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Risk assessment anesthesia

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https://www.readbyqxmd.com/read/28647806/pre-anesthetic-stroke-volume-variation-can-predict-cardiac-output-decrease-and-hypotension-during-induction-of-general-anesthesia
#1
Takashi Juri, Koichi Suehiro, Sayaka Tsujimoto, Shigemune Kuwata, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
This study aimed to assess the reliability of stroke volume variation (SVV) in predicting cardiac output (CO) decrease and hypotension during induction of general anesthesia. Forty-five patients undergoing abdominal surgery under general anesthesia were enrolled. Before induction of anesthesia, patients were required to maintain deep breathing (6-8 times/min), and pre-anesthetic SVV was measured for 1 min by electrical cardiometry. General anesthesia was induced with propofol, remifentanil, rocuronium, and sevoflurane...
June 24, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28643079/similar-clinical-outcomes-with-preoperative-and-postoperative-start-of-thromboprophylaxis-in-tha-a-register-based-study
#2
Pål O Borgen, Are H Pripp, Eva Dybvik, Lilian Leistad, Ola E Dahl, Olav Reikerås
BACKGROUND: Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding. QUESTIONS/PURPOSES: We asked the following questions: (1) Is there a difference in bleeding events with pre- versus postoperative thromboprophylaxis? (2) Is there a difference in thromboembolic episodes after THA between the two regimens? (3) How do the two approaches of thromboprophylaxis influence mortality, readmissions, and other complications? METHODS: We used a population-based followup design with predefined data based on international health codification to assess clinical effects of LMWH prophylaxis initiated before or after THA...
June 22, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#3
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28622969/probability-of-undiagnosed-obstructive-sleep-apnea-does-not-correlate-with-adverse-pulmonary-events-nor-length-of-stay-in-hip-and-knee-arthroplasty-using-intrathecal-opioid
#4
Matthew J Thompson, Bryce N Clinger, Robert M Simonds, Camille J Hochheimer, Laura A Lahaye, Gregory J Golladay
BACKGROUND: Recent emphasis on bundled payments and outcomes tracking has increased the focus on preoperative optimization in patients undergoing elective lower extremity arthroplasty. Since patients with obstructive sleep apnea (OSA) have an increased risk of adverse perioperative pulmonary events, screening for undiagnosed OSA is sometimes included as part of preoperative risk assessment. However, there are limited data regarding quantification of OSA risk in lower extremity arthroplasty patients, and little is known about the utility of quantitative OSA screening and the risk of pulmonary complications in hip and knee arthroplasty patients who receive intrathecal morphine anesthetic...
April 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28620866/high-levels-of-igf-1-predict-difficult-intubation-of-patients-with-acromegaly
#5
Yu Zhang, Xiaopeng Guo, Lijian Pei, Zhuhua Zhang, Gang Tan, Bing Xing
PURPOSE: To investigate the characteristics of difficult intubation and identify novel efficient predictors in patients with acromegaly. METHODS: Patients with either untreated acromegaly or non-functional pituitary adenomas were enrolled. Patients with acromegaly underwent hormone assays, upper airway computed tomography and magnetic resonance imaging examinations and preoperative overnight polysomnography. The modified Mallampati classification, mouth opening, neck circumference, and neck extension were assessed, and the Cormack-Lehane grades and the time of tracheal intubation were recorded...
June 15, 2017: Endocrine
https://www.readbyqxmd.com/read/28617687/preoperatively-assessable-clinical-and-pathological-risk-factors-for-parametrial-involvement-in-surgically-treated-figo-stage-ib-iia-cervical-cancer
#6
Emel Canaz, Eser Sefik Ozyurek, Baki Erdem, Merve Aldikactioglu Talmac, Ipek Yildiz Ozaydin, Ozgur Akbayir, Ceyhun Numanoglu, Volkan Ulker
OBJECTIVE: Determining the risk factors associated with parametrial involvement (PMI) is of paramount importance to decrease the multimodality treatment in early-stage cervical cancer. We investigated the preoperatively assessable clinical and pathological risk factors associated with PMI in surgically treated stage IB1-IIA2 cervical cancer. METHODS: A retrospective cohort study of women underwent Querleu-Morrow type C hysterectomy for cervical cancer stage IB1-IIA2 from 2001 to 2015...
June 14, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28614125/development-and-validation-of-a-risk-scale-for-emergence-agitation-after-general-anesthesia-in-children-a-prospective-observational-study
#7
Maai Hino, Takahiro Mihara, Saeko Miyazaki, Toshiyuki Hijikata, Takaaki Miwa, Takahisa Goto, Koui Ka
BACKGROUND: Emergence agitation (EA) is a common complication in children after general anesthesia. The goal of this 2-phase study was (1) to develop a predictive model (EA risk scale) for the incidence of EA in children receiving sevoflurane anesthesia by performing a retrospective analysis of data from our previous study (phase 1) and (2) to determine the validity of the EA risk scale in a prospective observational cohort study (phase 2). METHODS: Using data collected from 120 patients in our previous study, logistic regression analysis was used to predict the incidence of EA in phase 1...
June 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28607669/risk-factors-for-adverse-drug-reactions-in-pediatric-inpatients-a-systematic-review
#8
REVIEW
Paulo Henrique Santos Andrade, Adriano da Silva Santos, Carlos Adriano Santos Souza, Iza Maria Fraga Lobo, Wellington Barros da Silva
BACKGROUND: The main objective of the present systematic review is to identify potential risk factors for adverse drug reactions (ADRs) through prospective cohort studies in pediatric inpatients. METHODS: The data search was done in the following electronic databases PubMed/MEDLINE; Scopus; LILACS and Web of Science from the earliest record until 31 May 2015. Two reviewers independently screened each study and one of them assessed the methodological quality according to the Newcastle-Ottawa scale for cohort studies...
June 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28587738/important-non-technical-skills-in-video-assisted-thoracoscopic-surgery-lobectomy-team-perspectives
#9
Kirsten Gjeraa, Anna S Mundt, Lene Spanager, Henrik J Hansen, Lars Konge, René H Petersen, Doris Østergaard
BACKGROUND: Safety in the operating room is dependent on the team's non-technical skills. The importance of non-technical skills appears to be different for minimally invasive surgery as compared with open surgery. The aim of this study was to identify which non-technical skills are perceived by team members to be most important for patient safety, in the setting of video-assisted thoracoscopic surgery (VATS) lobectomy. METHODS: This was an explorative, semistructured interview-based study with 21 participants from all four thoracic surgery centers in Denmark that perform VATS lobectomy...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28583617/totally-implantable-intravenous-treprostinil-therapy-in-pulmonary-hypertension-assessment-of-the-implantation-procedure
#10
Aaron B Waxman, Hugh T McElderry, Mardi Gomberg-Maitland, Martin C Burke, Edgar L Ross, Malcolm M Bersohn, Sanjog S Pangarkar, James H Tarver, Diane L Zwicke, Jeremy P Feldman, Murali M Chakinala, Robert P Frantz, Geoffrey B Thompson, Fernando Torres, Richard L Rauck, Kathy Clagg, Louise Durst, Pei Li, Marty Morris, Kara L Southall, Leigh Peterson, Robert C Bourge
BACKGROUND: Prostacyclins improve symptoms and survival in pulmonary arterial hypertension (PAH). In response to risks associated with external delivery systems, an implantable intravenous infusion system was developed. A multicenter, prospective, single-arm, clinical trial (DelIVery for PAH) was conducted to evaluate this system for treprostinil in PAH. This analysis describes the findings related to the implant procedure. METHODS: Patients (n=64) with PAH (WHO Group 1) receiving stable intravenous treprostinil were enrolled...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28583247/pediatric-caries-risk-assessment-as-a-predictor-of-caries-outcomes
#11
Benjamin W Chaffee, John D B Featherstone, Ling Zhan
PURPOSE: To determine cumulative dental treatment experience in a retrospective clinical cohort, according to baseline caries risk assessment (CRA) information. METHODS: Evaluated were electronic records from a university pediatric dental clinic (2009 to 2014) of new, six- to 72- month-old patients who were not treated under sedation or general anesthesia (<small>N</small> equals 750). The mean number of teeth restored or extracted (two-year total and omitting the first 190 days post-baseline to discount initial treatment needs) was compared by baseline CRA category and CRA items (caries risk indicators, protective items, and clinical disease indicators)...
May 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/28576279/-atypical-reaction-to-anesthesia-in-duchenne-becker-muscular-dystrophy
#12
Helga Cristina Almeida da Silva, Marcia Hiray, Mariz Vainzof, Beny Schmidt, Acary Souza Bulle Oliveira, José Luiz Gomes do Amaral
BACKGROUND AND OBJECTIVES: Duchenne/Becker muscular dystrophy affects skeletal muscles and leads to progressive muscle weakness and risk of atypical anesthetic reactions following exposure to succinylcholine or halogenated agents. The aim of this report is to describe the investigation and diagnosis of a patient with Becker muscular dystrophy and review the care required in anesthesia. CASE REPORT: Male patient, 14 years old, referred for hyperCKemia (chronic increase of serum creatine kinase levels - CK), with CK values of 7,779-29,040IU...
May 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28555781/high-c-reactive-protein-predicts-delirium-incidence-duration-and-feature-severity-after-major-noncardiac-surgery
#13
Sarinnapha M Vasunilashorn, Simon T Dillon, Sharon K Inouye, Long H Ngo, Tamara G Fong, Richard N Jones, Thomas G Travison, Eva M Schmitt, David C Alsop, Steven D Freedman, Steven E Arnold, Eran D Metzger, Towia A Libermann, Edward R Marcantonio
OBJECTIVES: To examine associations between the inflammatory marker C-reactive protein (CRP) measured preoperatively and on postoperative day 2 (POD2) and delirium incidence, duration, and feature severity. DESIGN: Prospective cohort study. SETTING: Two academic medical centers. PARTICIPANTS: Adults aged 70 and older undergoing major noncardiac surgery (N = 560). MEASUREMENTS: Plasma CRP was measured using enzyme-linked immunosorbent assay...
May 26, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28547078/infiltrative-local-anesthesia-with-articaine-is-equally-as-effective-as-inferior-alveolar-nerve-block-with-lidocaine-for-the-removal-of-erupted-molars
#14
J Venkat Narayanan, Prashanthi Gurram, Radhika Krishnan, Veerabahu Muthusubramanian, V Sadesh Kannan
AIM: The aim of this study is to assess the efficacy of 4% articaine with 1:100,000 adrenaline given as buccal and lingual infiltration in adult patients undergoing erupted mandibular first and second molar teeth extraction versus inferior alveolar nerve block technique using 2% lignocaine with 1:80,000 adrenaline. MATERIALS AND METHODS: A total of 100 patients undergoing extraction of mandibular posterior teeth were divided into two equally matched groups for the study, out of which 50 patients were given 4% articaine with 1:100,000 adrenaline as buccal and lingual infiltration and 50 patients were given 2% lignocaine with 1:80,000 adrenaline using classic direct inferior alveolar nerve block with lingual and buccal nerve block...
May 25, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28543108/complications-and-30-day-hospital-readmission-rates-of-patients-undergoing-tracheostomy-a-prospective-analysis
#15
Emily Spataro, Nedim Durakovic, Dorina Kallogjeri, Brian Nussenbaum
OBJECTIVE: To determine inpatient and outpatient tracheostomy complication rates and 30-day hospital readmission rates, and to assess patient and procedural risk factors associated with complications and readmissions. STUDY DESIGN: Prospective cohort study. METHODS: Adult patients undergoing tracheostomy at a single academic hospital performed by any service, for any indication, were enrolled in this study over the course of 1 year. All patients had complete 30-day follow-up after discharge to determine complication and hospital readmission rates...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28542415/pharmacological-thromboprophylaxis-and-its-impact-on-venous-thromboembolism-following-total-knee-and-hip-arthroplasty-in-korea-a-nationwide-population-based-study
#16
Ho-Young Yhim, Juhyun Lee, Ji Yun Lee, Jeong-Ok Lee, Soo-Mee Bang
BACKGROUND: Limited data is available regarding the pharmacological prophylaxis for venous thromboembolism (VTE) in Asian patients undergoing total knee arthroplasty or total hip arthroplasty (TKA/THA). METHODS: We performed a population-based epidemiological study using the Health Insurance Review and Assessment Service database to estimate the rate of pharmacological thromboprophylaxis and its impact on VTE in Korean patients who underwent TKA/THA between 2009 and 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28540236/risk-factors-for-acute-renal-failure-in-nephrectomized-patients-treated-in-a-university-hospital
#17
João Paulo Pretti Fantin, Ronaldo de Carvalho Neiva, Marcio Gatti, Pedro Ferraz de Arruda, José Germano Ferraz de Arruda, Thiago Antoniassi, Luís Cesar Fava Spessoto, José Carlos Mesquita, Lilian Castiglioni, Fernando-Nestor Fácio-Júnior
BACKGROUND: New surgical techniques for nephrectomy mainly related to early diagnosis made possible by advances in imaging studies have been developed in recent decades. However, postoperative renal dysfunction is a constant concern because of the major problems faced by healthcare services and by the patients themselves. To assess risk factors for developing acute renal failure (ARF) in patients submitted to nephrectomy in a university hospital. METHODS: Seventy-seven patients submitted to nephrectomy for benign and malignant diseases in a university hospital were evaluated in respect to preoperative and postoperative creatinine clearance...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28537570/safe-and-uncomplicated-inguinal-hernia-surgery-in-the-elderly-message-from-anesthesiologists-to-general-surgeons
#18
Tomasz Chlebny, Piotr Zelga, Mateusz Pryt, Marta Zelga, Adam Dziki
Introduction Elderly patients are often discouraged from surgery due to the risk of complications that increases with age. Aim We wanted to assess mortality, morbidity, and complications in patients older than 75 years who underwent elective or emergency inguinal hernia repair in a single center. Methods All patients older than 75 years who were operated on because of inguinal hernia in the Department of General and Colorectal Surgery, Medical University of Lodz between 2003 and 2015 were analyzed. Detailed information was collected with regard to patient demographics, mode of admission, comorbidities, type of intervention, applied anesthesia, and 30-day outcomes...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#19
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28533746/intraoperative-frontal-alpha-band-power-correlates-with-preoperative-neurocognitive-function-in-older-adults
#20
Charles M Giattino, Jacob E Gardner, Faris M Sbahi, Kenneth C Roberts, Mary Cooter, Eugene Moretti, Jeffrey N Browndyke, Joseph P Mathew, Marty G Woldorff, Miles Berger
Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD...
2017: Frontiers in Systems Neuroscience
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