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https://www.readbyqxmd.com/read/28326200/the-anaesthesiologist-and-palliative-care-in-a-newborn-with-the-adam-sequence
#1
Alberto Vieira Pantoja, Maria Emília Gonçalves Estevez, Bruno Lima Pessoa, Fernando de Paiva Araújo, Bruno Mendonça Barcellos, Ciro Augusto Floriani, Marco Antonio Cardoso de Resende
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM "sequence," in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28323727/experience-with-the-use-of-single-use-disposable-bronchoscope-in-the-icu-in-a-tertiary-referral-center-of-singapore
#2
Dominic C Marshall, Rucha S Dagaonkar, Chan Yeow, Anura T Peters, Siew Kin Tan, Dessmon Y H Tai, Soon Keng Gohs, Albert Y H Lim, Benjamin Ho, Sennen J W Lew, John Abisheganaden, Akash Verma
BACKGROUND: Flexible bronchoscopy is performed frequently in intensive care units (ICUs) for various indications using the reusable conventional bronchoscope (CB). Recently, "single-use disposable bronchoscope" (SB) was introduced into the health care industry. The purpose of this study was to compare the utility of SB with CB in ICU. METHODS: A retrospective review of medical records of patients undergoing flexible bronchoscopy in the ICUs in the year 2015. RESULTS: Ninety-three patients undergoing flexible bronchoscopy in the ICU were studied...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#3
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28320386/delayed-gastric-emptying-following-pancreatoduodenectomy-with-alimentary-reconstruction-according-to-roux-en-y-or-billroth-ii
#4
Tim R Glowka, Markus Webler, Hanno Matthaei, Nico Schäfer, Volker Schmitz, Jörg C Kalff, Jens Standop, Steffen Manekeller
BACKGROUND: Delayed gastric emptying (DGE) remains the most frequent complication following pancreatoduodenectomy (PD) with published incidences as high as 61%. The present study investigates the impact of bowel reconstruction techniques on DGE following classic PD (Whipple-Kausch procedure) with pancreatogastrostomy (PG). METHODS: We included 168 consecutive patients who underwent PD with PG with either Billroth II type (BII, n = 78) or Roux-en-Y type reconstruction (ReY, n = 90) between 2004 and 2015...
March 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28318531/national-survey-on-postoperative-care-and-treatment-circuits-in-neurosurgery
#5
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#6
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28298944/4-point-ultrasonography-to-confirm-the-correct-position-of-the-nasogastric-tube-in-114-critically-ill-patients
#7
Marianna Zatelli, Norberto Vezzali
PURPOSE: Nasogastric feeding tube is routinely positioned in intensive care units. The complications of misplacement are rare but very dangerous for the patients. The aim of this study is to estimate the diagnostic accuracy of this new technique, 4-point ultrasonography to confirm nasogastric tube placement in intensive care. METHODS: One hundred fourteen critical ill patients monitored in ICU were included. The intensivist provided in real time to perform the exam in four steps: sonography from either the right or left side of the patient's neck to visualize the esophagus, sonography of epigastrium to confirm the passage through the esophagogastric junction and the positioning in antrum, sonography of the fundus...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#8
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28291303/thoracic-endovascular-aortic-repair-for-traumatic-type-b-aortic-dissection-a-five-year-experience-from-a-single-center
#9
Shuang Li, Wenwu Cai, Xin Li, Jian Qiu, Quanming Li, Chang Shu
BACKGROUND: to share our experience and demonstrate the feasibility, safety and efficacy of Thoracic endovascular aortic repair (TEVAR) for traumatic Type B Aortic Dissection (TTBAD). METHODS: Between October 2010 and October 2015, 36 patients, who have been diagnosed as TTBAD, were included. A computed tomography angiography (CTA) scan was performed to confirm the diagnosis and to localize the aortic entry. The clinical data and outcomes of these patients were retrospectively reviewed and collected for further analysis...
March 14, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#10
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28282377/before-the-bombing-high-burden-of-traumatic-injuries-in-kunduz-trauma-center-kunduz-afghanistan
#11
Hamayoun Hemat, Safieh Shah, Petros Isaakidis, Mrinalini Das, Nang Thu Thu Kyaw, Sattar Zaheer, Abdul Qayeum Qasemy, Mutallib Zakir, Gbane Mahama, Catherine Van Overloop, Lynette Dominguez
BACKGROUND: Médecins Sans Frontières (MSF) has been providing healthcare in Afghanistan since 1981 including specialized health services for trauma patients in Kunduz Trauma Center (KTC) from 2011. On October 3rd, 2015, a US airstrike hit the KTC, killing 42 people including 14 MSF staff. This study aims to demonstrate the impact on healthcare provision, after hospital destruction, by assessing the extent of care provided for trauma and injuries by the MSF KTC and to report on treatment outcomes from January 2014 to June 2015, three months prior to the bombing...
2017: PloS One
https://www.readbyqxmd.com/read/28281412/early-hybrid-approach-and-enteral-feeding-algorithm-could-reduce-the-incidence-of-necrotising-enterocolitis-in-neonates-with-ductus-dependent-systemic-circulation
#12
Lucia Manuri, Stefano Morelli, Salvatore Agati, Michele B Saitta, Lilia Oreto, Giuseppe Mandraffino, Enrico Iannace, Fiore S Iorio, Paolo Guccione
BACKGROUND: The reported incidence of necrotising enterocolitis in neonates with complex CHD with ductus-dependent systemic circulation ranges from 6.8 to 13% despite surgical treatment; the overall mortality is between 25 and 97%. The incidence of gastrointestinal complications after hybrid palliation for neonates with ductus-dependent systemic circulation still has to be defined, but seems comparable with that following the Norwood procedure. METHODS: We reviewed the incidence of gastrointestinal complications in a series of 42 consecutive neonates with ductus-dependent systemic circulation, who received early hybrid palliation associated with a standardised feeding protocol...
January 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28277896/resource-utilization-and-procedure-related-costs-associated-with-transfemoral-transcatheter-aortic-valve-replacement
#13
Holger Klein, Jana Boleckova
AIMS: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical valve replacement for patients with aortic stenosis (AS). This study assessed the impact of changing from a self-expandable (SE) valve to a balloon-expandable (BE) valve on healthcare resource use and procedural costs in a population of inoperable AS patients. METHODS: In this retrospective single center study, data for 195 patients who received either an SE or a BE valve between 2010 and 2014 were collected...
March 9, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28274520/the-carotid-artery-as-a-preferred-alternative-access-route-for-transcatheter-aortic-valve-replacement
#14
Eric B Kirker, Robert W Hodson, Kateri J Spinelli, Ethan C Korngold
BACKGROUND: In high-risk patients with severe aortic stenosis, transfemoral (TF) access for transcatheter aortic valve replacement (TAVR) is the preferred access route but is not always feasible. Compared with other alternative access routes, transcarotid (TC) access is often overlooked by many valvular heart teams. METHODS: We report our single-center experience of all patients undergoing TC (n = 25), transapical (TA) (n = 12), or TF (n = 100; limited to most recent cases) TAVR over a 1...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#15
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28257296/extracorporeal-circulation-during-lung-transplantation-procedures-a-meta-analysis
#16
Dominik J Hoechter, Yu-Ming Shen, Tobias Kammerer, Sabina Günther, Weig Thomas, René Schramm, Christian Hagl, Frank Born, Bruno Meiser, Gerhard Preissler, Hauke Winter, Stephan Czerner, Bernhard Zwissler, Mansmann Ulrich, Vera von Dossow
Extracorporeal circulation is an invaluable tool in lung transplantation. Over the past years, an increasing number of centers changed their standard for intraoperative extracorporeal circulation from cardiopulmonary bypass to extracorporeal membrane oxygenation - with differing results. This meta-analysis reviews the existing evidence.An online literature research on Medline, Embase, and Pubmed has been performed. Two persons independently judged the papers using the ACROBAT-NRSI tool of the Cochrane collaboration...
February 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28248802/repeat-head-imaging-in-blunt-pediatric-trauma-patients-is-it-necessary
#17
E Patricia Hill, P J Stiles, Jared Reyes, R Joseph Nold, Stephen D Helmer, James M Haan
BACKGROUND: Children with confirmed brain injury usually undergo follow-up computed tomography scan (CT) of the head within 24 hours of admission. To date, no evidence exists to validate the diagnostic or therapeutic value of these repeat CTs. The purpose of this study was to: (1) evaluate progression of traumatic brain injuries, (2) determine if routine repeat imaging changes management, and (3) compare the efficacy of recognizing worsening hemorrhage with serial neurologic examination versus repeat imaging...
February 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28247591/back-to-the-roots-dual-cannulation-strategy-for-ambulatory-ecmo-in-adolescent-lung-transplant-candidates-an-alternative
#18
F Schmidt, T Jack, M Sasse, C Mueller, N Schwerk, D Bobylev, P Beerbaum, H Koeditz
Bridging critically ill pediatric patients to lung transplantation still remains a major challenge. Although still controversial, within the last 5 years, ECMO has been increasingly used as a bridge to lung transplantation concept in adult and pediatric patients with acceptable outcomes. The outstanding developments in the field of extracorporeal devices and the introduction of awake ECMO concepts with the avoidance of mechanical ventilation have led to a real paradigm shift in the ICU management of pretransplant candidates with severe respiratory failure...
March 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28241370/evolution-of-laparoscopic-liver-surgery-as-standard-procedure-for-hcc-in-cirrhosis
#19
Daniel Seehofer, Robert Sucher, Moritz Schmelzle, Robert Öllinger, Andri Lederer, Timm Denecke, Eckart Schott, Johann Pratschke
Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed for HCC in Child-A cirrhosis at our center. Mean MELD score was 9 (6 - 12), and the mean LiMAx was 261 µg/h/kg (101 - 489). All resections were performed by conventional laparoscopy using 4 - 6 trocars...
February 27, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28240700/factors-influencing-weaning-older-adults-from-mechanical-ventilation-an-integrative-review
#20
Karen V Stieff, Fidelindo Lim, Leon Chen
This study aim was to describe the influences that affect weaning from mechanical ventilation among older adults in the intensive care unit (ICU). Adults older than 65 years comprised only 14.5% of the US population in 2014; however, they accounted up to 45% of all ICU admissions. As this population grows, the number of ICU admissions is expected to increase. One of the most common procedures for hospitalized adults 75 years and older is mechanical ventilation. An integrative review methodology was applied to analyze and synthesize primary research reports...
April 2017: Critical Care Nursing Quarterly
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