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Intraoperative ventilation

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https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#1
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#2
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29761478/pain-relief-for-women-undergoing-oocyte-retrieval-for-assisted-reproduction
#3
REVIEW
Irene Kwan, Rui Wang, Emily Pearce, Siladitya Bhattacharya
BACKGROUND: Various methods of conscious sedation and analgesia (CSA) have been used during oocyte retrieval for assisted reproduction. The choice of agent has been influenced by the quality of sedation and analgesia and by concerns about possible detrimental effects on reproductive outcomes. OBJECTIVES: To assess the effectiveness and safety of different methods of conscious sedation and analgesia for pain relief and pregnancy outcomes in women undergoing transvaginal oocyte retrieval...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29756694/effects-of-inhalation-and-intravenous-anaesthesia-on-intraoperative-cardiopulmonary-function-and-postoperative-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#4
Qian-Yun Pang, Ran An, Hong-Liang Liu
INTRODUCTION: There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anaesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. EVIDENCE ACQUISITION: We searched the Embase, Pubmed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anaesthesia and intravenous anaesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29736359/clinical-significance-of-candida-in-an-intraoperative-peritoneal-specimen-with-perforation-peritonitis-an-institutional-perspective
#5
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/29733827/successful-use-of-sternal-sparing-minimally-invasive-surgery-for-proximal-ascending-aortic-pathology
#6
Joseph Lamelas, Peter C Chen, Gabriel Loor, Angelo LaPietra
BACKGROUND: A sternal-sparing approach to surgery of the proximal aorta could decrease postoperative morbidity. METHODS: To determine the potential benefits of using a minimally invasive right thoracotomy approach for the treatment of ascending aortic pathology, we retrospectively reviewed our experience in patients who required circulatory arrest for the treatment of ascending aortic pathology (with or without aortic valve involvement) between January 2009 and November 2014 (N=177)...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29732908/airway-anomalies-in-patients-with-22q11-2-deletion-syndrome-a-5-year-review
#7
Joel W Jones, Meghan Tracy, Mollie Perryman, Jill M Arganbright
OBJECTIVES: To characterize the frequency of airway anomalies in patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Retrospective review of patients with 22q11DS who had undergone microlaryngoscopy/bronchoscopy (MLB) for aerodigestive symptoms at a tertiary care children's hospital from 2011 to 2016. RESULTS: Thirty patients underwent an MLB due to the following indications: aspiration (11), stridor (10), chronic respiratory failure due to ventilator dependence (8), and difficult intubation (1)...
May 1, 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#8
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29729016/revision-thoracic-slide-tracheoplasty-outcomes-following-unsuccessful-tracheal-reconstruction
#9
Douglas R Sidell, Catherine K Hart, Meredith E Tabangin, Roosevelt Bryant, Michael J Rutter, Peter B Manning, Jareen Meinzen-Derr, Karthik Balakrishnan, Christina Yang, Alessandro de Alarcon
OBJECTIVES/HYPOTHESIS: Over the past decade, thoracic slide tracheoplasty (TST) has become the principal operation in the management of congenital tracheal stenosis. The purpose of this report was to describe our experience with revision TST following unsuccessful prior tracheal reconstruction. STUDY DESIGN: Retrospective analysis at an academic children's hospital. METHODS: Patients undergoing TST on cardiopulmonary bypass between January 2005 and May 2014 were reviewed...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29721817/the-impact-of-hyperoxia-on-outcomes-after-cardiac-surgery-a-systematic-review-and-narrative-synthesis
#10
Jeffrey Heinrichs, Carly Lodewyks, Christine Neilson, Ahmed Abou-Setta, Hilary P Grocott
PURPOSE: Historically, cardiac surgery patients have often been managed with supraphysiologic intraoperative oxygen levels to protect against the risks of cellular hypoxia inherent in the un-physiologic nature of surgery and cardiopulmonary bypass. This may result in excessive reactive oxygen species generation and exacerbation of ischemia-reperfusion injury. In this review, we synthesize all available data from randomized controlled trials (RCTs) to investigate the impact that hyperoxia has on postoperative organ dysfunction, length of stay, and mortality during adult cardiac surgery...
May 2, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29717097/30-day-morbidity-and-mortality-rates-in-elderly-subjects-following-surgical-tracheostomy
#11
Sharon Ovnat Tamir, Nadia Khalaily, Sharon Einav, Shay Shemesh, Ofer Gluck, Tal Marom
BACKGROUND: Tracheostomy is considered to be effective in the respiratory support of mechanically ventilated patients. We studied a single-center experience of surgical tracheostomy in mechanically ventilated patients to describe the demographics, risk factors, and outcomes of early (≤ 14 d after ventilation) versus late surgical tracheostomy (≥ 15 d after ventilation). METHODS: In this retrospective study, we collected demographic data, medical history, timing of surgical tracheostomy in relation to ventilation day, blood test results, preoperative surgical assessment (subjective impression of neck length, difficulty in neck extension, presence of a goiter), intraoperative complications (bleeding > 100 mL, difficulties in cannula insertion), and postoperative morbidities (bleeding, wound infection, fever, inadvertent de-cannulation, and 30-d postoperative mortality rate) of subjects who underwent surgical tracheostomy in a secondary medical center during 2010-2015...
May 1, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29709469/effect-of-resident-involvement-on-morbidity-and-mortality-following-thoracic-endovascular-aortic-repair
#12
Derrick O Acheampong, Philip Paul, Shanice Guerrier, Percy Boateng, I Michael Leitman
OBJECTIVE: To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR). SUMMARY OF BACKGROUND DATA: Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012...
April 27, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29709437/the-effects-of-an-open-lung-approach-during-one-lung-ventilation-on-postoperative-pulmonary-complications-and-driving-pressure-a-descriptive-multicenter-national-study
#13
Javier Belda, Carlos Ferrando, Ignacio Garutti
OBJECTIVE: Thoracic surgical procedures are associated with an increased risk of postoperative pulmonary complications (PPCs), which seem to be related directly to intraoperative driving pressure. The authors conducted this study to describe the incidence of PPCs in patients in whom an individualized open-lung approach was applied during one-lung ventilation. DESIGN: This was a prospective, multicenter, national descriptive study. SETTING: Thoracic surgery patients undergoing one-lung ventilation...
March 27, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29707346/a-comparison-between-two-lung-ventilation-with-co-2-artificial-pneumothorax-and-one-lung-ventilation-during-thoracic-phase-of-minimally-invasive-esophagectomy
#14
Miao Lin, Yaxing Shen, Hao Wang, Yong Fang, Cheng Qian, Songtao Xu, Di Ge, Mingxiang Feng, Lijie Tan, Qun Wang
Background: To investigate the feasibility and safety of two lung ventilation with artificial pneumothorax in minimally invasive esophagectomy (MIE) through a comparison with conventional one lung ventilation. Methods: Eleven hundred and sixty-six patients with esophageal cancer, who underwent McKeown MIE in our center from February 2006 to December 2016, were studied retrospectively. Seven hundred and five patients who underwent one lung ventilation with double lumen endotracheal tube (DLET) were assigned to DLET group...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707324/non-intubated-thoracoscopic-bullectomy-under-sedation-is-safe-and-comfortable-in-the-perioperative-period
#15
Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min
Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29696515/use-of-bioglue%C3%A2-to-seal-a-difficult-to-treat-air-leak-in-a-complicated-empyema-patient
#16
Vasileios Kouritas, Emmanouel Kefaloyannis, Peter Tcherveniakov
Surgical sealants have been used in thoracic surgery in an effort to reduce air leak duration, intercostal drain duration, length of stay and complications. They are instilled over a defect usually treated with other means. We herein present the technique of controlling a difficult to treat defect by directly instilling Bioglue™ alone into a crater, caused during empyema Video-assisted thoracic surgery in a 50-year-old patient with a trapped lung. This deep crater had caused a significant air leak rendering intraoperative ventilation challenging...
April 25, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29688922/the-use-of-high-frequency-percussive-ventilation-for-whole-lung-lavage-a-case-report
#17
Sudhakar Kinthala, Mark Liang, Felix Khusid, Sebron Harrison
Whole-lung lavage (WLL) remains the gold standard in the treatment of pulmonary alveolar proteinosis. However, anesthetic management during WLL can be challenging because of the risk of intraoperative hypoxemia and various cardiorespiratory complications of 1-lung ventilation. Here, we describe a novel strategy involving the application of high-frequency percussive ventilation using a volumetric diffusive respirator (VDR-4) during WLL in a 47-year-old woman with pulmonary alveolar proteinosis. Our observations suggest that high-frequency percussive ventilation is a potentially effective ventilation strategy during WLL that may reduce the risk of hypoxemia and facilitate lavage...
April 23, 2018: A&A practice
https://www.readbyqxmd.com/read/29657253/minimally-invasive-mitral-valve-repair-through-right-minithoracotomy-11-year-single-institute-experience
#18
Taichi Sakaguchi, Toshinori Totsugawa, Masahiko Kuinose, Kentaro Tamura, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka
BACKGROUND: Although minimally invasive mitral valve repair (MIMVR) is increasingly being performed, only a few clinical studies from Japanese institutions have been reported.Methods and Results:From 2006 to 2017, 387 consecutive patients (135 females, mean age 56±13 years) underwent an initial isolated MIMVR through a right minithoracotomy. The mitral etiology was degenerative in 348, functional in 22, and endocarditis in 13 cases. Repair techniques included leaflet resection/plication in 280, chordal reconstruction in 109, and annuloplasty alone in 24 patients, and concomitant procedures included tricuspid valve repair and atrial fibrillation ablation in 70 (18...
April 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29643552/anaesthetic-management-and-perioperative-outcomes-of-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy-a-retrospective-analysis
#19
Kalpana P Balakrishnan, Sreedevi Survesan
Background and Aims: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming the standard treatment option for peritoneal carcinomatosis but is associated with high rates of morbidity and mortality. Our aim was to retrospectively analyse and evaluate intra-operative factors associated with morbidity and mortality of CRS and HIPEC. Methods: Intra-operative data were collected for cases done over 1 year (24 cases) and analysed for the primary outcome of post-operative ventilation >24 h, and secondary outcome of length of the Intensive Care Unit (ICU) stay >5 days...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#20
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
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