers for esophageal surgery, we selected a study group of 334 patients (31.6%) that fulfilled criteria of low comorbidity (American Society of Anesthesiologists score ≤2, WHO/ECOG score ≤1, age ≤65 years, body mass index 19-29 kg/m)...
August 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28795300/five-years-two-surgeons-and-over-500-bariatric-procedures-what-have-we-learned
#4
Brian Shea, William Boyan, James Botta, Syed Ali, Yaniv Fenig, Ethan Paulin, Steven Binenbaum, Frank Borao
BACKGROUND: Bariatric surgery has become an increasingly popular method for weight loss and mitigation of co-morbidities in the obese population. Like any field, there is a desire to standardize and accelerate the postoperative period while maintaining safe outcomes. METHODS: All laparoscopic sleeve gastrectomies (LSG) and gastric bypasses (LGB) were performed over a 5-year period were logged along with several aspects of postoperative care. Trends were followed in aspects of postoperative care over years as well as any documentation of complications or re-admissions...
August 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28780837/-application-and-efficacy-of-endotracheal-tube-of-drug-injection-for-postoperative-patients
#5
S Q Liu, Z Liu, W C Yang, Z H Hu, J L Zhang, Y Li
Objective: To evaluate the efficacy of endotracheal tube for drug injection in postoperative ICU patients. Methods: A total of 60 ICU patients who were given mechanical ventilation after surgical treatment were enrolled in this study from January 2015 to August 2016 at our hospital. All the patients were divided into the observation group (30 cases) and the control group (30 cases). In the observation group, the patients were treated with the endotracheal tube for surface anesthesia by injecting 2% lidocaine into the trachea, and patients in the control group were treated with saline instead of lidocaine...
August 1, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28777159/icu-admission-after-surgery-who-benefits
#6
Sadia Ghaffar, Rupert M Pearse, Michael A Gillies
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance. RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation...
August 1, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28774644/preincision-initiation-of-dexmedetomidine-maximally-reduces-the-risk-of-junctional-ectopic-tachycardia-in-children-undergoing-ventricular-septal-defect-repairs
#7
Nischal K Gautam, Yuliya Turiy, Chandra Srinivasan
OBJECTIVE: To evaluate whether initiation of dexmedetomidine (DEX) infusion before surgical incision and cardiopulmonary bypass (CPB) versus initiation after CPB had an impact on the incidence of junctional ectopic tachycardia (JET). DESIGN: Retrospective cohort study. SETTING: Single tertiary-care cardiac center. PARTICIPANTS: Children undergoing cardiopulmonary bypass for repair of congenital heart disease involving ventricular septal defects between January 2010 and February 2013...
April 10, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28774642/effect-of-0-9-saline-or-plasma-lyte-148-as-crystalloid-fluid-therapy-in-the-intensive-care-unit-on-blood-product-use-and-postoperative-bleeding-after-cardiac-surgery
#8
Sumeet K Reddy, Michael J Bailey, Richard W Beasley, Rinaldo Bellomo, Diane M Mackle, Alex J Psirides, Paul J Young
OBJECTIVE: To evaluate the effect of Plasma-Lyte 148 (PL-148) compared with 0.9% saline (saline) on blood product use and postoperative bleeding in patients admitted to the intensive care unit (ICU) following cardiac surgery. DESIGN: A post hoc subgroup analysis conducted within a multicenter, double-blind, cluster-randomized, double-crossover study (study 1) and a prospective, single-center nested-cohort study (study 2). SETTING: Tertiary-care hospitals...
April 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28767771/parapneumonic-pleural-effusion-early-versus-late-thoracoscopy
#9
Rodrigo Romualdo Pereira, Cristina Gonçalves Alvim, Cláudia Ribeiro de Andrade, Cássio da Cunha Ibiapina
Objective: To evaluate the best time to perform thoracoscopy for the treatment of complicated parapneumonic pleural effusion in the fibrinopurulent phase in patients ≤ 14 years of age, regarding the postoperative evolution and occurrence of complications. Methods: This was a retrospective comparative study involving patients with parapneumonic pleural effusion presenting with septations or loculations on chest ultrasound who underwent thoracoscopy between January of 2000 and January of 2013...
July 31, 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28763874/-correlation-between-serum-uric-acid-level-and-acute-renal-injury-after-coronary-artery-bypass-grafting
#10
D Q Xu, J Du, Z Zheng, Y Tang, L Zou, Y H Zhang, H T Zhang
Objective: To evaluate whether early postoperative serum uric acid level can predict postoperative acute renal injury (AKI) among patients undergoing coronary artery bypass grafting (CABG). Methods: The study retrospectively enrolled 1 306 patients undergoing CABG in Fuwai Hospital between September 2012 and December 2013. The patients were divided into 5 groups by the concentrations of serum uric acid measured on the morning of the first postoperative day, and uric acid categories were as follow: less than 195 μmol/L (Q1 group, 262 cases), 195-236 μmol/L (Q2 group, 263 cases), 237-280 μmol/L (Q3 group, 260 cases), 281-336 μmol/L (Q4 group, 261 cases), more than 336 μmol/L (Q5 group, 260 cases)...
July 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28757869/factors-associated-with-postoperative-prolonged-mechanical-ventilation-in-pediatric-liver-transplant-recipients
#11
Olubukola O Nafiu, Katari Carello, Anjana Lal, John Magee, Paul Picton
INTRODUCTION: Almost all pediatric orthotopic liver transplant (OLT) recipients require mechanical ventilation in the early postoperative period. Prolonged postoperative mechanical ventilation (PPMV) may be a marker of severe disease and may be associated with morbidity and mortality. We determined the incidence and risk factors for PPMV in children who underwent OLT. METHODS: This was a retrospective analysis of data collected on 128 pediatric OLT recipients. PPMV was defined as postoperative ventilation ≥ 4 days...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/28754410/laparoscopic-adjustable-gastric-band-explantation-and-implantation-at-academic-centers
#12
Christina Y Koh, Colette S Inaba, Sarath Sujatha-Bhaskar, Samuel Hohmann, Jaime Ponce, Ninh T Nguyen
BACKGROUND: The laparoscopic adjustable gastric band (LAGB) was approved for use in the US in 2001 and has been found to be a safe and effective surgical treatment for morbid obesity. However, there is a recent trend toward reduced use of LAGB nationwide. The objective of this study was to examine the prevalence and outcomes of primary LAGB implantation compared with revision and explantation at academic centers. STUDY DESIGN: Data were obtained from the Vizient database from 2007 through 2015...
July 25, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28750409/timp-2-igfbp7-nephrocheck%C3%A2-measurements-at-intensive-care-unit-admission-after-cardiac-surgery-are-predictive-for-acute-kidney-injury-within-48-hours
#13
Mehmet Oezkur, Attila Magyar, Phillip Thomas, Tabea Stork, Reinhard Schneider, Constanze Bening, Stefan Störk, Peter U Heuschmann, Rainer G Leyh, Martin Wagner
BACKGROUND/AIMS: Acute kidney injury (AKI) is a postoperative complication after cardiac surgery with a high impact on mortality and morbidity. Nephrocheck® [TIMP-2*IGFBP7] determines markers of tubular stress, which occurs prior to tubular damage. It is unknown at which time-point [TIMP-2*IGFBP7] measurement should be performed to ideally predict AKI. We investigated the association of [TIMP-2*IGFBP7] at various time-points with the incidence of AKI in patients undergoing elective cardiac surgery including cardio-pulmonary bypass...
July 27, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#14
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#15
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28740625/pulmonary-valve-replacement-in-patients-with-corrected-tetralogy-of-fallot
#16
Fotios M Mitropoulos, Meletios A Kanakis, Christos Ntellos, Constantinos Loukas, Periklis Davlouros, Theophili Kousi, Andrew C Chatzis
Introduction: Development of pulmonary insufficiency in patients with surgically corrected tetralogy of Fallot (TOF) may lead to severe right heart failure with serious consequences. We herein present our experience with pulmonary valve replacement (PVR) in these patients. Methods: From 2005-2013, 99 consecutive patients (71 males/28 females, mean age 38±8 years), underwent PVR after 7 to 40 (mean 29 ± 8) years from the initial correction. Seventy nine of the symptomatic patients presented in NYHA II, 14 in III and 2 in IV...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28736006/advantages-of-epidural-analgesia-on-pulmonary-functions-in-liver-transplant-donors
#17
H K Atalan, B Gucyetmez, R Donmez, A Kargi, K Y Polat
OBJECTIVE: Epidural analgesia (EA) has positive effects on anesthetic requirement, blood loss, postoperative analgesia, and pulmonary function tests (PFTs). The purpose of the present study was to investigate the effect of EA on postoperative PFTs in liver transplant donors (LTDs). METHODS: In the present study, 66 LTDs were classified as total intravenous anesthesia (TIVA) and TIVA+EA groups. Patient's age, sex, body mass index, induction and maintenance dose of propofol (IDP and MDP), operation duration, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, visual analog scale (VAS), atelectasis scores, and lengths of intensive care unit (ICU) and hospital stays were recorded...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735131/mini-craniotomy-under-local-anesthesia-for-chronic-subdural-hematoma-an-effective-choice-for-elderly-and-for-patients-in-a-resource-strained-environment
#18
Shaikh Danish Mahmood, Muhammad Waqas, Mirza Z Baig, Aneela Darbar
BACKGROUND: Mini craniotomy for chronic subdural hematoma (CSDH) is associated with lower recurrence rates. However, the procedure is mostly performed under general anesthesia (GA) and therefore frequently requires intensive care unit (ICU) facility, especially in the elderly population. Due to unavailability of ICU beds, and to avoid GA, we started to perform this procedure under local anesthesia (LA). MATERIALS AND METHODS: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#19
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28731404/jackson-pratt-drainage-in-pediatric-craniofacial-reconstructive-surgery-is-it-helping-or-hurting
#20
Kumar Vasudevan, Ahyuda Oh, R Shane Tubbs, David Garcia, Andrew Reisner, Joshua J Chern
OBJECTIVE Jackson-Pratt drains (JPDs) are commonly employed in pediatric craniofacial reconstructive surgery (CRFS) to reduce postoperative wound complications, but their risk profile remains unknown. Perioperative blood loss and volume shifts are major risks of CFRS. The goal of this study was to evaluate the risks of JPD usage in CFRS, particularly with regard to perioperative blood loss, hyponatremia, intensive care unit (ICU) length of stay, and postoperative wound complications. METHODS The authors performed a retrospective review of data obtained in pediatric patients who underwent CFRS at a single institution, as performed by multiple surgeons between January 2010 and December 2014...
July 21, 2017: Journal of Neurosurgery. Pediatrics
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