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Cardiovascular perioperative evaluation

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https://www.readbyqxmd.com/read/29658678/emergency-surgery-for-bowel-obstruction-in-extremely-aged-patients
#1
Alberto Oldani, Valentina Gentile, Chiara Magaton, Marcello Calabrò, Fabio Maroso, Lidia Ravizzini, Giacomo Deiro, Maurizio Amato, Sergio Gentilli
BACKGROUND: As a result of the increasing of life expectancy, the incidence of pathologies that can lead to operation for bowel obstruction is also increasing. Comorbidities and reduced physiological reserve can decrease elderly patients' ability to tolerate operations especially in an emergency context. We retrospectively evaluated the treatment and outcomes of a cohort of patients aged more than 85 years who underwent emergency surgery for intestinal occlusion. METHODS: 278 patients who were admitted to our Institution and operated for acute bowel obstruction have been included in our study...
April 13, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29618572/influence-of-diabetes-on-trends-in-perioperative-cardiovascular-events
#2
Jonathan D Newman, Tanya Wilcox, Nathaniel R Smilowitz, Jeffrey S Berger
OBJECTIVE: Patients undergoing noncardiac surgery frequently have diabetes mellitus (DM) and an elevated risk of cardiovascular disease. It is unknown whether temporal declines in the frequency of perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) apply to patients with DM. RESEARCH DESIGN AND METHODS: Patients ≥45 years of age who underwent noncardiac surgery from January 2004 to December 2013 were identified using the U.S. National Inpatient Sample...
April 4, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29610608/pharmacotherapy-evaluation-and-utilization-in-coronary-artery-bypass-grafting-patients-in-kosovo-during-the-period-2016-2017
#3
Armond Daci, Adnan Bozalija, Raif Cavolli, Rame Alaj, Giangiacomo Beretta, Shaip Krasniqi
BACKGROUND: Coronary Artery Bypass Grafting (CABG) is realised in patients with critical or advanced disease of coronary arteries. There are different pharmacotherapeutic approaches which are used as management, treatment and preventive therapy in cardiovascular disease or related comorbidities. Performing a successful surgery, pharmacotherapy, and increase of bypass patency rate remains a serious challenge. AIM: This study aims to analyse the patient characteristics undergoing CABG and evaluation of their drug utilisation rate and daily dosages in the perioperative period...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29598850/evaluation-of-risk-factors-for-complications-after-bariatric-surgery
#4
D Quilliot, M-A Sirveaux, C Nomine-Criqui, T Fouquet, N Reibel, L Brunaud
The decision to perform a bariatric surgical procedure, the conclusion of a clinical pathway in which management is individually adapted to each patient, is taken after multidisciplinary consultation. Paradoxically, the patients who would most benefit from surgery are also those who have the highest operative risk. In practice, predictive factors of mortality and severe postoperative complications (Clavien-Dindo>III) must be used to evaluate the benefit/risk ratio most objectively. The main risk factors are age, male gender, body mass index, obstructive sleep apnea syndrome, insulin resistance and diabetes, tobacco abuse, cardiovascular disease, ability to lose weight before surgery, hypoalbuminemia and functional disability...
March 26, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29559052/effect-of-gender-on-postoperative-morbidity-and-mortality-outcomes-a-retrospective-cohort-study
#5
Muhyeddine Al-Taki, Hamdi G Sukkarieh, Jamal J Hoballah, Sarah F Jamali, Mohamad Habbal, Karim Z Masrouha, Racha Abi-Melhem, Hani Tamim
Full extent of gender differences on postoperative outcomes has never been studied on large scale, specifically postoperative complications. This study aims to assess the effect of gender on 30-day morbidity and mortality after major surgery. A retrospective cohort study was carried out using data of patients undergoing major surgeries from the American College of Surgeons' National Surgical Quality Improvement Program database between 2008 and 2011. Demographics, pre- and perioperative risk factors, as well as 30-day morbidities, both overall and specific, were reviewed...
March 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29556907/perioperative-management-of-patients-with-inflammatory-rheumatic-diseases-undergoing-major-orthopaedic-surgery-a-practical-overview
#6
REVIEW
Roberta Gualtierotti, Marco Parisi, Francesca Ingegnoli
Patients with inflammatory rheumatic diseases often need orthopaedic surgery due to joint involvement. Total hip replacement and total knee replacement are frequent surgical procedures in these patients. Due to the complexity of the inflammatory rheumatic diseases, the perioperative management of these patients must envisage a multidisciplinary approach. The frequent association with extraarticular comorbidities must be considered when evaluating perioperative risk of the patient and should guide the clinician in the decision-making process...
March 20, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29533470/perioperative-beta-blockers-for-preventing-surgery-related-mortality-and-morbidity
#7
REVIEW
Hermann Blessberger, Juergen Kammler, Hans Domanovits, Oliver Schlager, Brigitte Wildner, Danyel Azar, Martin Schillinger, Franz Wiesbauer, Clemens Steinwender
BACKGROUND: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia...
March 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29529205/carotid-stenosis-with-impaired-brain-flow-reserve-is-associated-with-an-increased-risk-of-stroke-in-on-pump-cardiovascular-surgery
#8
Kazumasa Tsuda, Norihiko Shiiya, Naoki Washiyama, Katsushi Yamashita, Kazuhiro Ohkura, Daisuke Takahashi, Yumi Kando, Kayoko Natsume, Ken Yamanaka, Yuki Takeuchi
OBJECTIVES: To prevent haemodynamic stroke during cardiovascular surgery in patients with carotid stenosis, we routinely evaluated magnetic resonance angiography and selectively evaluated brain perfusion single-photon emission computed tomography with acetazolamide challenge. Off-pump surgery was preferred when cerebral blood flow reserve was impaired. This strategy's usefulness was investigated. METHODS: Among the 1059 consecutive patients who underwent preoperative carotid screening by magnetic resonance angiography, 84 (7...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29525764/hospital-readmission-after-perioperative-acute-myocardial-infarction-associated-with-noncardiac-surgery
#9
Nathaniel R Smilowitz, Joshua A Beckman, Scott E Sherman, Jeffrey S Berger
BACKGROUND : Acute myocardial infarction (AMI) is a major cardiovascular complication of noncardiac surgery. We aimed to evaluate the frequency, causes, and outcomes of 30-day hospital readmission after perioperative AMI. METHODS : Patients who were diagnosed with AMI during hospitalization for major noncardiac surgery were identified using the 2014 US Nationwide Readmission Database. Rates, causes, and costs of 30-day readmissions after noncardiac surgery with and without perioperative AMI were identified...
March 10, 2018: Circulation
https://www.readbyqxmd.com/read/29514697/cardiac-output-optimisation-following-liver-transplant-colt-trial-study-protocol-for-a-feasibility-randomised-controlled-trial
#10
Farid Froghi, Rahul Koti, Kurinchi Gurusamy, Susan Mallett, Douglas Thorburn, Linda Selves, Sarah James, Jeshika Singh, Manuel Pinto, Christine Eastgate, Margaret McNeil, Helder Filipe, Fatima Jichi, Nick Schofield, Daniel Martin, Brian Davidson
BACKGROUND: Patients with liver cirrhosis undergoing liver transplantation have a hyperdynamic circulation which persists into the early postoperative period making accurate assessment of fluid requirements challenging. Goal-directed fluid therapy (GDFT) has been shown to reduce morbidity and mortality in a number of surgery settings. The impact of GDFT in patients undergoing liver transplantation is unknown. A feasibility trial was designed to determine patient and clinician support for recruitment into a randomised controlled trial of GDFT following liver transplantation, adherence to a GDFT protocol, participant withdrawal, and to determine appropriate endpoints for a subsequent larger trial to evaluate the efficacy of GDFT in patients undergoing liver transplantation...
March 7, 2018: Trials
https://www.readbyqxmd.com/read/29514145/preoperative-midrregional-proadrenomedulin-and-high-sensitivity-troponin-t-predict-perioperative-cardiovascular-events-in-non-cardiac-surgery
#11
Mladjan Golubovic, Radmilo Jankovic, Dusan Sokolovic, Vladan Cosic, Vesna Maravic, Tomislav Kostic, Zoran Perisic, Nebojsa Ladjevic
OBJECTIVE: We evaluated the utility of preoperative mid-regional pro-adrenomedulin (MR-proADM) and cardiac troponin T (TnT) for improved detection of patients at high risk for perioperative cardiac events and mortality after major non-cardiac surgery. SUBJECTS AND METHODS: This prospective, single-center, observational study enrolled 79 patients undergoing major non-cardiac surgery. After initial clinical assessment (clinical history, physical examination, echocardiogram, blood tests, and chest X-ray), mid-regional pro-adrenomedulin and high sensitivity troponin T (hsTnT) were measured within 48 hours prior to surgery by immunoluminometric and electrochemiluminescence-immuno assay...
March 7, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29465201/-pulse-wave-transit-time-one-more-attempt-of-non-invasive-cardiac-output-measurement
#12
B A Akselrod, L A Tolstova, T A Pshenichniy, S V Fedulova
BACKGROUND: Estimated continuous cardiac output (esCCOTM) based on pulse wave transit time is one of alternative non-invasive CO measurement techniques. METHODS: Randomized study included 23 scheduled patients operated upon due to cardiovascular diseases. Cardiac index (CI) was measured Comparative analyses of esCCO and others CO measurement methods used intraoperative was carried out. In the first group (n = 9) esCCO was compared with transpulmonary thermodilution (PiCCO-plus); in the second group (n = 8) - with pulmonary artery thermodilution; in the third group (n = 6) - with transoesophageal echocardiography (velocity-time integral)...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29441909/the-effect-of-continuous-perfusion-of-esmolol-on-cardiovascular-risk-in-elderly-patients-undergoing-noncardiac-surgery
#13
X K Zhang, Q Hu, Q H Chen, W X Wang
We evaluated the effect of continuous perfusion of esmolol on cardiovascular risk during curative laparoscopic surgery for gastrointestinal cancer in elderly patients. Sixty patients with gastrointestinal cancer, aged from 60 to 80 years, were divided into an esmolol group (ES, n = 30) and a control group (NS, n = 30). ES patients were treated with esmolol at a dose of 0.3 mg/kg 3 min before tracheal intubation, and received continuous perfusion of esmolol at a dose of 50 μg/kg/min during operation. In NS, esmolol was replaced by saline...
August 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29428098/pathophysiological-consequences-of-obstructive-jaundice-and-perioperative-management
#14
REVIEW
Efstathios T Pavlidis, Theodoros E Pavlidis
BACKGROUND: Obstructive jaundice is a common problem in daily clinical practice. Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management. DATA SOURCES: A PubMed was searched for relevant articles published up to August 2016. The effect of obstructive jaundice on proinflammatory cytokines, coagulation status, hemodynamics and organ functions were evaluated. RESULTS: The effects of obstructive jaundice included biliary tree, the hepatic cell and liver function as well as systemic complications...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29410187/development-of-a-risk-prediction-model-and-clinical-risk-score-for-isolated-tricuspid-valve-surgery
#15
Damien J LaPar, Donald S Likosky, Min Zhang, Patty Theurer, C Edwin Fonner, John A Kern, Stephen F Bolling, Daniel H Drake, Alan M Speir, Jeffrey B Rich, Irving L Kron, Richard L Prager, Gorav Ailawadi
BACKGROUND: While tricuspid valve (TV) operations remain associated with high mortality (∼8-10%), no robust prediction models exist to support clinical decision-making. We developed a preoperative clinical risk model with an easily calculable clinical risk score (CRS) to predict mortality and major morbidity after isolated TV surgery. METHODS: Multi-state Society of Thoracic Surgeons database records were evaluated for 2,050 isolated TV repair and replacement operations for any etiology performed at 50 hospitals (2002-2014)...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29389729/a-narrative-review-of-cardiovascular-abnormalities-after-spontaneous-intracerebral-hemorrhage
#16
Abhijit Lele, Viharika Lakireddy, Sergii Gorbachov, Nophanan Chaikittisilpa, Vijay Krishnamoorthy, Monica S Vavilala
BACKGROUND: The recommended cardiac workup of patients with spontaneous intracerebral hemorrhage (ICH) includes an electrocardiogram (ECG) and cardiac troponin. However, abnormalities in other cardiovascular domains may occur. We reviewed the literature to examine the spectrum of observed cardiovascular abnormalities in patients with ICH. METHODS: A narrative review of cardiovascular abnormalities in ECG, cardiac biomarkers, echocardiogram, and hemodynamic domains was conducted on patients with ICH...
January 31, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29353319/management-strategies-for-noncardiac-surgery-following-a-coronary-artery-event
#17
REVIEW
Thomas F Whayne, Sibu P Saha
PURPOSE OF REVIEW: Coronary artery event includes acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Following such an event, risk of noncardiac surgery is increased. Of major concern is what can make this surgery safer? RECENT FINDINGS: High functional capacity improves cardiovascular (CV) risk; at least 4.0 metabolic equivalents (METs) on stress test are favorable. Risk scores can suggest need for further evaluation...
January 20, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29310598/assessing-cardiovascular-risk-in-chronic-kidney-disease-patients-prior-to-kidney-transplantation-clinical-usefulness-of-a-standardised-cardiovascular-assessment-protocol
#18
Robin Ramphul, Maria Fernandez, Sam Firoozi, Juan C Kaski, Rajan Sharma, Debasish Banerjee
BACKGROUND: Despite pre-kidney-transplant cardiovascular (CV) assessment being routine care to minimise perioperative risk, the utility of such assessment is not well established. The study reviewed the evaluation and outcome of a standardised CV assessment protocol. METHODS: Data were analysed for 231 patients (age 53.4 ± 12.9 years, diabetes 34.6%) referred for kidney transplantation between 1/2/2012-31/12/2014. One hundred forty-three patients were high-risk (age > 60 years, diabetes, CV disease, heart failure, peripheral vascular disease) and offered dobutamine stress echocardiography (DSE); 88 patients were low-risk and offered ECG and echocardiography with/without exercise treadmill test...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29305561/trends-in-cardiovascular-risk-factor-and-disease-prevalence-in-patients-undergoing-non-cardiac-surgery
#19
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Joshua A Beckman, Sripal Bangalore, Jeffrey S Berger
OBJECTIVES: Cardiovascular risk factors are prevalent in the population undergoing non-cardiac surgery. Changes in perioperative cardiovascular risk factor profiles over time are unknown. The objective of this study was to evaluate national trends in cardiovascular risk factors and atherosclerotic cardiovascular disease (ASCVD) among patients undergoing non-cardiac surgery. METHODS: Adults aged ≥45 years old who underwent non-cardiac surgery were identified using the US National Inpatient Sample from 2004 to 2013...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29285132/effects-of-dexmedetomidine-on-h-fabp-ck-mb-ctni-levels-neurological-function-and-near-term-prognosis-in-patients-undergoing-heart-valve-replacement
#20
Zhi Wang, Qiang Chen, Hao Guo, Zhishan Li, Jinfeng Zhang, Lei Lv, Yongqing Guo
This study investigated the effects of dexmedetomidine on heart-type fatty acid binding protein (H-FABP), creatine kinase isoenzymes (CK-MB), and troponin I (cTnI) levels, neurological function and near-term prognosis in patients undergoing heart valve replacement. Patients undergoing heart valve replacement were randomly allocated to remifentanil anesthesia (control group, n=48) or dexmedetomidine anesthesia (observation group, n=48). Hemodynamic parameters were measured before anesthesia induction (T1), 1 min after intubation (T2), 10 min after start of surgery (T3), and on completion of surgery (T4)...
December 2017: Experimental and Therapeutic Medicine
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