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Post operative fluid maintenance

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https://www.readbyqxmd.com/read/29569172/a-retrospective-evaluation-of-the-perioperative-drug-use-and-comparison-of-its-cost-in-robotic-vs-open-surgery-for-endometrial-cancer
#1
Reshu Agarwal, Anupama Rajanbabu, U G Unnikrishnan
To compare the usage and cost of analgesics (opioid and non-opioids), antiemetics, and IV fluids and its associated costs in robotic vs open staging surgery for endometrial cancer (EC). This retrospective study was performed at a single academic institution from January 2014 to June 2017 in the department of Gynecology Oncology at Amrita Institute of Medical Science, Kerala, India. The study included women with biopsy confirmed clinically early stage endometrial cancer or atypical hyperplasia, who underwent robotic-assisted or open staging surgery...
March 22, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29386975/balanced-fluid-versus-saline-based-fluid-in-post-operative-severe-traumatic-brain-injury-patients-acid-base-and-electrolytes-assessment
#2
Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29349881/speech-and-language-therapists-perspectives-of-therapeutic-alliance-construction-and-maintenance-in-aphasia-rehabilitation-post-stroke
#3
Michelle Lawton, Karen Sage, Gillian Haddock, Paul Conroy, Laura Serrant
BACKGROUND: Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change...
January 18, 2018: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/29207250/a-survey-of-dog-and-cat-anaesthesia-in-a-sample-of-veterinary-practices-in-new-zealand
#4
H Sano, K Barker, T Odom, K Lewis, P Giordano, V Walsh, J P Chambers
AIMS: To survey current anaesthesia practices for dogs and cats in small and mixed animal practices in New Zealand in order to improve anaesthesia education. METHODS: A questionnaire was sent to 440 small and mixed animal practices, including questions regarding the type of practice, preanaesthetic examination, anaesthetic drugs and management, anaesthetic machines, monitoring and topics of interest for continuing professional development. RESULTS: Responses were obtained from 113/440 (26%) practices, with 78 (69%) respondents from small and 35 (31%) from mixed animal practices...
March 2018: New Zealand Veterinary Journal
https://www.readbyqxmd.com/read/29132842/-a-comparison-of-post-surgical-plasma-glucose-levels-in-patients-on-fluids-with-different-glucose-concentrations
#5
Isabel Martínez Carapeto, José Domingo López Castilla, Reyes Fresneda Gutiérrez
OBJECTIVE: To compare plasma glucose levels and incidence of hyperglycaemia in the post-operative period after general surgery using fluids with different glucose. METHODOLOGY: A randomised, open-label, non-blind, clinical trial was conducted on patients admitted to Paediatric Intensive Care Unit after elective surgery. The inclusion criteria were from 6 months to 14 years of age, with a weight greater than 6kg, onset glucose level >60mg/dL, and a signed informed consent, with no oral intake and maintenance intravenous fluid therapy using fluids with 3...
November 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29068831/crystalloid-versus-colloid-for-intraoperative-goal-directed-fluid-therapy-using-a-closed-loop-system-a-randomized-double-blinded-controlled-trial-in-major-abdominal-surgery
#6
RANDOMIZED CONTROLLED TRIAL
Alexandre Joosten, Amelie Delaporte, Brigitte Ickx, Karim Touihri, Ida Stany, Luc Barvais, Luc Van Obbergh, Patricia Loi, Joseph Rinehart, Maxime Cannesson, Philippe Van der Linden
BACKGROUND: The type of fluid and volume regimen given intraoperatively both can impact patient outcome after major surgery. This two-arm, parallel, randomized controlled, double-blind, bi-center superiority study tested the hypothesis that when using closed-loop assisted goal-directed fluid therapy, balanced colloids are associated with fewer postoperative complications compared to balanced crystalloids in patients having major elective abdominal surgery. METHODS: One hundred and sixty patients were enrolled in the protocol...
January 2018: Anesthesiology
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#7
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27509767/traditional-canister-based-open-waste-management-system-versus-closed-system-hazardous-exposure-prevention-and-operating-theatre-staff-satisfaction
#8
COMPARATIVE STUDY
M Horn, N Patel, D M MacLellan, N Millard
INTRODUCTION: Exposure to blood and body fluids is a major concern to health care professionals working in operating rooms (ORs). Thus, it is essential that hospitals use fluid waste management systems that minimise risk to staff, while maximising efficiency. METHOD: The current study compared the utility of a 'closed' system with a traditional canister-based 'open' system in the OR in a private hospital setting. RESULTS: A total of 30 arthroscopy, urology, and orthopaedic cases were observed...
June 2016: ORNAC Journal
https://www.readbyqxmd.com/read/26643095/modes-of-mechanical-ventilation-for-the-operating-room
#9
REVIEW
Lorenzo Ball, Maddalena Dameri, Paolo Pelosi
Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis...
September 2015: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/26070865/the-effect-of-nacl-0-9-and-nacl-0-45-on-sodium-chloride-and-acid-base-balance-in-a-picu-population
#10
RANDOMIZED CONTROLLED TRIAL
Helena Isabel Almeida, Maria Inês Mascarenhas, Helena Cristina Loureiro, Clara S Abadesso, Pedro S Nunes, Marta S Moniz, Maria Céu Machado
OBJECTIVES: To study the effect of two intravenous maintenance fluids on plasma sodium (Na), and acid-base balance in pediatric intensive care patients during the first 24h of hospitalization. METHODS: A prospective randomized controlled study was performed, which allocated 233 patients to groups: (A) NaCl 0.9% or (B) NaCl 0.45%. Patients were aged 1 day to 18 years, had normal electrolyte concentrations, and suffered an acute insult (medical/surgical). MAIN OUTCOME MEASURED: change in plasma sodium...
September 2015: Jornal de Pediatria
https://www.readbyqxmd.com/read/25268098/management-and-prevention-of-chylous-leakage-after-laparoscopic-lymphadenectomy
#11
L-P Han, H-M Zhang, H-D Abha, T Liu, X-P Zhang
OBJECTIVE: To investigate the development and management of chylous leakage after laparoscopic retroperitoneal lymphadenectomy. PATIENTS AND METHODS: From July 2006 to September 2013, 13 cases of chylous leakage after the laparoscopic lymphadenectomy (6 cases of renal cell carcinoma, 4 cases of gastric cancer, 2 cases of ovarian cancer, 1 case of endometrial cancer) were studied to analyze the occurrence, development and management of chylous leakage. RESULTS: In 3 cases (2 cases of renal cell carcinoma, 1 case of gastric cancer) massive amount of milky fluid drainage was be seen after the first two days post operation...
2014: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/24966929/reduced-mir-9-and-mir-181a-expression-down-regulates-bim-concentration-and-promote-osteoclasts-survival
#12
Shilong Wang, Chaoliang Tang, Quan Zhang, Wenjun Chen
Tibial plateau fractures are often the result of blunt trauma and are associated with severe soft-tissue injury. Operative management of high-energy fractures remains difficult and challenging because the injuries often associated with serious complications. MicroRNAs (miRNAs) are the class of short noncoding single-stranded RNA molecules that negatively regulate gene expression. miRNAs contribute to every step of osteogenesis from embryonic bone development to maintenance of adult bone tissue, and disturbed miRNAs expression are identified related to osteoporosis, osteosarcoma, post-traumatic arthritis and bone remodeling...
2014: International Journal of Clinical and Experimental Pathology
https://www.readbyqxmd.com/read/23754309/surgical-site-infections-following-craniotomy-focusing-on-possible-post-operative-acquisition-of-infection-prospective-cohort-study
#13
O Sneh-Arbib, A Shiferstein, N Dagan, S Fein, L Telem, E Muchtar, N Eliakim-Raz, B Rubinovitch, G Rubin, Z H Rappaport, M Paul
Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections...
December 2013: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/23659421/gingival-crevicular-fluid-matrix-metalloproteinase-8-levels-predict-treatment-outcome-among-smokers-with-chronic-periodontitis
#14
COMPARATIVE STUDY
Jussi M Leppilahti, Mikko A Kallio, Taina Tervahartiala, Timo Sorsa, Päivi Mäntylä
BACKGROUND: Molecular biomarkers are needed for diagnostic use in periodontal diseases. The aim of this study is to explore different gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) patterns in smokers and non-smokers with chronic periodontitis (CP) and test the utility of baseline GCF MMP-8 levels in predicting categorically assessed treatment outcomes. METHODS: The study population comprised 15 patients with CP (five non-smokers and 10 smokers)...
February 2014: Journal of Periodontology
https://www.readbyqxmd.com/read/23418987/management-of-prolonged-post-operative-ileus-evidence-based-recommendations
#15
REVIEW
Ryash Vather, Ian Bissett
BACKGROUND: Prolonged post-operative ileus (PPOI) occurs in up to 25% of patients following major elective abdominal surgery. It is associated with a higher risk of developing post-operative complications, prolongs hospital stay and confers a significant financial load on health-care institutions. Literature outlining best-practice management strategies for PPOI is nebulous. The aim of this text was to review the literature and provide concise evidence-based recommendations for its management...
May 2013: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/22257473/management-of-acute-severe-ulcerative-colitis
#16
David B Sachar
When a patient is hospitalized with acute, severe ulcerative colitis, the primary decision is whether or not to proceed directly to surgery. Absolute indications for an immediate colectomy include exsanguinating hemorrhage, perforation and cancer. If medical therapy is undertaken, however, the decision for urgent surgery or non-operative salvage therapy will still be required in 15-50% of the patients in which there is a failure to respond within 3-5 days to a standard regimen of i.v. steroids, antibiotics, decompressive maneuvers, fluid and electrolyte replacement and other supportive measures...
February 2012: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/21955538/the-use-of-lidco-based-fluid-management-in-patients-undergoing-hip-fracture-surgery-under-spinal-anaesthesia-neck-of-femur-optimisation-therapy-targeted-stroke-volume-notts-study-protocol-for-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Matthew D Wiles, William J D Whiteley, Chris G Moran, Iain K Moppett
BACKGROUND: Approximately 70,000 patients/year undergo surgery for repair of a fractured hip in the United Kingdom. This is associated with 30-day mortality of 9% and survivors have a considerable length of acute hospital stay postoperatively (median 26 days). Use of oesophageal Doppler monitoring to guide intra-operative fluid administration in hip fracture repair has previously been associated with a reduction in hospital stay of 4-5 days. Most hip fracture surgery is now performed under spinal anaesthesia...
September 28, 2011: Trials
https://www.readbyqxmd.com/read/21943218/a-randomized-controlled-trial-of-isotonic-versus-hypotonic-maintenance-intravenous-fluids-in-hospitalized-children
#18
RANDOMIZED CONTROLLED TRIAL
Thomas G Saba, James Fairbairn, Fiona Houghton, Diane Laforte, Bethany J Foster
BACKGROUND: Isotonic saline has been proposed as a safer alternative to traditional hypotonic solutions for intravenous (IV) maintenance fluids to prevent hyponatremia. However, the optimal tonicity of maintenance intravenous fluids in hospitalized children has not been determined. The objective of this study was to estimate and compare the rates of change in serum sodium ([Na]) for patients administered either hypotonic or isotonic IV fluids for maintenance needs. METHODS: This was a masked controlled trial...
September 23, 2011: BMC Pediatrics
https://www.readbyqxmd.com/read/21729308/the-efficacy-of-hypotonic-and-near-isotonic-saline-for-parenteral-fluid-therapy-given-at-low-maintenance-rate-in-preventing-significant-change-in-plasma-sodium-in-post-operative-pediatric-patients-protocol-for-a-prospective-randomized-non-blinded-study
#19
RANDOMIZED CONTROLLED TRIAL
Urban Fläring, Per-Arne Lönnqvist, Björn Frenckner, Jan F Svensson, Ingimar Ingolfsson, Lena Wallensteen, Shayarina Stigzelius, Jan Kowalski, Rafael T Krmar
BACKGROUND: Hyponatremia is the most frequent electrolyte abnormality observed in post-operative pediatric patients receiving intravenous maintenance fluid therapy. If plasma sodium concentration (p-Na+) declines to levels below 125 mmol/L in < 48 h, transient or permanent brain damage may occur. There is an intense debate as to whether the administered volume (full rate vs. restricted rate of infusion) and the composition of solutions used for parenteral maintenance fluid therapy (hypotonic vs...
July 5, 2011: BMC Pediatrics
https://www.readbyqxmd.com/read/20935615/central-venous-pressure-during-the-post-anhepatic-phase-is-not-associated-with-early-postoperative-outcomes-following-orthotopic-liver-transplantation
#20
J B Cywinski, E Mascha, J You, M Argalious, L Kapural, E Christiansen, B M Parker
BACKGROUND: Fluid management during orthotopic liver transplantation poses unique challenges for the anesthesiologist. Maintenance of hypovolemia as indicated by low central venous pressure has been associated with reduced blood loss and improved outcomes in some studies, but with higher 30-day mortality and increased incidence of renal dysfunction in others. The primary aim was to evaluate the association of central venous pressure management after liver allograft reperfusion with immediate postoperative patient outcomes...
October 2010: Minerva Anestesiologica
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