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Intraoperative ventilation

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https://www.readbyqxmd.com/read/27906718/anesthesia-for-nonintubated-video-assisted-thoracic-surgery
#1
Hiroshi Sunaga, Justin D Blasberg, Paul M Heerdt
PURPOSE OF REVIEW: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. RECENT FINDINGS: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#2
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27904919/-seasonal-differences-of-tympanogram-and-middle-ear-findings-in-children-german-version
#3
S Knopke, A Böttcher, P Chadha, H Olze, F Bast
BACKGROUND: It is a known fact that bacterial or viral acute otitis media occurs more frequently in the winter months. Only a few older studies on seasonal differences in middle ear findings are available. These studies are based solely on tympanography, without correlation to intraoperative middle ear findings. This study addresses the question of whether seasonal differences can be found in the preoperative tympanogram and in the corresponding intraoperative findings in children with chronic middle ear problems...
November 30, 2016: HNO
https://www.readbyqxmd.com/read/27878479/total-transthoracic-approach-facilitates-laparoscopic-hepatic-resection-in-patients-with-significant-prior-abdominal-surgery
#4
Suguru Yamashita, Evelyne Loyer, Hyunseon C Kang, Thomas A Aloia, Yun Shin Chun, Reza J Mehran, Cathy Eng, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: While the oncologic safety of minimally invasive hepatectomy for colorectal liver metastases (CLM) has been demonstrated, lesions in the postero-superior segments may be challenging.1 (-) 3 For these lesions, a transthoracic approach may be particularly helpful, especially in patients with a hostile/reoperative abdomen or morbid obesity.4 (,) 5 PATIENT: A 43-year-old man with a body mass index of 36.0 who had undergone rectosigmoid resection for primary cancer 5 years ago recurred with a solitary liver metastasis in SVIII...
November 22, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27856390/a-comparison-of-balanced-and-unbalanced-crystalloid-solutions-in-surgery-patient-outcomes
#5
Tomas Kuca, Michael B Butler, Mete Erdogan, Robert S Green
INTRODUCTION: The objective of this study was to evaluate adverse patient outcomes associated with the choice of intravenous fluid administered during general anaesthesia. METHODS: This study was a retrospective chart review of vascular surgery patients at a Canadian tertiary care hospital. Patients were separated into three groups: those who were intraoperatively administered normal saline (NS), balanced crystalloids, or a combination of both solutions. Multivariate analysis was performed to determine association between volume of each fluid type administered and adverse outcomes including in-hospital mortality, prolonged intensive care unit admission, vasopressor requirement, ventilator requirement, hemodialysis requirement, and a composite endpoint of any of these adverse events occurring...
November 14, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27855591/effects-of-perioperative-fluid-replacement-therapy-in-lung-transplant-patients
#6
Emil Björkbom, Pekka Hämmäinen, Alexey Schramko
OBJECTIVES: Approximately 10 to 25 lung transplant procedures are performed annually in Finland, and 1-year survival has been 95% over the last 10 years. Our aim was to find associations between perioperative fluid replacement therapies and postoperative patient outcomes, with special emphasis on the use of colloids and blood products. MATERIALS AND METHODS: We retrospectively evaluated data from 100 patients who underwent lung transplant with cardiopulmonary bypass support in Finland from 2007 to 2013...
November 18, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27850683/1045-changes-in-cerebral-oxygenation-based-on-intraoperative-ventilation-strategy
#7
Jeffrey Naples, Mumin Hakim, Hina Walia, Joseph Tobias
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27828807/predictors-and-outcomes-of-sternotomy-conversion-and-cardiopulmonary-bypass-assistance-in-minimally-invasive-coronary-artery-bypass-grafting
#8
Maria L Rodriguez, Harry R Lapierre, Benjamin Sohmer, Jean-Philippe Ruel, Marc A Ruel
OBJECTIVE: This work's objective was to identify the determinants of conversion of minimally invasive coronary artery bypass grafting to sternotomy, with and without cardiopulmonary bypass assistance, and to compare clinical outcomes in patients who needed conversion. METHODS: This is a prospectively collected data on patients who underwent minimally invasive coronary bypass done by a single surgeon from February 2005 to September 2014. Statistical analyses were expressed as mean values ± standard deviation or proportions...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27816133/anesthesia-for-patients-with-concomitant-sepsis-and-cardiac-dysfunction
#9
REVIEW
Abed Abubaih, Charles Weissman
Anesthesiologists faced with a patient with sepsis and concurrent cardiac dysfunction must be cognizant of the patient's cardiac status and cause of the cardiac problem to appropriately adapt physiologic and metabolic monitoring and anesthetic management. Anesthesia in such patients is challenging because the interaction of sepsis and cardiac dysfunction greatly complicates management. Intraoperative anesthesia management requires careful induction and maintenance of anesthesia; optimizing intravascular volume status; avoiding lung injury during mechanical ventilation; and close monitoring of arterial blood gases, serum lactate concentrations, and hematology renal and electrolyte parameters...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27815701/laparoscopic-versus-open-distal-pancreatectomy-a-propensity-score-matched-analysis-from-the-german-studoq-pancreas-registry
#10
Ulrich Friedrich Wellner, Hryhoriy Lapshyn, Detlef K Bartsch, Ioannis Mintziras, Ulrich Theodor Hopt, Uwe Wittel, Hans-Jörg Krämling, Hubert Preissinger-Heinzel, Matthias Anthuber, Bernd Geissler, Jörg Köninger, Katharina Feilhauer, Merten Hommann, Luisa Peter, Natascha C Nüssler, Thomas Klier, Ulrich Mansmann, Tobias Keck
PURPOSE: The aim of this study was to assess intraoperative, postoperative, and oncologic outcome in patients undergoing laparoscopic distal pancreatectomy (LDP) versus open distal pancreatectomy (ODP) for benign and malignant lesions of the pancreas. METHODS: Data from patients undergoing distal pancreatic resection were extracted from the StuDoQ|Pancreas registry of the German Society for General and Visceral Surgery. After propensity score case matching, groups of LDP and ODP were compared regarding demography, comorbidities, operative details, histopathology, and perioperative outcome...
November 4, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27810167/comparative-clinical-outcomes-after-thymectomy-for-myasthenia-gravis-thoracoscopic-versus-trans-sternal-approach
#11
Sophon Siwachat, Apichat Tantraworasin, Worakitti Lapisatepun, Chidchanok Ruengorn, Emanuela Taioli, Somcharoen Saeteng
BACKGROUND: Thymectomy is an effective treatment option for long-term remission of myasthenia gravis. The superiority of the trans-sternal and thoracoscopic surgical approaches is still being debated. The aims of this study are to compare postoperative outcomes and neurologic outcomes between the two approaches and to identify prognostic factors for complete stable remission (CSR). METHODS: Myasthenia gravis patients who underwent thymectomy with trans-sternal or thoracoscopic approach in MahaRaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between January1, 2006 and December 31, 2013 were retrospectively reviewed...
November 1, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27805961/intraoperative-adverse-events-in-abdominal-surgery-what-happens-in-the-operating-room-does-not-stay-in-the-operating-room
#12
Jordan D Bohnen, Michael N Mavros, Elie P Ramly, Yuchiao Chang, D Dante Yeh, Jarone Lee, Marc de Moya, David R King, Peter J Fagenholz, Kathryn Butler, George C Velmahos, Haytham M A Kaafarani
OBJECTIVE: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. SUMMARY OF BACKGROUND DATA: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. METHODS: The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration"...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27788818/similar-mortality-and-morbidity-of-orthotopic-heart-transplantation-for-patients-70-years-of-age-and-older-compared-with-younger-patients
#13
M Awad, L S C Czer, J Mirocha, A Ruzza, M de Robertis, M Rafiei, H Reich, M Sasevich, K Rihbany, R Kass, J Kobashigawa, F Arabia, A Trento, F Esmailian, D Ramzy
BACKGROUND: The upper age limit of heart transplantation remains controversial. The goal of the present study was to investigate the mortality and morbidity of orthotopic heart transplantation (HT) for recipients ≥70 compared with those <70 years of age. METHODS: Of 704 adults who underwent HT from December 1988 to June 2012 at our institution, 45 were ≥70 years old (older group) and 659 were <70 years old (younger group). Survival, intraoperative blood product usage, intensive care unit (ICU) and hospital stays, and frequency of reoperation for chest bleeding, dialysis, and >48 hours ventilation were examined after HT...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788811/effects-of-intraoperative-magnesium-sulfate-administration-on-postoperative-tramadol-requirement-in-liver-transplantation-a-prospective-double-blind-study
#14
B Gucyetmez, H K Atalan, S Aslan, S Yazar, K Y Polat
BACKGROUND: Magnesium is an N-methyl-d-aspartate receptor blocker and is known to have analgesic effect. Hypomagnesemia can often be seen in liver transplantation and may be associated with higher morbidity and mortality. The objective of this study was to investigate the effects of intraoperative magnesium sulfate administration on postoperative tramadol requirement in liver transplant patients. METHODS: Liver transplant patients >18 years of age were screened prospectively from October 2014 to April 2015...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27784315/intraoperative-hemidiaphragm-electrical-stimulation-reduces-oxidative-stress-and-upregulates-autophagy-in-surgery-patients-undergoing-mechanical-ventilation-exploratory-study
#15
Robert T Mankowski, Shakeel Ahmed, Thomas Beaver, Marvin Dirain, Chul Han, Phillip Hess, Tomas Martin, Barbara K Smith, Shinichi Someya, Christiaan Leeuwenburgh, A Daniel Martin
BACKGROUND: Mechanical ventilation (MV) during a cardio-thoracic surgery contributes to diaphragm muscle dysfunction that impairs weaning and can lead to the ventilator- induced diaphragm dysfunction. Especially, it is critical in older adults who have lower muscle reparative capacity following MV. Reports have shown that the intraoperative intermittent hemidiaphragm electrical stimulation can maintain and/or improve post-surgery diaphragm function. In particular, from a molecular point of view, intermittent ES may reduce oxidative stress and increase regulatory autophagy levels, and therefore improve diaphragm function in animal studies...
October 26, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27764049/current-trends-in-anesthesia-for-esophagectomy
#16
Chris Durkin, Travis Schisler, Jens Lohser
PURPOSE OF REVIEW: Despite marked improvements in perioperative outcomes, esophagectomy continues to be a high-risk operation associated with significant morbidity and mortality. Progress has been achieved through evidence-based changes in preoperative optimization, intraoperative ventilation strategies, fluid therapy, and analgesia, as well as expedited postoperative recovery pathways. This review will summarize the recent literature on the anesthetic management of patients undergoing esophageal resection...
October 18, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27763916/hemodynamic-instability-following-airway-spray-cryotherapy
#17
Alessia Pedoto, Dawn P Desiderio, David Amar, Robert J Downey
BACKGROUND: Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. METHODS: A retrospective review of a single institution experience with intraoperative and postoperative hemodynamic complications associated with SCT was performed...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27761444/outcomes-of-off-pump-versus-on-pump-coronary-artery-bypass-graft-surgery-in-patients-with-severely-dilated-left-ventricle
#18
Sen Li, Wenhui Gong, Quan Qi, Zezhe Yuan, Anqing Chen, Jun Liu, Junfeng Cai, Mi Zhou, Zhe Wang, Xiaofeng Ye, Qiang Zhao
BACKGROUND: Currently, off-pump coronary artery bypass (OPCAB) grafting has been the standard procedure for surgical revascularization in patients with coronary artery disease (CAD). This study aimed to examine the safety and applicability of OPCAB compared with on-pump coronary artery bypass (ONCAB) in patients with severely dilated left ventricle. METHODS: A retrospective study of giant left ventricle patients [left ventricular end diastolic diameter (LVEDD) ≥ VE mm] undergoing coronary bypass grafting from 2009 through 2015 at a single center was conducted...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27751832/safe-and-optimal-pneumoperitoneal-pressure-for-transperitoneal-laparoscopic-renal-surgery-in-infant-less-than-10%C3%A2-kg-looked-beyond-intraoperative-period-a-prospective-randomized-study
#19
Sanjoy K Sureka, Nitesh Patidar, Varun Mittal, Rakesh Kapoor, Aneesh Srivastava, Kamal Kishore, Sanjay Dhiraj, M S Ansari
OBJECTIVE: A safe and optimal pneumoperitoneal pressure (PP) for laparoscopic renal surgery in infants is difficult to define. In a broad sense, a safe and optimal PP should cause least intraoperative and postoperative physiological stress for the infants and should be optimal for surgeon's technical feasibility. Unfortunately, the safe and optimal PP in infant for transperitoneal laparoscopic surgery has not been established by well validated study. To determine safe and optimal PP for laparoscopic renal surgery (LRS) in infants less than 10 kg...
March 4, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27749756/is-it-necessary-to-treat-otitis-media-with-effusion-ome-prior-to-cochlear-implantation-results-over-a-long-term-follow-up
#20
Meirav Sokolov, Ohad Hilly, David Ulanovski, Yotam Shkedy, Joseph Attias, Eyal Raveh
OBJECTIVES: Evaluate the intra- and postoperative effects of untreated otitis media with effusion (OME) in cochlear implant (CI) patients, and to assess the role of ventilation tube (VT) introduction before implantation. STUDY DESIGN: A retrospective chart review. SETTING: Tertiary referral center. PATIENTS: CI patients, aged 10 years or younger, implanted during 2009 to 2013. INTERVENTIONS: Cases were divided into three groups: 1) normal aerated middle ear before CI, 2) OME treated with VT, and 3) untreated OME...
December 2016: Otology & Neurotology
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