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Perioperative anaemia

Patrick Lauscher, Harry Kertscho, Malte Krömker, Barbara Haberichter, Kai Zacharowski, Peter Rosenberger, Jens Meier
BACKGROUND: Clonidine effectively decreases perioperative mortality by reducing sympathetic tone. However, application of clonidine might also restrict anaemia tolerance due to impairment of compensatory mechanisms. Therefore, the influence of clonidine induced, short-term sympathicolysis on anaemia tolerance was assessed in anaesthetized pigs. We measured the effect of clonidine on anaemia tolerance and of the potential for macrohemodynamic alterations to constrain the acute anaemia compensatory mechanisms...
October 12, 2016: BMC Anesthesiology
David Propper, Keith Jones, D Alan Anthoney, Wasat Mansoor, Daniel Ford, Martin Eatock, Roshan Agarwal, Michiyasu Inatani, Tomohisa Saito, Masaichi Abe, T R Jeffry Evans
BACKGROUND: TP300, a recently developed synthetic camptothecin analogue, is a highly selective topoisomerase I inhibitor. A phase I study showed good safety and tolerability. As camptothecins have proven active in oesophago-gastric adenocarcinomas, in this phase II study we assessed the efficacy and safety of TP300 in patients with gastric or gastro-oesophageal junction (GOJ) adenocarcinomas. METHODS: Eligible patients had metastatic or locally advanced gastric or Siewert Types II or III GOJ inoperable adenocarcinoma...
October 10, 2016: BMC Cancer
Véronique Livet, Paul Pillard, Isabelle Goy-Thollot, David Maleca, Quentin Cabon, Denise Remy, Didier Fau, Éric Viguier, Céline Pouzot, Claude Carozzo, Thibaut Cachon
OBJECTIVES: The purpose of this study was to describe the perioperative and postoperative complications as well as short-term and long-term outcomes in cats with ureteral obstructions treated by placement of a subcutaneous ureteral bypass (SUB) device without imaging control. The second objective of this study was to compare cats treated by SUB device with cats treated by traditional surgical intervention. METHODS: Data were obtained retrospectively from the medical records (2014-2016) of cats that underwent SUB placement (SUB cats) and cats that underwent traditional ureteral surgery (C cats)...
September 30, 2016: Journal of Feline Medicine and Surgery
Awad Shamali, Raymond McCrudden, Pradeep Bhandari, Fanny Shek, Emily Barnett, Adrian Bateman, Mohammed Abu Hilal
BACKGROUND: Pancreaticoduodenectomy (PD) is a complex procedure, associated with a definite risk of mortality and 30-50% risk of complications. For nonampullary duodenal lesions, PD can carry a higher morbidity as they are more commonly associated with a soft pancreas and narrow-calibre main pancreatic ducts. It is therefore paramount that the risks and benefits of surgery are considered carefully in this group of patients. A preoperative histological diagnosis for duodenal lesions is normally achieved by endoscopic biopsy...
September 3, 2016: European Journal of Gastroenterology & Hepatology
Alhossain A Khalafallah, Carl Yan, Raghad Al-Badri, Ella Robinson, Brooke E Kirkby, Emily Ingram, Zara Gray, Vinod Khelgi, Iain K Robertson, Brian P Kirkby
BACKGROUND: Despite increasing efforts in perioperative management, postoperative iron deficiency anaemia persists, and few data are available about the management of this condition. In this study, we aimed to determine whether giving postoperative intravenous iron (in the form of ferric carboxymaltose) improved iron stores, haemoglobin concentrations, and outcomes following surgery. METHODS: We did a prospective, open-label, randomised, controlled study of patients at two centres (a general hospital and a private health-care centre) in Tasmania, Australia, undergoing elective surgery with functional iron deficiency anaemia (haemoglobin 70-120 g/L and ferritin ≤100 μg/L or iron saturation ≤20%), measured at day 1 postoperatively...
September 2016: Lancet Haematology
Sheng Lu, Min Yan, Chen Li, Chao Yan, Xuexin Yao, Minming Chen, Runhua Feng, Renda Bi, Wentao Liu, Zhenglun Zhu, Zhenggang Zhu
OBJECTIVE: To investigate the clinicopathological features and postoperative short-term complications in the elderly gastric cancer patients. METHODS: Clinical data of 270 elderly patients with gastric cancer who underwent gastrectomy in Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine between July 2012 and June 2014 were analyzed retrospectively. Among 270 patients, 220 were 70 to 79 years old( old group) and 50 were ≥80 years old(oldest group)...
May 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Z Aga, M Machina, S A McCluskey
BACKGROUND: We carried out a retrospective assessment of whether perioperative fluid volume was associated with length of hospital stay (LOS) after colorectal surgery. METHODS: A single-centre chart review was conducted on colorectal surgeries that took place between January 2008 and December 2013. The primary outcome was LOS, with prolonged LOS defined as greater than median LOS. Secondary outcomes included postoperative pulmonary oedema, acute renal failure, myocardial infarction, and mortality...
June 2016: British Journal of Anaesthesia
A G Kleinerüschkamp, K Zacharowski, C Ettwein, M M Müller, C Geisen, C F Weber, P Meybohm
BACKGROUND: Patient blood management (PBM) is a multidisciplinary approach focusing on the diagnosis and treatment of preoperative anaemia, the minimisation of blood loss, and the optimisation of the patient-specific anaemia reserve to improve clinical outcomes. Economic aspects of PBM have not yet been sufficiently analysed. OBJECTIVES: The aim of this study is to analyse the costs associated with the clinical principles of PBM and the project costs associated with the implementation of a PBM program from an institutional perspective...
June 2016: Der Anaesthesist
J M Henderson, D Pitcher, R Steenkamp, S Fowler, F X Keeley
INTRODUCTION: The aim of this study was to determine the patient and disease factors predictive of adverse perioperative outcomes after nephrectomy using the British Association of Urological Surgeons (BAUS) audit database. METHODS: All nephrectomies entered on the BAUS database for the year 2012 were included and ten patient or disease factors were selected for analysis. Logistic regression was used to calculate the area under the receiver operating characteristic curve (AUC) (0...
May 2016: Annals of the Royal College of Surgeons of England
Samer Tohme, Patrick R Varley, Douglas P Landsittel, Alexis P Chidi, Allan Tsung
BACKGROUND: Preoperative anaemia is associated with adverse outcomes after surgery but outcomes after liver surgery specifically are not well established. We aimed to analyze the incidence of and effects of preoperative anemia on morbidity and mortality in patients undergoing liver resection. METHODS: All elective hepatectomies performed for the period 2005-2012 recorded in the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database were evaluated...
March 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
James O M Plumb, James M Otto, Michael P W Grocott
Haemoglobin is the blood's oxygen carrying pigment and is encapsulated in red blood corpuscles. The concentration of haemoglobin in blood is dependent on both its total mass in the circulation (tHb-mass) and the total plasma volume in which it is suspended. Aerobic capacity is defined as the maximum amount of oxygen that can be consumed by the body per unit time and is one measure of physical fitness. Observations in athletes who have undergone blood doping or manipulation have revealed a closer relationship between physical fitness (aerobic capacity) and total haemoglobin mass (tHb-mass) than with haemoglobin concentration ([Hb])...
2016: Extreme Physiology & Medicine
Paul Kopanidis, Andrew Hardidge, Larry McNicol, Stanley Tay, Peter McCall, Laurence Weinberg
BACKGROUND: Optimisation of blood management in total hip (THA) and knee arthroplasty (TKA) is associated with improved patient outcomes. This study aimed to establish the effectiveness of a perioperative blood management programme in improving postoperative haemoglobin (Hb) and reducing the rate of allogenic blood transfusion. METHODS: This retrospective before and after study involves 200 consecutive patients undergoing elective TKA and THA before (Usual Care group) and after (Intervention group) the introduction of a blood management programme in an Australian teaching hospital...
2016: Journal of Orthopaedic Surgery and Research
Barrie D Keeler, Amitabh Mishra, Christiana L Stavrou, Sophia Beeby, J Alastair Simpson, Austin G Acheson
INTRODUCTION: Preoperative identification and treatment of anaemia is advocated as part of Patient Blood Management due to the association of adverse outcome with the perioperative use of blood transfusion. This study aimed to establish the rate of anaemia identification, treatment and implications of this preoperative anaemia on ARBT use. METHODS: All patients who underwent elective surgery for colorectal cancer over 18 months at a single Tertiary Centre were reviewed...
March 2016: Annals of Medicine and Surgery
M Sanoufa, W Smisson, H Floyd, J S Robinson
Ways of reducing the length of hospital stay have received increased attention in recent years. Both preoperative and postoperative anaemia have been implicated as causative agents in increasing postoperative length of stay (LOS). In a retrospective study, 317 patients that underwent lumbar decompression and fusion surgery were assessed. Two separate block multivariate linear regression analyses were performed to evaluate the impact of preoperative anaemia, postoperative anaemia, and the degree of perioperative haemoglobin drop on LOS...
December 2015: Journal of Perioperative Practice
Lesley De Pietri, Valentina Serra, Giuseppe Preziosi, Gianluca Rompianesi, Bruno Begliomini
AIM: To describe our single-centre experience in liver transplantation (LT) with the infusion of high perioperative thymoglobulin doses. The optimal dosage and timing of thymoglobulin(®) [antithymocyte globulin (ATG)] administration during LT remains controversial. Cytokine release syndrome, haemolytic anaemia, thrombocytopenia, neutropenia, fever and serum sickness are potential adverse effects associated with ATG infusion. METHODS: Between December 2009 and December 2010, 16 adult non-randomized patients (ATG group), receiving a liver graft from a deceased donor, received an intraoperative infusion (4-6 h infusion) of thymoglobulin (3 mg/kg, ATG: Thymoglobuline(®))...
December 24, 2015: World Journal of Transplantation
Ciara I Donohue, Susan V Mallett
Liver transplantation (LT) was historically associated with massive blood loss and transfusion. Over the past two decades transfusion requirements have reduced dramatically and increasingly transfusion-free transplantation is a reality. Both bleeding and transfusion are associated with adverse outcomes in LT. Minimising bleeding and reducing unnecessary transfusions are therefore key goals in the perioperative period. As the understanding of the causes of bleeding has evolved so too have techniques to minimize or reduce the impact of blood loss...
December 24, 2015: World Journal of Transplantation
Qunn Jid Lee, Wai Ping Mak, Yiu Chung Wong
PURPOSE: To evaluate the incidence and risk factors of periprosthetic joint infection (PJI) in patients undergoing total knee arthroplasty (TKA) in a high-volume hospital. METHODS: Records of 1133 primary TKAs were reviewed. Correlation between surgery volume and infection rate was determined. Risk factors for PJI were identified using case-control analysis of variables. TKAs performed between October 2012 and March 2013 without infection were used as controls. RESULTS: Of 1133 TKAs, 8 (0...
December 2015: Journal of Orthopaedic Surgery
O Goren, I Matot
Perioperative acute kidney injury (AKI) is not uncommon and is associated with considerable morbidity and mortality. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Novel biomarkers are under investigation as fast and accurate predictors of AKI. Several special considerations regarding the risk of AKI are of note in the surgical patient. Co-morbidities are important risk factors for AKI. The surgery in itself, especially emergency and major surgery in the critically ill, is associated with a high incidence of AKI...
December 2015: British Journal of Anaesthesia
Raghavendra Venkatesh, Vikas Tandon, Nishit Patel, H S Chhabra
INTRODUCTION: Solitary plasmacytoma of bone is a local primary bone tumour consisting of malignant plasma cells without systemic involvement. These tumours are known for large amount of blood loss, and the use of electrocautery is helpful in reducing blood loss and performing surgery in a relatively bloodless field; however, use of unipolar cautery in patients with indwelling cardiac pacemaker is known to cause arrhythmias and cardiac events. Minimally invasive techniques offer potential advantages over open techniques particularly in patients with spinal tumours, where massive amount of blood loss is expected, if open procedure is performed...
December 2015: Journal of Clinical Orthopaedics and Trauma
B Kearney, J To, K Southam, D Howie, B To
BACKGROUND: An anaemia clinic was established to improve the preoperative management of elective orthopaedic patients scheduled for arthroplasty. This paper is a report on the first 100 patients assessed. AIM: To assess the incidence and causes of anaemia in patients on a waiting list for elective arthroplasty in a public hospital and to assess the impact of anaemia detection in this patient population. METHODS: Patients attending an Anaemia Clinic for elective orthopaedic surgical patients, during March 2010 to June 2013 were studied...
January 2016: Internal Medicine Journal
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