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https://www.readbyqxmd.com/read/28403397/complications-of-robotic-assisted-laparoscopic-surgery-distant-from-the-surgical-site
#1
D A Maerz, L N Beck, A J Sim, D M Gainsburg
With the ever-increasing popularity of robotic-assisted laparoscopic surgery over the past decades, the literature reporting complications distant from the surgical site involving the use of this technology has also grown. The goal of this non-systematic review is to summarise these reports with a systems-based presentation of these complications. The most commonly observed complications were related to the peripheral nervous system and the most devastating occurring in cardiac and ophthalmic systems. There were no reports of patient complications directly related to the robot itself...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28398962/population-based-assessment-of-intraoperative-fluid-administration-practices-across-three-surgical-specialties
#2
Scott E Regenbogen, Nirav J Shah, Stacey D Collins, Samantha Hendren, Michael J Englesbe, Darrell A Campbell
OBJECTIVE: To assess the variation in hospitals' approaches to intraoperative fluid management and their association with postoperative recovery. BACKGROUND: Despite increasing interest in goal-directed, restricted-volume fluid administration for major surgery, there remains little consensus on optimal strategies, due to the lack of institution-level studies of resuscitation practices. METHODS: Among 64 hospitals in a state-wide surgical collaborative, we profiled fluid administration practices during 8404 intestinal resections, 22,854 hysterectomies, and 1471 abdominopelvic endovascular procedures...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28396471/contact-tracing-performance-during-the-ebola-virus-disease-outbreak-in-kenema-district-sierra-leone
#3
Mikiko Senga, Alpha Koi, Lina Moses, Nadia Wauquier, Philippe Barboza, Maria Dolores Fernandez-Garcia, Etsub Engedashet, Fredson Kuti-George, Aychiluhim Damtew Mitiku, Mohamed Vandi, David Kargbo, Pierre Formenty, Stephane Hugonnet, Eric Bertherat, Christopher Lane
Contact tracing in an Ebola virus disease (EVD) outbreak is the process of identifying individuals who may have been exposed to infected persons with the virus, followed by monitoring for 21 days (the maximum incubation period) from the date of the most recent exposure. The goal is to achieve early detection and isolation of any new cases in order to prevent further transmission. We performed a retrospective data analysis of 261 probable and confirmed EVD cases in the national EVD database and 2525 contacts in the Contact Line Lists in Kenema district, Sierra Leone between 27 April and 4 September 2014 to assess the performance of contact tracing during the initial stage of the outbreak...
May 26, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#4
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28378467/compared-effects-on-cerebral-oxygenation-of-ephedrine-vs-phenylephrine-to-treat-hypotension-during-carotid-endarterectomy
#5
Jugurtha Aliane, Christian Dualé, Nader Guesmi, Charlotte Baud, Eugenio Rosset, Bruno Pereira, Damien Bouvier, Pierre Schoeffler
While both ephedrine and phenylephrine are currently used to treat hypotension occurring during carotid endarterectomy (CEA) under general anaesthesia, phenylephrine may have deleterious effects on the cerebral watershed, due to its exclusively vasoconstrictive action. In this controlled, double-blind randomised trial, we compared the effects of ephedrine and phenylephrine administered in a standardised algorithm to treat the first hypotensive event occurring since induction of anaesthesia until carotid cross-clamping...
April 4, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28377842/goal-directed-fluid-therapy-what-the-mind-does-not-know-the-eye-cannot-see
#6
COMMENT
Joshua A Bloomstone, Randal O Dull, Lais H C Navarro
No abstract text is available yet for this article.
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28365143/applying-human-factors-and-ergonomics-to-the-misuse-of-nonsterile-clinical-gloves-in-acute-care
#7
Jennie Wilson, Aggie Bak, Heather P Loveday
BACKGROUND: Health care workers (HCWs) are recommended to wear nonsterile clinical gloves (NSCG) for direct contact with blood and body fluids. However, there is evidence of extensive inappropriate NSCG use. METHODS: A mixed-methods study comprising observation of NSCG use in 2 acute hospitals and semistructured HCW interviews. Qualitative data were categorized using thematic analysis. Findings were mapped to the Systems Engineering Initiative for Patient Safety model and used to develop a strategy for improving NSCG use...
March 29, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28359132/point-of-care-testing-in-liver-disease-and-liver-surgery
#8
Lasitha Abeysundara, Susan V Mallett, Ben Clevenger
The alterations in coagulation and hemostasis that accompany liver disease are complex, and while patients with this disease have traditionally been perceived as having a bleeding diathesis, it is now understood that in stable patients hemostasis is "re-balanced." Hepatic surgery, and particularly liver transplantation, can be associated with large fluid shifts, massive bleeding, and coagulopathy, as well as postoperative thrombosis. Point-of-care tests (POCTs) of coagulation facilitate goal-directed treatments and hemostatic monitoring in dynamic environments where the coagulation status can alter rapidly and often unpredictably...
March 30, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28343684/fluid-therapy-recommendations-for-major-abdominal-surgery-via-rica-recommendations-revisited-part-ii-goal-directed-hemodynamic-therapy-rationale-for-optimising-intravascular-volume
#9
J Ripollés-Melchor, D Chappell, H D Aya, Á Espinosa, M G Mhyten, A Abad-Gurumeta, S D Bergese, R Casans-Francés, J M Calvo-Vecino
No abstract text is available yet for this article.
March 24, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28343682/fluid-therapy-recommendations-for-major-abdominal-surgery-via-rica-recommendations-revisited-part-iii-goal-directed-hemodynamic-therapy-rationale-for-maintaining-vascular-tone-and-contractility
#10
J Ripollés-Melchor, D Chappell, H D Aya, Á Espinosa, M G Mhyten, A Abad-Gurumeta, S D Bergese, R Casans-Francés, J M Calvo-Vecino
No abstract text is available yet for this article.
March 24, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28341372/evaluation-of-remote-dielectric-sensing-reds-technology-guided-therapy-for-decreasing-heart-failure-re-hospitalizations
#11
Offer Amir, Tuvia Ben-Gal, Jean Marc Weinstein, Jorge Schliamser, Daniel Burkhoff, Aharon Abbo, William T Abraham
OBJECTIVE: We tested whether remote dielectric sensing (ReDS)-directed fluid management reduces readmissions in patients recently hospitalized for heart failure (HF). BACKGROUND: Pulmonary congestion is the most common cause of worsening HF leading to hospitalization. Accurate remote monitoring of lung fluid volume may guide optimal treatment and prevent re-hospitalization. ReDS technology is a quantitative non-invasive method for measuring absolute lung fluid volume...
March 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#12
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28321811/interleukin-2-old-and-new-approaches-to-enhance-immune-therapeutic-efficacy
#13
Pooja Dhupkar, Nancy Gordon
Interleukin-2 (IL-2) is a very well-known cytokine that has been studied for the past 35 years. It plays a major role in the growth and proliferation of many immune cells such NK and T cells. It is an important immunotherapy cytokine for the treatment of various diseases including cancer. Systemic delivery of IL-2 has shown clinical benefit in renal cell carcinoma and melanoma patients. However, its use has been limited by the numerous toxicities encountered with the systemic delivery. Intravenous IL-2 causes the well-known "capillary leak syndrome," or the leakage of fluid from the circulatory system to the interstitial space resulting in hypotension (low blood pressure), edema, and dyspnea that can lead to circulatory shock and eventually cardiopulmonary collapse and multiple organ failure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28320242/early-goal-directed-therapy-for-septic-shock-a-patient-level-meta-analysis
#14
(no author information available yet)
Background After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was designed prospectively to improve statistical power and explore heterogeneity of treatment effect of EGDT. Methods We harmonized entry criteria, intervention protocols, outcomes, resource-use measures, and data collection across the trials and specified all analyses before unblinding...
March 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28288059/effects-of-intraoperative-fluid-management-on-postoperative-outcomes-a-hospital-registry-study
#15
Christina H Shin, Dustin R Long, Duncan McLean, Stephanie D Grabitz, Karim Ladha, Fanny P Timm, Tharusan Thevathasan, Alberto Pieretti, Cristina Ferrone, Andreas Hoeft, Thomas W L Scheeren, Boyd Taylor Thompson, Tobias Kurth, Matthias Eikermann
OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols driven by such measures are limited in their ability to define the optimal fluid state during surgery. METHODS: This analysis of data on file included 92,094 adult patients undergoing noncardiac surgery with endotracheal intubation between 2007 and 2014 at an academic tertiary care hospital and two affiliated community hospitals...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28253353/effect-of-goal-directed-therapy-on-outcome-after-esophageal-surgery-a-quality-improvement-study
#16
Denise P Veelo, Mark I van Berge Henegouwen, Kirsten S Ouwehand, Bart F Geerts, Maarten C J Anderegg, Susan van Dieren, Benedikt Preckel, Jan M Binnekade, Suzanne S Gisbertz, Markus W Hollmann
BACKGROUND: Goal-directed therapy (GDT) can reduce postoperative complications in high-risk surgery patients. It is uncertain whether GDT has the same benefits in patients undergoing esophageal surgery. Goal of this Quality Improvement study was to evaluate the effects of a stroke volume guided GDT on post-operative outcome. METHODS AND FINDINGS: We compared the postoperative outcome of patients undergoing esophagectomy before (99 patients) and after (100 patients) implementation of GDT...
2017: PloS One
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#17
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28187752/targeting-urine-output-and-30-day-mortality-in-goal-directed-therapy-a-systematic-review-with-meta-analysis-and-meta-regression
#18
Esther N van der Zee, Mohamud Egal, Diederik Gommers, A B Johan Groeneveld
BACKGROUND: Oliguria is associated with a decreased kidney- and organ perfusion, leading to organ damage and increased mortality. While the effects of correcting oliguria on renal outcome have been investigated frequently, whether urine output is a modifiable risk factor for mortality or simply an epiphenomenon remains unclear. We investigated whether targeting urine output, defined as achieving and maintaining urine output above a predefined threshold, in hemodynamic management protocols affects 30-day mortality in perioperative and critical care...
February 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28152987/trends-and-causes-of-maternal-mortality-in-ethiopia-during-1990-2013-findings-from-the-global-burden-of-diseases-study-2013
#19
Gizachew Assefa Tessema, Caroline O Laurence, Yohannes Adama Melaku, Awoke Misganaw, Sintayehu A Woldie, Abiye Hiruye, Azmeraw T Amare, Yihunie Lakew, Berihun M Zeleke, Amare Deribew
BACKGROUND: Maternal mortality is noticeably high in sub-Saharan African countries including Ethiopia. Continuous nationwide systematic evaluation and assessment of the problem helps to design appropriate policy and strategy in Ethiopia. This study aimed to investigate the trends and causes of maternal mortality in Ethiopia between 1990 and 2013. METHODS: We used the Global Burden of Diseases and Risk factors (GBD) Study 2013 data that was collected from multiple sources at national and subnational levels...
February 2, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28126672/goal-directed-fluid-therapy-for-reducing-risk-of-surgical-site-infections-following-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
REVIEW
Jianhu Yuan, Yanxia Sun, Chuxiong Pan, Tianzuo Li
BACKGROUND AND OBJECTIVE: Surgical site infections (SSIs) become a key indicator of quality of care. This meta-analysis aimed to determine the effect of goal-directed fluid therapy (GDFT) on the risk of SSIs after abdominal surgery. METHODS: MEDLINE, Embase, CINAHL, Scopus, the Cochrane Controlled Trials Register, and Cochrane Database of Systematic Reviews were searched for randomized controlled trials (RCTs), from inception to May 2016 that compared the incidence of SSIs in abdominal surgical patients with or without GDFT treatment...
January 23, 2017: International Journal of Surgery
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