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pulmonary complications of anesthesia

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https://www.readbyqxmd.com/read/28537970/neuraxial-and-combined-neuraxial-general-anesthesia-compared-to-general-anesthesia-for-major-truncal-and-lower-limb-surgery-a-systematic-review-and-meta-analysis
#1
Lauren M Smith, Crispiana Cozowicz, Yoshiaki Uda, Stavros G Memtsoudis, Michael J Barrington
Neuraxial anesthesia may improve perioperative outcomes when compared to general anesthesia; however, this is controversial. We performed a systematic review and meta-analysis using randomized controlled trials and population-based observational studies identified in MEDLINE, PubMed, and EMBASE from 2010 to May 31, 2016. Studies were included for adult patients undergoing major surgery of the trunk and lower extremity that reported: 30-day mortality (primary outcome), cardiopulmonary morbidity, surgical site infection, thromboembolic events, blood transfusion, and resource use...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28527967/feasibility-and-safety-of-the-transbronchial-access-tool-for-peripheral-pulmonary-nodule-and-mass
#2
Mark R Bowling, Craig Brown, Carlos J Anciano
BACKGROUND: Navigational bronchoscopy and other imaging modalities have improved the ability to evaluate pulmonary nodules/mass. Many of these lesions are located outside the bronchial airway and are difficult to access even with these devices. The Transbronchial Access Tool (Medtronic, Minneapolis, MN) allows the bronchoscopist to create a pathway from the bronchial airway, across the lung parenchyma, and into the target lesion. We are reporting the feasibility and safety of this new device...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28523031/myocardial-protection-with-glucose-insulin-potassium-infusion-during-adult-cardiac-surgery
#3
Suhail Ahmad, Rana Altaf Ahmad, Bilal Ahsan Qureshi, Mirza Ahmad Raza Baig
BACKGROUND & OBJECTIVE: Recent meta-analysis reports have called for more randomized trials to evaluate the effectiveness of GIK solution in patients of cardiac surgery. So this study was conducted to evaluate the effectiveness of Glucose-insulin-potassium (GIK) solutions in non-diabetic patients undergoing coronary artery bypass grafting. METHODS: A total number of one hundred and sixty (160) patients were randomized into two equal groups; GIK Group and non-GIK group...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#4
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28457827/ventilation-distribution-assessed-with-electrical-impedance-tomography-and-the-influence-of-tidal-volume-recruitment-and-positive-end-expiratory-pressure-in-isoflurane-anesthetized-dogs
#5
Aline M Ambrosio, Tatiana P A Carvalho-Kamakura, Keila K Ida, Barbara Varela, Felipe S R M Andrade, Lara L Facó, Denise T Fantoni
OBJECTIVE: To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Fourteen client-owned bitches weighing 26 ± 7 kg undergoing elective ovariohysterectomy. METHODS: Isoflurane-anesthetized dogs in dorsal recumbency were ventilated with 0 cmH2O PEEP and pressure-controlled ventilation by adjusting the peak inspiratory pressure (PIP) to achieve a low (7 mL kg(-1); n = 7) or a high (12 mL kg(-1); n = 7) VT...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28455784/clinical-features-of-patients-with-diffuse-alveolar-hemorrhage-due-to-negative-pressure-pulmonary-edema
#6
Damien Contou, Guillaume Voiriot, Michel Djibré, Vincent Labbé, Muriel Fartoukh, Antoine Parrot
PURPOSE: Diffuse alveolar hemorrhage (DAH) with negative-pressure pulmonary edema (NPPE) is an uncommon yet life-threatening condition. We aimed at describing the circumstances, clinical, radiological, and bronchoscopic features, as well as the outcome of patients with NPPE-related DAH. METHODS: We performed a retrospective, observational cohort study, using data prospectively collected over 35 years in an intensive care unit (ICU). RESULTS: Of the 149 patients admitted for DAH, we identified 18 NPPE episodes in 15 patients, one admitted four times for recurrent NPPE-related DAH...
April 28, 2017: Lung
https://www.readbyqxmd.com/read/28454590/protective-intraoperative-ventilation-with-higher-versus-lower-levels-of-positive-end-expiratory-pressure-in-obese-patients-probese-study-protocol-for-a-randomized-controlled-trial
#7
T Bluth, R Teichmann, T Kiss, I Bobek, J Canet, G Cinnella, L De Baerdemaeker, C Gregoretti, G Hedenstierna, S N Hemmes, M Hiesmayr, M W Hollmann, S Jaber, J G Laffey, M J Licker, K Markstaller, I Matot, G Müller, G H Mills, J P Mulier, C Putensen, R Rossaint, J Schmitt, M Senturk, A Serpa Neto, P Severgnini, J Sprung, M F Vidal Melo, H Wrigge, M J Schultz, P Pelosi, M Gama de Abreu
BACKGROUND: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients...
April 28, 2017: Trials
https://www.readbyqxmd.com/read/28449498/trans-tracheostomy-repair-of-tracheo-esophageal-fistula-under-endoscopic-view-in-a-75-year-old-woman
#8
Francesco Paolo Caronia, Alfonso Reginelli, Mario Santini, Roberto Alfano, Sebastiano Trovato, Ettore Arrigo, Alfonso Fiorelli
Tracheo-esophageal fistula is a life-threatening condition for fatal pulmonary complications. Surgery is the treatment of choice. Unfortunately, the most of patients are unfit for surgery and in these cases there is no a standardized management. Herein, we reported a clinical case of a 75-year-old-woman with a tracheoesophageal fistula related to tracheostomy. The fistula was localized 3.5 cm below the vocal folds and extended 3 cm distally. The patient's poor clinical condition contraindicated surgery while the characteristics of fistula prevented any successfully endoscopic repair with standard methods as application of fibrin glue, clipping, or stenting...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28442930/thoracic-epidural-analgesia-reduces-myocardial-injury-in-ischemic-patients-undergoing-major-abdominal-cancer-surgery
#9
Mohamad Farouk Mohamad, Montaser A Mohammad, Diab F Hetta, Eman Hasan Ahmed, Ahmed A Obiedallah, Alaa Ali M Elzohry
BACKGROUND AND OBJECTIVES: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA) on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery. PATIENTS AND METHODS: One hundred and twenty patients (American Society of Anesthesiologists grade II and III) of either sex were scheduled for elective upper gastrointestinal cancer surgeries...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#10
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28390062/outcome-of-laparoscopic-adrenalectomy-for-resection-of-unilateral-noninvasive-adrenocortical-tumors-in-11-cats
#11
Jeffrey W Mitchell, Philipp D Mayhew, William T N Culp, J Brad Case, Ameet Singh, Mark C Fuller, Ann Della Maggiore
OBJECTIVE: To describe the technique and outcomes of laparoscopic adrenalectomy (LA) in cats with adrenocortical neoplasia. STUDY DESIGN: Retrospective case series. ANIMALS: Eleven client-owned cats with unilateral adrenal tumors. METHODS: Medical records of cats that underwent LA for unilateral functional adrenal tumors at 3 veterinary teaching hospitals were reviewed. Data collected included signalment, clinical signs, physical examination findings, diagnostic imaging results, preoperative laboratory tests, laparoscopic port placement and techniques, duration of anesthesia and surgery, complications, concomitant procedures, need for conversion to an open celiotomy, histopathological diagnosis, and postoperative survival...
April 8, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28379017/-radiofrequency-catheter-ablation-of-atrial-fibrillation-performed-under-general-anesthesia-results-of-a-unicentric-randomized-trial
#12
Klára Stašková, Alan Bulava, Richard Tesařík, František Toušek
INTRODUCTION: Radiofrequency catheter ablation (RFA) has recently become a routine part of atrial fibrillation (AF) treatment. The goal of our study was to determine whether the implementation of RFA of AF under general anesthesia (GA), compared to analgosedation (AS), will affect important characteristics of the ablation procedure, comfort of the patient and whether there is any clinical impact on the complication rate and the overall success of the procedure. METHODS: 50 patients with AF were randomized in a ratio of 1 : 1 into two groups for RFA in AS and in GA...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28378573/bispectral-index-guided-sedation-in-transfemoral-transcatheter-aortic-valve-implantation-a-retrospective-control-study
#13
Wei He, Rong-Rong Huang, Qing-Yu Shi, Xian-Bao Liu, Jian-An Wang, Min Yan
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is a minimally invasive therapy for elderly patients with severe aortic valve stenosis who were refused surgical aortic valve replacement because of the high perioperative risk. Traditionally, this procedure has been done under general anesthesia, but more recently local anesthesia and sedation have become popular. This research assessed the effectiveness of transfemoral TAVI under bispectral index (BIS)-guided sedation. METHODS: In this single-center retrospective control analysis, clinical data, including demographic characteristics, echocardiography, periprocedural data, and main complications, were collected and assessed in 113 patients undergoing TAVI through the femoral artery under general anesthesia (GA group, n=36) and under BIS-guided sedation (SED group, n=77)...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28366463/transthoracic-device-closure-of-juxtaarterial-ventricular-septal-defects-midterm-follow-up-results
#14
Xueying Song, Quansheng Xing, Qin Wu, Yueyi Ren, Hao Wan, Jun Li
BACKGROUND: In recent years, minimally invasive transthoracic device closure has been introduced as an alternative treatment option for selected patients with juxtaarterial ventricular septal defects. This study evaluated the midterm safety and efficacy of using device closure in selected patients. METHODS: Between January 2008 and December 2014, 25 patients with juxtaarterial ventricular septal defects who met the inclusion criteria were enrolled in this study...
March 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28355374/qualitative-and-quantitative-ultrasound-assessment-of-gastric-content
#15
Flora Margarida Barra Bisinotto, Patrícia Luísa Pansani, Luciano Alves Matias da Silveira, Aline de Araújo Naves, Ana Cristina Abdu Peixoto, Hellen Moreira de Lima, Laura Bisinotto Martins
Objective: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content. Method: A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal...
February 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28343597/national-trends-and-in-hospital-outcomes-in-pregnant-women-with-heart-disease-in-the-united-states
#16
Fabio V Lima, Jie Yang, Jianjin Xu, Kathleen Stergiopoulos
Investigation of trends and outcomes in heart disease (HD) and pregnancy has been limited. We chose to identify the prevalence, trends, and outcomes of pregnant women with different forms of HD in the United States. Healthcare Cost and Utilization Project's National Inpatient Sample was screened for hospital admissions for delivery in pregnant women with HD from 2003 to 2012. Maternal clinical characteristics and outcomes were identified in women with and without HD, and in HD subtypes: congenital (CHD), valvular HD, cardiomyopathy, and pulmonary hypertension (PH)...
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28306578/selective-low-volume-nerve-block-for-the-open-surgical-fixation-of-a-midshaft-clavicle-fracture-in-a-conscious-high-risk-patient-a-case-report
#17
Carlos I Salvadores de Arzuaga, José M Naya Sieiro, Oscar Salmeron Zafra, Miguel A González Posada, Esther Marquez Martínez
We report a case of successful intraoperative management using only low-volume regional anesthesia for the open surgical fixation of a traumatic clavicle fracture in a conscious 69-year-old man with severe chronic obstructive pulmonary disease. To avoid general anesthesia, we provided low-volume C5 and C6 nerve root blocks along with a superficial cervical plexus block using only 9 mL of anesthetic solution to avoid the often encountered complications of higher volume injections. Throughout the procedure, the patient remained comfortable and cooperative with stable hemodynamics and respiration...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28288059/effects-of-intraoperative-fluid-management-on-postoperative-outcomes-a-hospital-registry-study
#18
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/28281366/artificial-pneumothorax-a-safe-and-simple-method-to-relieve-pain-during-microwave-ablation-of-subpleural-lung-malignancy
#19
Xiaowei Hou, Xingjun Zhuang, Haiwen Zhang, Kai Wang, Yuanxin Zhang
BACKGROUND: Microwave ablation has been extensively used for eliminating pulmonary tumors; however, it is usually associated with severe pain under local anesthesia. Decreasing the power and shortening the ablation time can help to relieve the pain; however, this leads to incomplete ablation and an increasing recurrence rate. This research aims to employ an artificial pneumothorax to increase both the curative effect and pain relief during the ablation procedure. MATERIAL AND METHODS: From July 2013 to January 2015, nine patients presenting with 10 subpleural lung tumors (age: 44-78 years) with a high possibility of severe pain underwent the artificial pneumothorax during microwave ablation...
February 14, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28277258/continuous-versus-single-shot-brachial-plexus-block-and-their-relationship-to-discharge-barriers-and-length-of-stay
#20
Matthew Thompson, Robert Simonds, Bryce Clinger, Kristen Kobulnicky, Adam P Sima, Laura Lahaye, N Douglas Boardman
BACKGROUND: Brachial plexus block has been associated with improved pain control and decreased length of stay in patients undergoing upper extremity arthroplasty. Continuous delivery is associated with a shorter length of stay; however, comparisons to single-shot delivery in this setting are scarce. As the paradigm shifts to outpatient arthroplasty in the era of bundled payments, there exists a strong impetus to identify the most effective mode of analgesia associated with the least risk to patients...
October 26, 2016: Journal of Shoulder and Elbow Surgery
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