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Intraoperative ventilation

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https://www.readbyqxmd.com/read/28331446/lung-transplantation-and-the-routine-use-of-cardiopulmonary-bypass-and-median-sternotomy-experience-at-the-ochsner-multi-organ-transplant-institute
#1
Michael Bates, Matthew Factor, P Eugene Parrino, Aditya Bansal, Reinaldo Rampolla, Leonardo Seoane, Jose Mena, Matthew Gaudet, William Smith, P Michael McFadden
BACKGROUND: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#2
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306591/ventilation-with-high-versus-low-peep-levels-during-general-anaesthesia-for-open-abdominal-surgery-does-not-affect-postoperative-spirometry-a-randomised-clinical-trial
#3
Tanja A Treschan, Maximilian Schaefer, Johann Kemper, Bea Bastin, Peter Kienbaum, Benedikt Pannen, Sabrine N Hemmes, Marcelo G de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Invasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function. OBJECTIVE: We investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry. DESIGN: This was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28299222/complete-obstruction-of-endotracheal-tube-in-an-infant-with-a-retropharyngeal-and-anterior-mediastinal-abscess
#4
Dennis B Thapa, Nathaniel H Greene, Andrea G Udani
Intraoperative ventilatory failure is not an uncommon complication; however, acute endotracheal obstruction by a foreign body or blood clot can be difficult to quickly discriminate from other causes. Once the diagnosis is made, quick action is needed to restore ventilation. The ultimate solution is to exchange the endotracheal tube; however, there can be other ways of resolving this in situations where reintubation would be difficult or unsafe. This case report discusses such an event in an infant with multiple airway challenges including a retropharyngeal and anterior mediastinal abscess...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28298763/effect-of-switching-between-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-hemodynamics-in-obese-patients-during-abdominoplasty
#5
Medhat Mikhail Messeha
BACKGROUND: The ideal intraoperative ventilation strategy in obese patients remains obscure. This prospective, randomized study was designed to evaluate the effect of pressure-controlled ventilation (PCV) before or after volume-controlled ventilation (VCV) on lung mechanics and hemodynamics variables in obese patients subjected to abdominoplasty operation. PATIENTS AND METHODS: The study included forty patients with body mass index 30-45 kg/m(2) subjected to abdominoplasty...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296782/the-safety-and-efficacy-of-dexmedetomidine-remifentanil-in-children-undergoing-flexible-bronchoscopy-a-retrospective-dose-finding-trial
#6
Xia Li, Xue Wang, Shuguang Jin, Dongsheng Zhang, Yanuo Li
Flexible bronchoscopy is more and more used for diagnosis and management of various pulmonary diseases in pediatrics. As poor coordination of children, the procedure is usually performed under general anesthesia with spontaneous or controlled ventilation to increase children and bronchoscopists' safety and comfort. Previous studies have reported that dexmedetomidine (DEX) could be safely and effectively used for flexible bronchoscopy in both adulate and children. However, there is no trial to evaluate the dose-finding of safety and efficacy of dexmedetomidine-remifentanil (DEX-RF) in children undergoing flexible bronchoscopy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28281769/long-term-surgical-anaesthesia-with-isoflurane-in-human-habituated-nile-crocodiles
#7
George F Stegmann, Catherine J A Williams, Craig Franklin, Tobias Wang, Michael Axelsson
A suitable long-term anaesthetic technique was required for implantation of physiological sensors and telemetric devices in sub-adult Nile crocodiles (Crocodylus niloticus) to allow the collection of physiological data. Five Nile crocodiles with a median body mass of 24 kg were used. After manual capture, they were blindfolded and 0.2 mL (1 mg/mL) medetomidine was administered intramuscularly in four of the animals which had an estimated body mass between 20 kg and 30 kg. One crocodile with an estimated body mass of 50 kg received 0...
February 24, 2017: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/28277322/utilizing-forced-vital-capacity-to-predict-low-lung-compliance-and-select-intraoperative-tidal-volume-during-thoracic-surgery
#8
Nir Hoftman, Eric Eikermann, John Shin, Jack Buckley, Kaveh Navab, Fereidoun Abtin, Tristan Grogan, Maxime Cannesson, Aman Mahajan
BACKGROUND: Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. METHODS: One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT)...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28277256/-anesthetic-considerations-for-awake-craniotomy-case-report
#9
Cassiano Hamacek de Freitas, Celso Homero Santos Oliveira, Daniel Câmara de Rezende, Joyce Romano, Henrique Rodrigues Lemos Silva, Ivana Mares Trivellato
BACKGROUND AND OBJECTIVES: The conscious patient cooperation during neurological procedures has become necessary for the delimitation of areas to be managed by a neurosurgeon, with better results in the treatment of tumor lesions, vascular or epileptic foci, and sequelae minimization. The need for perioperative awareness (responsiveness to commands) challenges anesthesiologists to further ensure patient safety during the procedure. Several techniques have been described for this purpose...
October 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28267940/a-six-month-evaluation-of-the-vivasight%C3%A2-video-double-lumen-endotracheal-tube-after-introduction-into-thoracic-anaesthetic-practice-at-a-single-institution
#10
I L Rapchuk, Sam Kunju, I J Smith, D J Faulke
For a six-month period, all airway options used for non-emergent patients undergoing thoracic surgery requiring one-lung ventilation at a single institution were assessed after introduction of the VivaSight™ double-lumen endotracheal tube (VivaSight-DL), a novel double-lumen tube with an integrated camera. This device displays a continuous view of the position of the tube relative to the carina. A total of 72 patients had lung separation with the VivaSight-DL. Lung separation was achieved on first attempt without additional manipulation in 85% of cases...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#11
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28261294/influence-of-intraoperative-positive-end-expiratory-pressure-level-on-pulmonary-complications-in-emergency-major-trauma-surgery
#12
Thomas Stueber, Jan Karsten, Nikolas Voigt, Michaela Wilhelmi
INTRODUCTION: Pulmonary complications have a major impact on the morbidity and mortality of critically ill patients with multiple trauma. Intraoperative protective ventilation with low tidal volume may prevent lung injury and infection, whereas the role of positive end-expiratory pressure (PEEP) levels is unclear. The aim of this study was to evaluate the influence of different intraoperative PEEP levels on incidence of pulmonary complications after emergency trauma surgery. MATERIAL AND METHODS: We retrospectively analysed data of multiple trauma patients who underwent emergency surgery within 24 h after injury in our level I trauma centre (n = 86)...
March 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28260433/effect-of-graft-weight-to-recipient-body-weight-ratio-on-hemodynamic-and-metabolic-parameters-in-pediatric-liver-transplant-a-retrospective-analysis
#13
Zeynep Ersoy, Serife Kaplan, Aycan Ozdemirkan, Adnan Torgay, Gulnaz Arslan, Arash Pirat, Mehmet Haberal
OBJECTIVES: To analyze how graft-weight-to-bodyweight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. MATERIALS AND METHODS: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio ≤ 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28259372/-gas-tamponade-following-intraoperative-pneumothorax-on-a-single-lung-a-case-study
#14
S D El Jaouhari, O Mamane Nassirou, M Meziane, M Bensghir, C Haimeur
Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation...
March 1, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28257296/extracorporeal-circulation-during-lung-transplantation-procedures-a-meta-analysis
#15
Dominik J Hoechter, Yu-Ming Shen, Tobias Kammerer, Sabina Günther, Thomas Weig, René Schramm, Christian Hagl, Frank Born, Bruno Meiser, Gerhard Preissler, Hauke Winter, Stephan Czerner, Bernhard Zwissler, Mansmann Ulrich, Vera von Dossow
Extracorporeal circulation is an invaluable tool in lung transplantation. Over the past years, an increasing number of centers changed their standard for intraoperative extracorporeal circulation from cardiopulmonary bypass to extracorporeal membrane oxygenation - with differing results. This meta-analysis reviews the existing evidence.An online literature research on Medline, Embase, and Pubmed has been performed. Two persons independently judged the papers using the ACROBAT-NRSI tool of the Cochrane collaboration...
February 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28235495/use-of-sugammadex-in-an-octagenerian-with-myaesthenia-gravis-undergoing-emergency-laporotomy
#16
Deep Shah, Aynkaran Dharmarajah
BACKGROUND: Myaesthenia Gravis is an autoimmune disorder that results in increased sensitivity to neuromuscular blockers. Anaesthesia and surgery in patients with Myaesthenia Gravis is associated with an increased incidence of complications, including post operative ventilation. We report the successful use of intra-operative train of four ratio monitoring and Sugammadex to reverse rocuronium induced neuromuscular blockade in an elderly octagenarian with Myaesthenia Gravis undergoing an emergency laporotomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28222645/total-intravenous-anesthesia-produces-outcomes-superior-to-those-with-combined-intravenous-inhalation-anesthesia-for-laparoscopic-gynecological-surgery-at-high-altitude
#17
Rui Xu, Shuqin Zhou, Jin Yang, Haiyan Li, Qingguo Zhang, Guohong Zhang, Shiyuan Xu, Qing Peng
Objective We compared efficacy and adverse outcomes following totally intravenous anesthesia (TIVA) versus combined intravenous-inhalation anesthesia (CIVIA) on hemodynamics and postoperative recovery following laparoscopic gynecological (LG) surgery at high altitudes. Methods We enrolled 80 ASA I or II patients scheduled for LG surgery and randomly assigned them to TIVA with propofol (group P, n = 40) or CIVIA with isoflurane (group I, n = 40). Mean arterial pressure, heart rate, pulse oxygen saturation, and partial pressure of end-tidal carbon dioxide were measured at various time points...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28203413/better-perioperative-outcomes-in-thoracoscopic-esophagectomy-with-two-lung-ventilation-in-semi-prone-position
#18
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
#19
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
#20
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)...
April 2017: European Journal of Anaesthesiology
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