Keywords: Acute kidney injury, chronic kidney disease, end stage renal disease (ESRD), general anesthesia, hemodialysis, intraoperative hypotension, preventative nephrology.. Abstract: Background/Objective: Intraoperative hypotension (IOH) invariably follows the induction of general anesthesia during surgical operations. The current prevailing and predominant consensus is that IOH has immense clinical benefits such as reduced bleeding, less need for blood transfusions, and shorter surgery times. Simultaneously, it is assumed that IOH is devoid of adverse renal, hepatic and neurological consequences. Emerging new evidence and our experiences suggest a strong link between IOH and postoperative acute kidney injury (AKI). Method/Case Reports: We report on three case presentations to illustrate the impact of IOH on postoperative AKI. Conclusion: Our recent experiences suggest and show a link between IOH and postoperative AKI. Sun et al. (2015) recently demonstrated that postoperative AKI was ...
TY - JOUR. T1 - Octreotide for treatment of intraoperative hypotension due to an unexpected neuroblastoma in an adult. AU - Jaffe, R. S.. AU - Ankunding, J.. AU - Goodnight Jr, James E. PY - 1994. Y1 - 1994. KW - Neuroblastoma. KW - Neuroendocrine tumors. KW - Octreotide. KW - Somatostatin. UR - http://www.scopus.com/inward/record.url?scp=0027994737&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0027994737&partnerID=8YFLogxK. M3 - Article. C2 - 7978489. AN - SCOPUS:0027994737. VL - 81. SP - 1294. EP - 1296. JO - Anesthesiology. JF - Anesthesiology. SN - 0003-3022. IS - 5. ER - ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
Botto, F, Alonso-Coello, P, Chan, MT, Villar, JC, Xavier, D, Srinathan, S, Guyatt, G, Cruz, P, Graham, M, Wang, CY, Berwanger, O, Pearse, RM, Biccard, BM, Abraham, V, Malaga, G, Hillis, GS, Rodseth, RN, Cook, D, Polanczyk, CA, Szczeklik, W, Sessler, DI, Sheth, T, Ackland, GL, Leuwer, M, Garg, AX, Lemanach, Y, Pettit, S, Heels-Ansdell, D, Luratibuse, G, Walsh, M, Sapsford, R, Schünemann, HJ, Kurz, A, Thomas, S, Mrkobrada, M, Thabane, L, Gerstein, H, Paniagua, P, Nagele, P, Raina, P, Yusuf, S, Devereaux, PJ, Devereaux, PJ, Sessler, DI, Walsh, M, Guyatt, G, McQueen, MJ, Bhandari, M, Cook, D, Bosch, J, Buckley, N, Yusuf, S, Chow, CK, Hillis, GS, Halliwell, R, Li, S, Lee, VW, Mooney, J, Polanczyk, CA, Furtado, MV, Berwanger, O, Suzumura, E, Santucci, E, Leite, K, Santo, JA, Jardim, CA, Cavalcanti, AB, Guimaraes, HP, Jacka, MJ, Graham, M, McAlister, F, McMurtry, S, Townsend, D, Pannu, N, Bagshaw, S, Bessissow, A, Bhandari, M, Duceppe, E, Eikelboom, J, Ganame, J, Hankinson, J, Hill, S, Jolly, S, Lamy, ...
Introduction. Multiple clinical methods for detecting myocardial ischemia are utilised in the hospital setting each day, but there is uncertainty about their diagnostic accuracy. In the operating room, multiple methods may be employed, while in the CCU advanced electrophysiological (ECG) techniques for myocardial ischemia detection, and in particular, ST segment analysis, are common. Vectorcardiography (VCG) is one form of ECG.. Several conditions other than ischemia may cause marked ST changes, which can impair the process of diagnosis of clinical ischemia. Elevated HR is one of these factors, which is studied here. The hypotheses were about concordance of different methods to detect ischemia, and relation of ECG ST levels to HR with and without myocardial ischemia.. Methods. Study I. Anesthetised vascular surgical patients with coronary artery disease were studied during the start of anesthesia and surgery: ECG, hemodynamic, mechanical, and metabolic parameters were measured and categorised as ...
Venous air embolism (VAE), a subset of gas embolism, is an entity with the potential for severe morbidity and mortality. Venous air embolism is a predominantly iatrogenic complication that occurs when atmospheric gas is introduced into the systemic venous system.
Infants who undergo surgical procedures in the first few months of life are at a higher risk of death or subsequent neurodevelopmental abnormalities. Although the pathogenesis of these outcomes is multifactorial, an understanding of the nature and pathogenesis of brain injury in these infants may assist the anesthesiologist in consideration of their day-to-day practice to minimize such risks. This review will summarize the main types of brain injury in preterm and term infants and their key pathways. In addition, the review will address key potential pathogenic pathways that may be modifiable including intraoperative hypotension, hypocapnia, hyperoxia or hypoxia, hypoglycemia, and hyperthermia. Each of these conditions may increase the risk of perioperative neurological injury, but their long-term ramifications are unclear.. Read More. ...
Hartveit F, Lystad H, Minken A. The pathology of venous air embolism. Br J Exp Pathol. 1968 Feb;49(1):81-6.. http://www.ncbi.nlm.nih.gov/pubmed/5640639. Full Text Link. ...
|div id=teaser class=fragment teaser ||div class=p|Everything NICE has said on preventing and managing inadvertent perioperative hypothermia in adults having surgery in an interactive flowchart|/div||/div|
... : Diabetes is a chronic, life-long condition that requires careful control. Without proper management it can lead to various complications such as cardiovascular disease, kidney failure, blindness and nerve damage.
Comorbidity of glaucoma poses some increased risks for cataract surgery, but even when there are intraoperative complications during the lens removal procedure, it is almost always possible to still add micro-invasive glaucoma surgery (MIGS), said Reay H. Brown, MD. ...
The study probably included enough patients to support its conclusion that there is no difference in conversion rates, but it is underpowered to detect a difference in iatrogenic injury rates or mortality because those events are so infrequent. To conclude that there is no difference in iatrogenic injury or mortality rates is what is known in statistical circles as a "Type II error" or failure to reject a false null hypothesis. The two null hypotheses in this situation were that there is no difference in 1) iatrogenic injury or 2) mortality rates when surgeons are rested or not ...
The examination of special competence in basic perioperative transesophageal echocardiography. This examination is intended for those who wish to demonstrate special competence in basic perioperative transesophageal echocardiography. [Scope of Practice: The application of a basic perioperative TEE examination is limited to non-diagnostic use within the customary practice of anesthesiology. Because the goal of and training in basic PTE is focused on intraoperative monitoring rather than specific diagnosis, except in emergent situations, diagnoses requiring intraoperative cardiac surgical intervention or postoperative medical/surgical management must be confirmed by an individual with advanced skills in TEE or by an independent diagnostic technique ...
We have emailed you at with instructions on how to set up a new password. If you do not receive an email in the next 24 hours, or if you misplace your new password, please contact:. ASA members: ...
Capgnography is the monitoring of the concentration or partial pressure of carbon dioxide in the expired respiratory gases; as such, it is a non-invasive monitoring technique which allows fast and reliable insight into ventilation, circulation and metabolism. Capnography has proven to be more effective than clinical judgement alone in the early detection of adverse respiratory events. The shape of a capnogram is identical in all humans with healthy lungs; any deviations in shape must be investigated to determine a physiological or a pathological cause of the abnormality.. Data from a previous pilot study yielded two major findings:. ...
Perioperative ischemiaRepresentative pre- and postoperative (| 72h after surgery) MRI scans from a patient with perioperative ischemia ARE shown.
Urostomy complications - Whats a urostomy and does it have complications? UROSTOMY. There are several types of urostomies and they all have their own potential complications.
Insight is the patients awareness of the situation they are in, and an understanding of the implications of their condition as well as the potential complications that may occur as a result of it ...
DOI: 10.11607/jomi.4884 Purpose: To analyze the occurrence of intraoperative complications during sinus floor elevation with a lateral approach and their correlations with the technique adopted by surgeons. Materials and Methods: Electronic and manual searches resulted in 4,417 records on sinus floor elevation. Twenty-one randomized clinical trials (RCTs) and 11 prospective controlled clinical trials (CCTs) reporting occurrence of intraoperative complications were included. Risk of bias was assessed according to the Cochrane tool and a modified Downs and Black quality analysis for RCTs and CCTs, respectively. Results: Sinus membrane perforation and hemorrhagic events following vascular lesions were the only intraoperative complications reported by the selected studies with overall occurrences of 15.7% and 0.4%, respectively. Three different surgical devices (rotary instruments, piezoelectric osteotomes, and manual bone scrapers) were used to perform the lateral antrostomy. Ultrasonic devices and ...
Background: HMG-CoA reductase inhibitors (statins) improve mortality in high-risk patients. Statins may have beneficial properties beyond its lipid-lowering potential, including inflammation reduction and atherosclerotic plaque stabilization. In this study, we examined whether statins can reduce perioperative myocardial ischemia and improve long-term outcome in patients undergoing major vascular surgery.. Methods: A total of 213 consecutive patients (mean age 68 ± 10 years, 79% male) underwent surgery for abdominal aortic aneurysms or lower extremity bypass grafting. Statins were prescribed in 55% of the patients and serial cholesterol levels were measured 3 months and 1 week prior to surgery. Myocardial ischemia was assessed by continuous 12-lead ECG monitoring, starting 1 day before surgery and continuing for 3 days after. Serial troponin T measurements were performed on day 1, 3 and 7 after surgery. During follow-up, mortality was noted.. Results: In this study cohort, 71 patients (33%) had ...
PubMedID: 23255281 | Free flap reconstruction of oral composite defect complicated by intraoperative cardiac arrest: a case report. | Microsurgery | 3/1/2013
Downloadable! For the successful resolution of a crisis it is of key importance that the crisis is tackled by managers which along with a desirable knowledge of the companys activities are familiarized with the special characteristics of the crisis management and general creative (intuitive) approach. For their work crisis management will require strategic, as well as fully operational formal and empirical knowledge, possessing at least the minimum amount of knowledge from every business field, including basic knowledge of economic psychology. Additionally, some special knowledge and skills are demanded. In view of the complexity of the management of a company undergoing serious difficulties, crisis management is therefore denoted as a composite discipline, because a multi-disciplinary approach to problem solving is required in order to achieve the objectives of managing a company undergoing a crisis.
Current corneal assessment technologies make the process of corneal evaluation extremely fast and simple, and several devices and technologies show signs that help in identification of different diseases thereby, helping in diagnosis, management, and follow-up of patients. The purpose of this review is to present and update readers on the evaluation of cornea and ocular surface. This first part reviews a description of slit lamp biomicroscopy (SLB), endothelial specular microscopy, confocal microscopy, and ultrasound biomicroscopy examination techniques and the second part describes the corneal topography and tomography, providing up-to-date information on the clinical recommendations of these techniques in eye care practice. Although the SLB is a traditional technique, it is of paramount importance in clinical diagnosis and compulsory when an eye test is conducted in primary or specialist eye care practice. Different techniques allow the early diagnosis of many diseases, especially when ...
a Cochrane review concluded that BIS within 40 to 60 may improve anaesthetic delivery and postoperative recovery from relatively deep anaesthesia, and more important that BIS-guided anaesthesia significantly reduces the incidence of intraoperative recall in surgical patients with high risk of awareness (ex. TIVA) [Punjasawadwong et al. Cochrane Database Syst Rev. 4: CD003843, 2007]. The largest study in Cochrane was Myles et al. (2463 patients), the second-largest was only 268 patients. Cochrane did not review Avidan (see below), which was published later.. Myles et al. conducted a randomized, double blind trial of 2463 "high risk" patients (caesarean section, high-risk cardiac surgery [EF ,30%, cardiac index ,2·1 L/min per m2, severe aortic stenosis, pulmonary hypertension, or undergoing off-pump coronary artery bypass graft surgery], acute trauma with hypovolaemia, rigid bronchoscopy, significant impairment of cardiovascular status and expected intraoperative hypotension requiring treatment, ...
We studied 30 patients with asymptomatic, severe AS with a mean age of 78 + or - 9 years, an aortic valve area of 0.77 + or - 0.16 cm(2), a mean gradient of 50.1 + or - 9.5 mm Hg, and a peak gradient of 84 + or - 22 mm Hg. They were compared to 60 age-matched (within 2 years) and gender-matched (ratio of 1:2) patients with mild-to-moderate AS (controls).. Combined postoperative events were more common for the patients (n = 10; 33%) than for the controls (n = 14; 23%), but the difference was not statistically significant (p = 0.06).. Intraoperative hypotension requiring vasopressor use was more likely for the patients (n = 9; 30%) than for the controls (n = 10; 17%; odds ratio 2.5; p = 0.11). The perioperative myocardial infarction rates were similar for both groups (3%; p = 0.74). No deaths, heart failure events, or ventricular arrhythmias occurred in the patients and 1 death and 1 ventricular arrhythmia episode occurred in the controls ...
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Surgeon can use the printed medical model of the mandible to adjust the implant to the particular patient even before the procedure. It is tailor-made - says the model creator, Dr. Paweł Turek from Rzeszów University of Technology. His research and the process of mandible model development were the subject of his doctoral dissertation Methodology of designing and manufacturing medical models of the mandible.
Now you can avoid long-term clinical complications, extended hospital stays and medical liability costs caused by air embolisms ...
Crisis management planning is instrumental to the management of, and response to, any disruption. Firestorm crisis management plans focus on crisis management planning across the organization.
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures ...
Hello there, dear reader. I am so, so sorry. I am so sorry for everything you are going through. Relationships can be the most rewarding experiences of life, however they can also be the most heart wrenching. If you have been cheated on, abandoned, or abused, my heart goes out to you. I am truly sorry for your loss. If you are currently in an abusive situation and are afraid for the safety of yourself or your children, read on. I want to help you with the following tips:. ...
Forest plots of peri-procedural complications associated with RD.A, Pooled univariate hazard ratio of patients without RD compared with patients with RD for all
Medical Consultant continued Medications thought to increase the risk of surgical complications that are not essential for short term improvement in quality of life should be held in the perioperative period Muluk V, Macpherson DS. Perioperative medication management. UpToDate Online
The aim of the present study was to investigate the influence of fixation delay and the perioperative ischemia on hypoxia inducible factor (HIF)-1α gene expression, HIF-1α protein expression, and immunohistochemical (IHC) expression of HIF-1α, GLUT-1, Bcl-2, and Ki-67 in colorectal cancer. The study included 25 surgically removed colorectal tumors. Three ...
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A surgical complication is defined as any undesirable result of surgery. Minor complication has little risk but patients are unnessesarily afraid of them too much.
TCFA is committed to patient centered healthcare services providing diagnosis, treatment and management of a wide spectrum of illnesses and diseases. Our providers educate and empower patients about the benefits of holistic coordinated healthcare. An educated patient is more compliant with prescribed treatment regimens thus resulting in better management of chronic illnesses and greater success in overall recovery. Let us help you to enjoy living again on your path to a healthy lifestyle!. Our doctors listen to you and do not treat you as just a number or financial transaction. They actually take time to understand your concerns without making you feel rushed during your visit. TCFA team of professionals makes you feel special and unique while providing:. ...
The arrival of real synthetic blood is also likely to bring with it its own set of serious socioeconomic issues, including ones that have complicated many medical advances that before it.
Complication coding is a hot topic among coding, clinical, and compliance professionals. Its considered to be one of the more challenging aspects of...
Objective: The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). Design: Retrospective analysis. Setting: Tertiary-care hospital. Participants: Patients undergoing on-pump coronary artery bypass grafting from June 2011 to January 2014. Interventions: ... read more None. Measurements and Main Results: IOH-CPB was defined as blood pressure below several absolute and relative mean arterial pressure (MAP) thresholds and as the area under the curve for absolute MAP thresholds. AKI was defined as an absolute increase in serum creatinine of≥26 μmol/L within 48 hours or an increase to 150% or more within 7 days of surgery. Poisson regression with robust standard errors both before and after adjustment for confounders was used. Of the 1,891 patients included, 386 (20%) developed AKI. In univariable analysis, all IOH-CPB thresholds defined as a MAP of 50 ...
Crisis Management Plan. A crisis management plan (CMP) is a reference tool, not a blueprint. A CMP provides lists of key contact information, reminders of what typically should be done in a crisis, and forms to be used to document the crisis response.
Anesthesiology. Zick Suzanna M, Alrawi Sara, Merel Gary, Burris Brodie, Sen Ananda, Litzinger Amie, Harris Richard E. Relaxation acupressure reduces persistent cancer-related fatigue. Evidence-based complementary and alternative medicine : eCAM. 2011. 2011(): . PMID# 20924499. Williams David A, Kuper David, Segar Michelle, Mohan Niveditha, Sheth Manish, Clauw Daniel J. Internet-enhanced management of fibromyalgia: a randomized controlled trial. Pain. 2010 Dec. 151(3): 694-702. PMID# 20855168. Nafiu Olubukola O, Maclean Sarah, Blum James, Kheterpal Sachin, Cowan Andy, Tremper Kevin K. High BMI in children as a risk factor for intraoperative hypotension. European journal of anaesthesiology. 2010 Dec. 27(12): 1065-8. PMID# 20683335. Nguyen Khoi Tan, Soong Ronald, Lm Sang-Choul, Waskell Lucy, Ramamoorthy Ayyalusamy, Chen Zhan. Probing the spontaneous membrane insertion of a tail-anchored membrane protein by sum frequency generation spectroscopy. Journal of the American Chemical Society. 2010 Nov 3. ...
Advanced Perioperative Crisis Management is a high-yield, clinically-relevant resource for understanding the epidemiology, pathophysiology, assessment, and management of a wide variety of perioperative emergencies.Three introductory chapters review a critical thinking approach to the unstable or pulseless patient, crisis resource management principles to improve team performance and the importance of cognitive aids in adhering to guid
Dr. Lucian L. Leape opened medicines Pandoras box in his 1994 paper, "Error in Medicine," which appeared in the Journal of the American Medical Association (JAMA).(16) He found that Schimmel reported in 1964 that 20% of hospital patients suffered iatrogenic injury, with a 20% fatality rate. In 1981 Steel reported that 36% of hospitalized patients experienced iatrogenesis with a 25% fatality rate, and adverse drug reactions were involved in 50% of the injuries. In 1991, Bedell reported that 64% of acute heart attacks in one hospital were preventable and were mostly due to adverse drug reactions.. Leape focused on the "Harvard Medical Practice Study" published in 1991, (16a) which found a 4% iatrogenic injury rate for patients, with a 14% fatality rate, in 1984 in New York State. From the 98,609 patients injured and the 14% fatality rate, he estimated that in the entire U.S. 180,000 people die each year partly as a result of iatrogenic injury.. Why Leape chose to use the much lower figure of 4% ...
Dr. Lucian L. Leape opened medicines Pandoras box in his 1994 paper, "Error in Medicine, which appeared in the Journal of the American Medical Association (JAMA).(16) He found that Schimmel reported in 1964 that 20% of hospital patients suffered iatrogenic injury, with a 20% fatality rate. In 1981 Steel reported that 36% of hospitalized patients experienced iatrogenesis with a 25% fatality rate, and adverse drug reactions were involved in 50% of the injuries. In 1991, Bedell reported that 64% of acute heart attacks in one hospital were preventable and were mostly due to adverse drug reactions. Leape focused on the "Harvard Medical Practice Study published in 1991, (16a) which found a 4% iatrogenic injury rate for patients, with a 14% fatality rate, in 1984 in New York State. From the 98,609 patients injured and the 14% fatality rate, he estimated that in the entire U.S. 180,000 people die each year partly as a result of iatrogenic injury. Why Leape chose to use the much lower figure of 4% ...
Purpose This study was designed to evaluate the effect of preoperative pregabalin on intraoperative neurophysiological monitoring in adolescents undergoing surgery for spinal deformities.
video (Warning: There is a graphic depiction of a shooting at the 1:14-1:22 minutes section of this video. Some people may choose to avoid this section.) ...
Single User: Authorizes use by the person who places the order or for whom the order was placed.. Sitewide: Authorizes use of the report for a geographic site. All people at site can view the report for a year and copies can be printed.. Corporate: Authorizes use for the entire company for a year and copies can be printed. No limitations for usage inside the company ...