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cardiac surgery and anesthesia

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https://www.readbyqxmd.com/read/29232194/persistent-ventricular-bigeminy-during-anesthesia-in-pediatric-patients-a-case-report-of-an-11-year-old-child
#1
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29229895/prevalence-and-predictors-of-myocardial-ischemia-by-preoperative-myocardial-perfusion-single-photon-emission-computedtomography-in-patients-undergoing-noncardiac-surgery
#2
Abdelkareem Saleh Al-Oweidi, Hesham Albabtain, Suleiman M Kharabsheh, Peter Kimme, Mahmoud Almustafa, Samer Seder, Mohamed Shoukri, Ahmed L Fathala
BACKGROUND: The prevalence and predictors of myocardial ischemia before noncardiac surgery are unknown. In addition the predictive value of myocardial perfusion single-photon emission computed tomography (SPECT) before noncardiac in individual patients is uncertain. OBJECTIVE: Evaluate the prevalence and predictors of myocardial ischemia before noncardiac surgery, and determine the postoperative cardiac outcome based on results of myocardial perfusion SPECT. DESIGN: Retrospective...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#3
Tina Hu, Yves Collin, Réal Lapointe, François Martin Carrier, Luc Massicotte, Annik Fortier, Jean Lambert, Franck Vandenbroucke-Menu, André Y Denault
OBJECTIVE: The use of cerebral near-infrared spectroscopy (NIRS) has become widespread in cardiac surgery after research demonstrated an association between perioperative cerebral desaturations and postoperative complications. Somatic NIRS desaturation also is associated with an increased risk of postoperative complications and mortality. The objective of this study was to explore the trends of both somatic and cerebral NIRS during liver transplantation. DESIGN: A prospective, single-site, observational case series...
July 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29225156/performance-of-tci-propofol-using-the-schnider-model-for-cardiac-surgery-on-cardiopulmonary-bypass-a-pilot-study
#4
Aaron Kwang Yang Lee, Aaron Yik Hang Kong, Chee Fai Kong
OBJECTIVE: This pilot study aimed to evaluate the performance of target-controlled infusion (TCI) of propofol using the Schnider pharmacokinetic model in patients undergoing cardiac surgery requiring cardiopulmonary bypass. DESIGN: This was a prospective pharmacokinetic study. SETTING: A tertiary care hospital. PARTICIPANTS: This study is comprised of 10 patients, aged between 46 and 81, who underwent elective cardiac surgery requiring the use of cardiopulmonary bypass...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29214434/risk-factors-for-intraoperative-bradycardia-during-ear-nose-throat-and-maxillofacial-surgery
#5
Tjaša Ivošević, Biljana Miličić, Milovan Dimitrijević, Branislava Ivanović, Aleksandar Pavlović, Marina Stojanović, Mirko Lakićević, Ksenija Stevanović, Nevena Kalezić
Intraoperative bradycardia (IOB) is one of the most common cardiac arrhythmias observed in clinical anaesthetic practice. Controlled hypotension, as a strategy of lowering patient's blood pressure during anesthesia has been practiced for decades in head and neck surgery. The aim of our study was to determine the incidence and the risk factors for intraoperative bradycardia in maxillofacial, ear, nose and throat surgery, as well as to determine whether controlled hypotension affects the occurrence of IOB. The retrospective study included 2304 patients who underwent maxillofacial, ear, nose or throat surgery...
December 6, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29210794/effect-of-remote-ischemic-preconditioning-on-outcomes-in-adult-cardiac-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-studies
#6
Jianfeng Xie, Xiwen Zhang, Jingyuan Xu, Zhongheng Zhang, Nathan J Klingensmith, Songqiao Liu, Chun Pan, Yi Yang, Haibo Qiu
BACKGROUND: Remote ischemic preconditioning (RIPC) has been demonstrated to prevent organ dysfunction in cardiac surgery patients. However, recent large, prospective, multicenter, randomized controlled trials (RCTs) had controversial results. Thus, a meta-analysis of RCTs was performed to investigate whether RIPC can reduce the incidence of acute myocardial infarction (AMI), acute kidney injury (AKI), and mortality in adult cardiac surgery patients. METHODS: Study data were collected from Medline, Elsevier, Cochrane Central Register of Controlled Trials and Web of Science databases...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#7
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29200368/influence-of-fasting-duration-on-body-fluid-and-hemodynamics
#8
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Fasting before general anesthesia aims to reduce the volume and acidity of stomach contents, which reduces the risk of regurgitation and aspiration. Prolonged fasting for many hours prior to surgery could lead to unstable hemodynamics, however. Therefore, preoperative oral intake of clear fluids 2 hours prior to surgery is recommended to decrease dehydration without an increase in aspiration risk. In this study, we investigated the body fluid composition and hemodynamics of patients undergoing general anesthesia as the first case of the day versus the second subsequent case...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29200367/anesthetic-management-in-mitochondrial-encephalomyopathy-a-case-report
#9
Toru Yamamoto, Noriko Miyazawa, Shinichi Yamamoto, Hiroshi Kawahara
We report on a morbidly obese 16-year-old boy (weight, 116 kg; height, 176 cm; body mass index, 35.5 kg/m2) with mitochondrial encephalomyopathy and a history of cerebral infarction, epilepsy, and severe mental retardation. The patient was scheduled for elective surgery under general anesthesia for multiple dental caries and entropion of the left eye. Preoperative examination results, including an electrocardiogram, were normal. No obvious cardiac function abnormalities were observed on echocardiography. Midazolam (10 mg) was administered orally as premedication 30 minutes before transfer to the operating room; however, the patient was uncooperative, and his body movements were difficult to control upon entering the operating room...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29199541/impact-of-temperature-on-the-narcotrend-index-during-hypothermic-cardiopulmonary-bypass-in-children-with-sevoflurane-anesthesia
#10
Nils Dennhardt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Alexander Horke, Sebastian Tiedge, Martin Boehne, Robert Sümpelmann
BACKGROUND: During cardiopulmonary bypass (CPB) in children, anesthesia maintained by sevoflurane administered via the oxygenator is increasingly common. Anesthetic uptake and requirement may be influenced by the non-physiological conditions during hypothermic CPB. Narcotrend-processed EEG monitoring may, therefore, be useful to guide the administration of sevoflurane during this phase. OBJECTIVE: The objective of this prospective, clinical, observational study was to assess the correlation between body temperature, Narcotrend Index (NI) and administered sevoflurane in children during CPB...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29189439/leading-causes-of-anesthesia-related-liability-claims-in-ambulatory-surgery-centers
#11
Darrell Ranum, Anair Beverly, Fred E Shapiro, Richard D Urman
OBJECTIVE: We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). METHODS: We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value...
November 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29187656/-perioperative-safety-of-tibetan-children-with-congenital-heart-disease-undergoing-cardiac-surgery-and-anesthesia-in-low-altitude-area
#12
Yundan Pan, Jiaojiao Niu, Gang Qin, Lu Wang, Fan Zhang, E Wang
To observe the clinical parameters and short-term prognosis of Tibetan high-altitude area children with congenital heart disease undergoing surgery and anaesthesia in low-altitude area, and to investigate the perioperative safety of the treatment.
 Methods: From January, 2016 to December, 2016, 14 children with congenital heart disease who underwent surgery were assigned into 2 groups (n=7 each): the high-altitude area group (X group, children from Tibetan Autonomous Region) and the low-altitude area group (H group, children from Hunan Province)...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29183368/incidence-of-orthostatic-hypotension-and-cardiovascular-response-to-postoperative-early-mobilization-in-patients-undergoing-cardiothoracic-and-abdominal-surgery
#13
Masatoshi Hanada, Yuichi Tawara, Takuro Miyazaki, Shuntaro Sato, Yosuke Morimoto, Masato Oikawa, Hiroshi Niwa, Kiyoyuki Eishi, Takeshi Nagayasu, Susumu Eguchi, Ryo Kozu
BACKGROUND: In cardiothoracic and abdominal surgery, postoperative complications remain major clinical problems. Early mobilization has been widely practiced and is an important component in preventing complications, including orthostatic hypotension (OH) during postoperative management. We investigated cardiovascular response during early mobilization and the incidence of OH after cardiothoracic and abdominal surgery. METHODS: In this prospective observational study, we consecutively analyzed data from 495 patients who underwent elective cardiothoracic and abdominal surgery...
November 28, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29159490/-prewarming-according-to-the-awmf-s3-guidelines-on-preventing-inadvertant-perioperative-hypothermia-2014-retrospective-analysis-of-7786-patients
#14
R Grote, A J Wetz, A Bräuer, M Menzel
BACKGROUND: Inadvertent perioperative hypothermia, which is defined as a core body temperature of less than 36.0 °C, can have serious consequences in surgery patients. These include cardiac complications, increased blood loss, wound infections and postoperative shivering; therefore, the scientific evidence that inadvertent perioperative hypothermia should be avoided is undisputed and several national guidelines have been published summarizing the scientific evidence and recommending specific procedures...
November 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29151335/comparison-of-tidal-volume-and-deep-breath-preoxygenation-techniquesundergoing-coronary-artery-bypass-graft-surgery-effects-of-hemodynamicresponse-and-arterial-oxygenation
#15
Zafer Taş, Tülay Hoşten, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Ahmet Arıkan, Zeynep Mine Solak
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29151310/comparison-of-the-cardioprotective-effects-of-dexmedetomidineand-remifentanil-in-cardiac-surgery
#16
Mediha Türktan, Yasemin Güneş, Hafize Yalınız, Selçuk Matyar, Zehra Hatipoğlu, Ersel Güleç, Uğur Göçen, Atakan Atalay
Background/aim: Myocardial protection is an important factor of open heart surgery and biological biomarkers (lactate, CKMB, cardiac troponin I, and pyruvate) are used to assess myocardial damage. This study compares the effects of dexmedetomidine and remifentanil on myocardial protection during coronary artery bypass grafting (CABG) surgery. Materials and methods: Patients scheduled for elective CABG surgery (n = 60) were included in this study. Anesthesia induction was introduced with propofol, fentanyl, and vecuronium bromide...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29149820/mechanisms-of-cardioprotection-of-halogenated-agents-during-extracorporeal-circulation-in-cardiac-surgery
#17
M Ramirez Aliaga, J J Escalona Belmonte, Alicia Ramirez-Fernandez, M Rubio Navarro, J Cruz Manas
The implementation of cardioprotective strategies involving pre-, intra-, and postoperative interventions is key during cardiac surgery requiring extracorporeal circulation (ECC). The primary goal of this study was to review the physiopathology of and protection strategies against myocardial damage secondary to ECC during cardiac surgery. The administration of halogenated anesthetics for cardiac anesthesia is commonplace due to their well-known cardioprotective effects and their capacity to ensure hypnosis...
November 16, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29140967/near-infrared-spectroscopy-and-vascular-occlusion-test-for-predicting-clinical-outcome-in-pediatric-cardiac-patients-a-prospective-observational-study
#18
Ji-Hyun Lee, Young-Eun Jang, In-Kyung Song, Eun-Hee Kim, Hee-Soo Kim, Jin-Tae Kim
OBJECTIVES: This study is designed to determine the feasibility and utility of vascular occlusion test variables as measured by INVOS Medtronic, Dublin, Ireland) in pediatric cardiac patients. DESIGN: A prospective observational study. SETTING: A tertiary children's hospital. PATIENTS: Children less than or equal to 8 years old who were scheduled for elective cardiac surgery under cardiopulmonary bypass. INTERVENTIONS: A vascular occlusion test (3 min of ischemia and reperfusion) was performed on the calf at three time points: after induction of anesthesia (T0), during cardiopulmonary bypass (T1), and after sternal closure (T2)...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29132699/is-endocan-a-diagnostic-marker-for-pneumonia-after-cardiac-surgery-the-endolung-study
#19
Andréa Perrotti, Camille Chenevier-Gobeaux, Fiona Ecarnot, Karine Bardonnet, Benoit Barrucand, Guillaume Flicoteaux, Philippe Lassalle, Sidney Chocron
BACKGROUND: Postoperative pneumonia is frequent after cardiac surgery and is associated with increased morbidity and mortality. We tested the hypothesis that endocan is an early biomarker for the detection of pneumonia after cardiac surgery. METHODS: Between January and May 2016, 155 patients scheduled to undergo elective cardiac surgery with cardiopulmonary bypass were prospectively included in the study. Serum level of endocan was measured at five timepoints (preoperative, and at 6, 24, 48, and 72 hours after the end of surgery)...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#20
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
BACKGROUND: The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. METHODS: In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 30, 2017: New England Journal of Medicine
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