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https://www.readbyqxmd.com/read/29243334/effects-of-a-targeted-blood-management-programme-on-allogeneic-blood-transfusion-in-abdominal-aortic-aneurysm-surgery
#1
M D Stoneham, S Von Kier, L Harvey, M Murphy
OBJECTIVES: To investigate the impact of a dedicated cell salvage practitioner team on blood loss and allogeneic transfusion in abdominal aortic aneurysm (AAA) surgery. BACKGROUND: Cell salvage reduces allogeneic transfusion in AAA surgery, but is commonly performed by the anaesthetic nurse. At our hospital, a dedicated patient blood management practitioner is present for all elective open AAA repairs. METHODS/MATERIALS: Data were collected on 171 AAA patients operated on at the John Radcliffe Hospital, Oxford over a 3-year period, looking at the Patient Blood Management processes, including: blood loss, cell salvage, near-patient testing (thrombelastography) and transfusion rates of allogeneic blood products...
December 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29241912/radiofrequency-ablation-for-selective-reduction-in-complex-monochorionic-multiple-pregnancies-a-case-series
#2
Hong-Mei Wang, Hong-Yan Li, Xie-Tong Wang, Yan-Yun Wang, Lei Li, Bo Liang, Jing Wang, Jia Song
OBJECTIVE: To determine the safety and efficacy of radiofrequency ablation (RFA) for selective fetal reduction in complex monochorionic multiple pregnancies. MATERIALS AND METHODS: From July 2011 to January 2015, data on all cases treated with RFA were collected prospectively in our hospital. Indications, procedure details, cause of fetal demise and pregnancy outcomes were analyzed. Sonography and magnetic resonance imaging were performed to detect fetal brain damage...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29240601/efficacy-of-transanal-drainage-tube-placement-after-modified-posterior-pelvic-exenteration-for-primary-ovarian-cancer
#3
Kazuyoshi Kato, Kohei Omatsu, Maki Matoda, Hidetaka Nomura, Sanshiro Okamoto, Hiroyuki Kanao, Kuniko Utsugi, Nobuhiro Takeshima
OBJECTIVE: The aim of this study was to investigate the clinical usefulness of the placement of a transanal drainage tube (TDT) to prevent anastomotic leakage after a modified posterior pelvic exenteration (MPPE) for the treatment of primary ovarian cancer. METHODS: We performed a retrospective review of all the consecutive patients who had undergone an MPPE for primary ovarian, tubal, or peritoneal cancer between October 2012 and November 2016 at our institution...
December 13, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29238996/quality-management-of-a-massive-transfusion-protocol
#4
John R Hess, Patrick J Ramos, Nina E Sen, Virginia G Cruz-Cody, Erin E Tuott, Max J Louzon, Eileen M Bulger, Saman Arbabi, Monica B Pagano, Ryan A Metcalf
BACKGROUND: Massive transfusion is a response to massive uncontrolled hemorrhage. To be effective, it must be timely and address the patient's needs for blood volume, oxygen transport, and hemostasis. STUDY DESIGN AND METHODS: A review was performed on all activations of the massive transfusion protocol (MTP) in a hospital with large emergency medicine, trauma, and vascular surgery programs. Indications, transfused amounts, and outcomes were determined for each MTP event to determine appropriateness of MTP use...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29238981/incidence-risk-factors-and-outcome-of-transfusion-associated-circulatory-overload-in-a-mixed-intensive-care-unit-population-a-nested-case-control-study
#5
Joachim J Bosboom, Robert B Klanderman, Maarten Zijp, Markus W Hollmann, Denise P Veelo, Jan M Binnekade, Bart F Geerts, Alexander P J Vlaar
BACKGROUND: The objective of this study was to determine the incidence, risk factors, and outcome of transfusion-associated circulatory overload (TACO) in a cohort of mixed intensive care unit patients and to compare risk factors with those for cardiac overload in the absence of transfusion. STUDY DESIGN AND METHODS: In a retrospective cohort study, patients who developed TACO were compared using multivariate analysis of two control groups: patients without pulmonary deterioration who received transfusion and patients who developed circulatory overload in the absence of transfusion...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29238657/30-day-adverse-event-rates-following-penile-prosthesis-surgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-based-evaluation
#6
Isaac Palma-Zamora, Akshay Sood, Ali A Dabaja
Background: Commonly utilized as a third-line therapy for erectile dysfunction (ED) management, the penile prostheses have become a staple treatment for ED refractory to pharmacological interventions. There is however a paucity of data in the literature pertaining to short-term adverse outcomes following penile prosthesis surgery. We thus sought to leverage the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to evaluate such outcomes within 30 days of surgery in these patients...
November 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29238644/impact-of-preoperative-anemia-on-outcomes-in-adults-undergoing-elective-posterior-cervical-fusion
#7
Kevin Phan, Alexander E Dunn, Jun S Kim, John Di Capua, Sulaiman Somani, Parth Kothari, Nathan J Lee, Joshua Xu, James E Dowdell, Samuel K Cho
Study Design: Retrospective analysis of prospectively collected data. Objectives: Few studies have investigated the role of preoperative anemia on postoperative outcomes of posterior cervical fusion. This study looked to investigate the potential relationship between preoperative anemia and postoperative outcomes following posterior cervical spine fusion. Methods: Data from patients undergoing elective posterior cervical fusions between 2005 and 2012 was collected from the American College of Surgeons National Surgical Quality Improvement Program database using inclusion/exclusion criteria...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238634/asa-classification-as-a-risk-stratification-tool-in-adult-spinal-deformity-surgery-a-study-of-5805-patients
#8
Sulaiman Somani, John Di Capua, Jun S Kim, Kevin Phan, Nathan J Lee, Parth Kothari, Joung-Heon Kim, James Dowdell, Samuel K Cho
Study Design: Retrospective analysis of prospectively collected data. Objectives: Adult spinal deformity (ASD) surgery is a highly complex procedure that has high complication rates. Risk stratification tools can improve patient management and may lower complication rates and associated costs. The goal of this study was to identify the independent association between American Society of Anesthesiologists (ASA) class and postoperative outcomes following ASD surgery...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238586/international-prospective-observational-study-of-upper-gastrointestinal-haemorrhage-does-weekend-admission-affect-outcome
#9
Iain A Murray, Harry R Dalton, Adrian J Stanley, Jing H Ngu, Brian Maybin, Mahmoud Eid, Kenneth G Madsen, Rozeta Abazi, Hamad Ashraf, Mohamed Abdelrahim, Rebecca Lissmann, Jenny Herrod, Christopher Jl Khor, Hock S Ong, Doreen Sc Koay, Yung K Chin, Stig B Laursen
Introduction: Out of hours admissions have higher mortality for many conditions but upper gastrointestinal haemorrhage studies have produced variable outcomes. Methods: Prospective study of 12 months consecutive admissions of upper gastrointestinal haemorrhage from four international high volume centres. Admission period (weekdays, weeknights or weekends), demographics, haemodynamic parameters, laboratory results, endoscopy findings, further procedures and 30-day mortality were recorded...
December 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29238100/clinical-outcomes-and-quality-of-life-after-surgery-for-dilated-ascending-aorta-at-the-time-of-aortic-valve-replacement-wrapping-versus-graft-replacement
#10
Tomonobu Abe, Sachie Terazawa, Hideki Ito, Yoshiyuki Tokuda, Kazuro Fujimoto, Masato Mutsuga, Yuji Narita, Hideki Oshima, Akihiko Usui
Wrapping and graft replacement are two optional procedures for the treatment of dilated ascending aorta at the time of aortic valve replacement (AVR). Wrapping is considered less invasive. The aim of this study was to compare the short- and long-term clinical outcomes as well as the long-term quality of life in patients undergoing these two procedures.This study enrolled 40 consecutive patients with dilated ascending aorta who had undergone either wrapping (WAA group, n=20) or replacement (RAA group, n=20) of the ascending aorta at the time of AVR...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29238008/association-between-platelet-count-and-postoperative-blood-loss-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-and-fresh-frozen-plasma-administration-guided-by-thromboelastometry
#11
Junko Ichikawa, Yoshiko Osada, Mitsuharu Kodaka, Keiko Nishiyama, Makiko Komori
BACKGROUND: Coagulopathy after cardiopulmonary bypass (CPB) is caused by multiple factors, including reduced coagulation factors and a low platelet count.Methods and Results:In this study, we undertook a post hoc analysis to identify factors associated with increased postoperative blood loss in 97 patients undergoing cardiac surgery with CPB, with fresh frozen plasma administered according to a ROTEM-guided algorithm. We identified 24 patients for the top quartile of postoperative blood loss, >528 mL and defined as having excessive blood loss...
December 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29234658/blood-level-changes-in-total-knee-arthroplasty-with-and-without-a-tourniquet
#12
Marco Felipe Francisco Honorato de Barros, Evandro Junior Christovam Ribeiro, Rafael Gomes Dias
Objective: To evaluate the difference between the total blood loss in patients undergoing primary total knee arthroplasty with and without the use of tourniquet. Methods: A retrospective cohort study, with analysis of medical records of patients undergoing primary total knee arthroplasty in 2015, with and without the use of a tourniquet. Comparison was performed of hemoglobin (HB) and hematocrit (HT) variation in the complete blood count (CBC) during the pre- and post-operative period between the two groups...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29233118/risks-and-complications-of-transurethral-resection-of-bladder-tumors-in-patients-receiving-antiplatelet-and-or-anticoagulant-therapy-a-retrospective-cohort-study
#13
Tsuzumi Konishi, Satoshi Washino, Yuhki Nakamura, Masashi Ohshima, Kimitoshi Saito, Yoshiaki Arai, Tomoaki Miyagawa
BACKGROUND: Information on the safety of transurethral resection of bladder tumors (TURBT) in patients receiving anti-thromboembolic drugs is currently lacking. This study aimed to evaluate the clinical safety of TURBT in patients receiving anti-thromboembolic agents compared with patients not taking these agents and patients who interrupted their use perioperatively. METHODS: We retrospectively analyzed data for patients who underwent TURBT at Jichi Medical University Saitama Medical Center from September 2013 to August 2016...
December 12, 2017: BMC Urology
https://www.readbyqxmd.com/read/29232772/s-nitrosohemoglobin-levels-and-patient-outcome-after-transfusion-during-pediatric-bypass-surgery
#14
Faisal Matto, Peter C Kouretas, Richard Smith, Jacob Ostrowsky, Anthony J Cina, Douglas T Hess, Jonathan S Stamler, James D Reynolds
Banked blood exhibits impairments in nitric oxide (NO)-based oxygen delivery capability, reflected in rapid depletion of S-nitrosohemoglobin (SNO-Hb). We hypothesized that transfusion of even freshly-stored blood used in pediatric heart surgery would reduce SNO-Hb levels and worsen outcome. In a retrospective review (n = 29), the percent of estimated blood volume (% eBV) replaced by transfusion directly correlated with ventilator time and inversely correlated with kidney function; similar results were obtained in a prospective arm (n = 20)...
December 12, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/29232529/arantius-ligament-suspension-a-novel-technique-for-retraction-of-the-left-lateral-lobe-liver-during-laparoscopic-isolated-caudate-lobectomy
#15
Songshan Chai, Jianping Zhao, Yuxin Zhang, Shuai Xiang, Wanguang Zhang
BACKGROUND: Laparoscopic isolated caudate lobectomy remains a challenging procedure because of its deep location and proximity to the important vessels. We present a novel technique, Arantius ligament suspension, which could improve operative field exposure in laparoscopic isolated caudate lobectomy through retraction of the left lateral lobe liver. MATERIALS AND METHODS: The Arantius ligament suspension technique was performed in 6 selected patients during laparoscopic isolated caudate lobectomy in our center: 2 with symptomatic hepatic cavernous hemangioma and 4 with hepatocellular carcinoma (HCC)...
December 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29229578/left-lateral-endosurgical-extraperitoneal-total-hysterectomy-with-para-aortic-and-pelvic-lymphadenectomy-a-novel-approach-for-the-obese-patient-with-endometrial-cancer
#16
Gwenael Ferron, Javier De Santiago, Denis Querleu, Alejandra Martinez, Martina Aida Angeles, Berenice Boulet, Frederic Guyon, Ignacio Zapardiel
STUDY OBJECTIVE: To describe the left lateral extraperitoneal approach to perform complete para-aortic and pelvic lymphadenectomy and transverse total hysterectomy from left to right as a novel approach to treat obese patients with endometrial cancer. Laparoscopic management of obese patients represents a challenge for the gynecological surgeon. The extraperitoneal approach is technically easier in the obese patient as it naturally creates a bowel-free operative field. DESIGN: A prospective pilot bicentric and descriptive study (Canadian Task Force III) evaluating the feasibility and reproducibility of the transverse total hysterectomy and complete lymphadenectomy through left endoscopic extraperitoneal approach in obese patients with endometrial cancer...
December 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29229350/predictors-of-readmissions-and-reoperations-related-to-venous-thromboembolic-events-after-spine-surgery-a-single-institution-experience-with-6-869-patients
#17
Michael Cloney, Ekamjeet S Dhillon, Helena Roberts, Zachary A Smith, Tyler R Koski, Nader S Dahdaleh
BACKGROUND: Readmission and reoperation are used as hospital and surgeon quality metrics. Venous thromboembolic events (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), are a major cause of readmission, morbidity, mortality, after spine surgery. Specific procedural, perioperative, and patient characteristics may be associated with these outcomes. METHODS: We retrospectively examined records from 6869 consecutive spine surgeries at our institution...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#18
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/29228571/identification-of-a-novel-de-novo-ank1-r1426-nonsense-mutation-in-a-chinese-family-with-hereditary-spherocytosis-by-ngs
#19
Xiong Wang, Bin Yi, Ketao Mu, Na Shen, Yaowu Zhu, Qun Hu, Yanjun Lu
Hereditary spherocytosis (HS) is an inherited heterogeneous hemolytic anemia, characterized by the presence of spherical-shaped erythrocytes on the peripheral blood smear, and the clinical manifestation ranges from asymptomatic to severely anemic, and transfusion-dependent patients. Mutations in at least five genes (ANK1, EPB42, SLC4A1, SPTA1, and SPTB) have been identified so far, and mutations of ANK1 gene are responsible for the majority of all HS cases. In this study, targeted next generation sequencing (NGS) was applied to identify a novel de novo ANK1 c...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228313/transfusion-of-red-blood-cells-in-coronary-surgery-is-there-an-effect-on-long-term-mortality-when-adjusting-for-risk-factors-and-postoperative-complications
#20
Long Tran, Guri Greiff, Hilde Pleym, Alexander Wahba, Roar Stenseth, Vibeke Videm
OBJECTIVES: The aim of this study was to compare long-term mortality in patients undergoing primary isolated coronary artery bypass grafting who received ≥1 units of red blood cells (RBCs) or no RBCs. We hypothesized that a possible difference in long-term mortality was due to preoperative morbidity and/or postoperative morbidity. METHODS: This prospective cohort study, part of the Cardiac Surgery Outcome Study (CaSOS) at St. Olavs University Hospital, Trondheim, Norway, included patients operated on from 2000 through 2014 (n = 4014) and excluded those with large intra- or postoperative blood loss or 30-day mortality...
December 8, 2017: European Journal of Cardio-thoracic Surgery
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