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Intraoperative ventilation

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https://www.readbyqxmd.com/read/28203413/better-perioperative-outcomes-in-thoracoscopic-esophagectomy-with-two-lung-ventilation-in-semi-prone-position
#1
Lei Cai, Yan Li, Li Sun, Xue-Wen Yang, Wen-Bin Wang, Fan Feng, Guang-Hui Xu, Man Guo, Xiao Lian, Hong-Wei Zhang
BACKGROUND: One-lung ventilation (OLV) anesthesia intubation route is often used in patients undergoing thoracoscopic-esophagectomy in semi-prone position. Recently, the two-lung ventilation (TLV) approach becomes popular. However, limited studies have compared the two ventilation approaches in parallel. Here, we report a single-center, retrospective study of comparing TLV and OLV approach in patients undergoing thoracoscopic-esophagectomy in semi-prone position. METHODS: From January 2013 to November 2014, 147 patients were enrolled into the current study and were given thoracoscopic-esophagectomy in semi-prone position either by OLV or TLV...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28197273/clinical-and-surgical-strategies-for-avoiding-or-reducing-allogeneic-blood-transfusions
#2
Antonio Alceu Dos Santos, Jose Francisco Baumgratz, Jose Henrique Andrade Vila, Rodrigo Moreira Castro, Rodrigo Freire Bezerra
Blood transfusions have still been used as a standard therapy to treat severe anemia. Current evidences point to both excessive allogeneic blood consumption and decreased donations, which result in reduced stocks in blood banks. Several studies have increasingly suggested a more restrictive transfusion practice for blood products. Currently, a number of autologous blood conservation protocols in surgeries have been noted. We report a case of severe anemia with 2.9 g/dL hemoglobin, which was successfully handled without using the standard therapy to treat anemia with hemotransfusions...
April 2016: Cardiology Research
https://www.readbyqxmd.com/read/28187051/kinetics-of-plasma-biomarkers-of-inflammation-and-lung-injury-in-surgical-patients-with-or-without-postoperative-pulmonary-complications
#3
Ary Serpa Neto, Pedro P Z A Campos, Sabrine N T Hemmes, Lieuwe D Bos, Thomas Bluth, Marion Ferner, Andreas Güldner, Markus W Hollmann, Inmaculada India, Thomas Kiss, Rita Laufenberg-Feldmann, Juraj Sprung, Demet Sulemanji, Carmen Unzueta, Marcos F Vidal Melo, Toby N Weingarten, Anita M Tuip-de Boer, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz
BACKGROUND: Postoperative pulmonary complications (PPCs) are common after major abdominal surgery. The kinetics of plasma biomarkers could improve identification of patients developing PPCs, but the kinetics may depend on intraoperative ventilator settings. OBJECTIVE: To test whether the kinetics of plasma biomarkers are capable of identifying patients who will develop PPCs, and whether the kinetics depend on the intraoperative level of positive end-expiratory pressure (PEEP)...
February 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28183564/the-effect-of-tramadol-plus-paracetamol-on-consumption-of-morphine-after-coronary-artery-bypass-grafting
#4
Dilek Altun, Özlem Çınar, Emre Özker, Ayda Türköz
STUDY OF OBJECTIVE: To compare the effects of oral tramadol+paracetamol combination on morphine consumption following coronary artery bypass grafting (CABG) in the patient-controlled analgesia (PCA) protocol. DESIGN: A prospective, double-blind, randomized, clinical study. SETTING: Single-institution, tertiary hospital. PATIENTS: Fifty cardiac surgical patients undergoing primary CABG surgery. INTERVENTIONS: After surgery, the patients were allocated to 1 of 2 groups...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28122491/mild-volume-acute-normovolemic-hemodilution-is-associated-with-lower-intraoperative-transfusion-and-postoperative-pulmonary-infection-in-patients-undergoing-cardiac-surgery-a-retrospective-propensity-matching-study
#5
Zhen-Feng Zhou, Xiu-Ping Jia, Kai Sun, Feng-Jiang Zhang, Li-Na Yu, Tian Xing, Min Yan
BACKGROUND: Perioperative allogenic transfusion is required in almost 50% of patients undergoing cardiac surgery and is associated with higher risk of mortality and morbidity (Xue et al., Lancet 387:1905, 2016; Ferraris et al., Ann Thorac Surg 91:944-82, 2011). Acute normovolemic hemodilution (ANH) is recommended as a potential strategy during cardiac surgery, but the blood conservation effect and the degree of ANH was still controversial. There is also an increasing concern about the improved outcomes associated with ANH...
January 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28114921/prevention-of-hypothermia-in-patients-undergoing-orthotopic-liver-transplantation-using-the-humigard%C3%A2-open-surgery-humidification-system-a-prospective-randomized-pilot-and-feasibility-clinical-trial
#6
RANDOMIZED CONTROLLED TRIAL
Laurence Weinberg, Andrew Huang, Daniel Alban, Robert Jones, David Story, Larry McNicol, Brett Pearce
BACKGROUND: Perioperative thermal disturbances during orthotopic liver transplantation (OLT) are common. We hypothesized that in patients undergoing OLT the use of a humidified high flow CO2 warming system maintains higher intraoperative temperatures when compared to standardized multimodal strategies to maintain thermoregulatory homeostasis. METHODS: We performed a randomized pilot study in adult patients undergoing primary OLT. Participants were randomized to receive either open wound humidification with a high flow CO2 warming system in addition to standard care (Humidification group) or to standard care alone (Control group)...
January 23, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#7
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
December 23, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28101662/strategies-to-prevent-cast-formation-in-patients-with-plastic-bronchitis-undergoing-heart-transplantation
#8
John J Parent, Robert K Darragh, Jeffrey G Gossett, Thomas D Ryan, Chet R Villa, Angela Lorts, John L Jefferies, Jeffrey A Towbin, Clifford Chin
Plastic bronchitis, a rare complication after Fontan palliation, carries a high morbidity and mortality risk. Heart transplantation is an effective treatment option, but casts may occur in the early post-operative period. We present a case series detailing peri-operative management strategies to minimize morbidity and mortality related to plastic bronchitis in patients undergoing heart transplantation. Patient 1 received no treatment pre-, intra-, or post-transplant for prevention of bronchial casts and developed severe respiratory acidosis 18 h following transplant...
January 19, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28096580/randomized-double-blind-comparison-of-remifentanil-and-alfentanil-in-patients-undergoing-laparoscopic-cholecystectomy-using-total-intravenous-anesthesia
#9
José M Beleña, Mónica Núñez, Alfonso Vidal, Diego Anta
BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096575/the-effect-of-epidural-dexmedetomidine-on-oxygenation-and-shunt-fraction-in-patients-undergoing-thoracotomy-and-one-lung-ventilation-a-randomized-controlled-study
#10
Prachi Kar, Padmaja Durga, Ramachandran Gopinath
BACKGROUND AND AIMS: Role of epidural dexmedetomidine in providing analgesia is well documented, but its effect on oxygenation and shunt fraction is not well established. We studied the hypothesis that epidural dexmedetomidine may improve oxygenation and shunt fraction during one-lung ventilation (OLV). MATERIAL AND METHODS: After taking Institutional Ethics Committee approval, sixty patients undergoing thoracotomy and OLV were randomized to receive epidural ropivacaine with saline (RS group) or epidural ropivacaine with dexmedetomidine (RD group)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28092320/does-a-platelet-transfusion-independently-affect-bleeding-and-adverse-outcomes-in-cardiac-surgery
#11
Fabienne M A van Hout, Esther K Hogervorst, Peter M J Rosseel, Johanna G van der Bom, Mohamed Bentala, Eveline L A van Dorp, Nan van Geloven, Anneke Brand, Nardo J M van der Meer, Leo M G van de Watering
BACKGROUND: Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients. METHODS: For this observational study, 23,860 cardiac surgery patients were analyzed. Patients who received one early (shortly after cardiopulmonary bypass while still in the operating room) platelet transfusion, and no other transfusions, were defined as the intervention group...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28089646/a-risk-score-to-predict-the-incidence-of-prolonged-air-leak-after-video-assisted-thoracoscopic-lobectomy-an-analysis-from-the-european-society-of-thoracic-surgeons-database
#12
Cecilia Pompili, Pierre Emmanuel Falcoz, Michele Salati, Zalan Szanto, Alessandro Brunelli
OBJECTIVE: The study objective was to develop an aggregate risk score for predicting the occurrence of prolonged air leak after video-assisted thoracoscopic lobectomy from patients registered in the European Society of Thoracic Surgeons database. METHODS: A total of 5069 patients who underwent video-assisted thoracoscopic lobectomy (July 2007 to August 2015) were analyzed. Exclusion criteria included sublobar resections or pneumonectomies, lung resection associated with chest wall or diaphragm resections, sleeve resections, and need for postoperative assisted mechanical ventilation...
December 22, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#13
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074797/minimally-invasive-compared-to-conventional-approach-for-coronary-artery-bypass-grafting-improves-outcome
#14
Jitumoni Baishya, Antony George, Jayaprakash Krishnamoorthy, Geetha Muniraju, Murali Chakravarthy
INTRODUCTION: Minimally invasive (MI) cardiac surgery is a rapidly gaining popularity, globally as well as in India. We aimed to compare the outcome of MI to the conventional approach for coronary artery bypass graft (CABG) surgery. METHODS: This prospective, comparative study was conducted at a tertiary care cardiac surgical center. All patients who underwent CABG surgery via MI approach (MI group) from July 2015 to December 2015 were enrolled and were compared against same number of EuroSCORE II matched patients undergoing CABG through conventional mid-sternotomy approach (CON group)...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072601/risk-factors-and-clinical-outcomes-associated-with-perioperative-transfusion-associated-circulatory-overload
#15
Leanne Clifford, Qing Jia, Arun Subramanian, Hemang Yadav, Darrell R Schroeder, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. METHODS: In this case-control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28066607/risk-factors-and-outcome-of-primary-graft-dysfunction-after-lung-transplantation-in-korea
#16
Sungwoo Moon, Moo Suk Park, Jin Gu Lee, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Hyo Chae Paik, Song Yee Kim
BACKGROUND: Primary graft dysfunction (PGD) is a severe, acute and post-transplantation lung injury associated with early morbidity and mortality. We aimed to identify clinical risk factors for PGD, as well as the outcome of PGD after lung transplantation in Korea. METHODS: We retrospectively analyzed lung transplant patients in a South Korean Hospital. The primary outcome was grade 3 PGD, defined according to the International Society for Heart and Lung Transplantation criteria...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28051921/tube-thoracostomy-at-the-time-of-congenital-diaphragmatic-hernia-repair-reassessing-the-risks-and-benefits
#17
Avraham Schlager, Kelly Arps, Ragavan Siddharthan, Matthew S Clifton
PURPOSE: Postoperative pneumothorax and effusion remain a concern following congenital diaphragmatic hernia (CDH) repair. Despite a recent trend away from intraoperative thoracostomy, few studies have actually compared outcomes with and without a chest tube. Rationale commonly cited for the more minimalistic approach include the presumed low likelihood of postoperative complications, potential risk of patch infection, and prolonged intubation. We evaluate these theories, as well as the implications of intraoperative chest tube (IOCT) placement...
January 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28033082/surgical-site-infection-after-pediatric-cardiothoracic-surgery
#18
Anthony A Sochet, Alexander M Cartron, Aoibhinn Nyhan, Michael C Spaeder, Xiaoyan Song, Anna T Brown, Darren Klugman
BACKGROUND: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. METHODS: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28009669/effect-of-peak-inspiratory-pressure-on-the-development-of-postoperative-pulmonary-complications-in-mechanically-ventilated-adult-surgical-patients-a-systematic-review-protocol
#19
Chelsa Wamsley, Donald Missel
The objective is to identify the effect of peak inspiratory pressure on the development of postoperative pulmonary complications.More specifically, the objective is to identify the effect of maintaining intraoperative peak inspiratory pressure less than or equal to 30 cmH2O compared with peak inspiratory pressure greater than 30 cmH2O on the incidence of postoperative atelectasis, pneumonia and acute respiratory distress syndrome in mechanically ventilated adult surgical patients.
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28008896/-anesthesia-during-video-assisted-thoracoscopic-lobectomy-using-laryngeal-ductwork-and-auxiliary-mechanical-ventilation
#20
V A Porkhanov, I S Polyakov, V V Danilov, V B Kononenko, V A Zhikharev
The article presents the experience of video-assisted thoracoscopic lobectomies in patients without endotracheal intubation and sparing of spontaneous breathing. The results of intraoperative monitoring and laboratory data of all perioperative period are described. In view of these data it was concluded that such approach can decline the severity of stress-response against surgical aggression in this group of patients.
2016: Khirurgiia
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