Tag: surgery
Automated Anesthetic Management Outperforms Manual Control and May Have an Impact on Delayed Neurocognitive Recovery
Among older, non-frail patients undergoing moderate and high-risk noncardiac surgery, an automated anesthetic management using the combination of three independent closed-loop systems outperformed manual control and may have... read more
Preoperative Vitamin D Concentration and Cardiac, Renal, and Infectious Morbidity after Noncardiac Surgery
Preoperative vitamin D was not associated with a composite of postoperative 30-day cardiac outcomes. However, there was a significant association between vitamin D deficiency and a composite of infectious complications and... read more
Delayed Interhospital Transfer of Critically Ill Patients with Surgical Sepsis
Patients with surgical sepsis who spent more than 24 hours at an outside facility prior to transfer had greater initial illness severity, longer intervals between admission and source control, and more nosocomial infections... read more
Preoperative Risk and the Association between Hypotension and Postoperative AKI
Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative... read more
Complications in Acute Care Surgery: The Management of Difficult Clinical Scenarios
This text provides the reader a starting point for the most difficult and uncommon complications in acute care surgery. It is designed to provide options to that ubiquitous intra-operative or bedside question "Well, now what... read more
Effects of Neuromuscular Block Reversal with Sugammadex vs. Neostigmine on Postoperative Respiratory Outcomes After Major Abdominal Surgery
No differences found in pulmonary function in patients reversed with sugammadex or neostigmine in a high-risk population. 126 patients were included in the main analysis. In the neostigmine group (n = 64), mean (95%... read more
Epidemiology of Clinically Relevant Bleeding in Critically Ill Adolescents
Clinically Relevant Bleeding (CRB) is common in critically ill adolescents who are at high risk of venous thromboembolism (VTE). Admission after trauma or surgery can be used to stratify the risk of CRB in this population.... read more
Prehabilitation and Nutritional Support to Improve Perioperative Outcomes
Studies evaluating exercise and nutrition interventions before elective major surgery in adults are producing encouraging early results, but definitive clinical evidence is currently very limited. Future research should... read more
Intra-Operative Events During Cardiac Surgery are Risk Factors for the Development of Delirium in the ICU
Risk factors for delirium following cardiac surgery are incompletely understood. The aim of this study was to investigate whether intra-operative pathophysiological alterations and therapeutic interventions influence... read more
The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients
In a mixed population of ICU patients, vitamin C administration is associated with no significant effect on survival, length of ICU or hospital stay. In cardiac surgery, beneficial effects on postoperative atrial fibrillation,... read more
Ramelteon for Prevention of Postoperative Delirium
Ramelteon 8 mg did not prevent postoperative delirium in patients admitted for elective cardiac surgery. Incident delirium was measured twice daily using the Confusion Assessment Method-ICU. The safety outcome was... read more
Vitamin D Deficiency in ICU Patients
Vitamin D research has experienced a true hype in all fields of medicine in the last decades. In critical illness, this increased interest has only started 10 years ago. The high prevalence of vitamin D deficiency in... read more
Implementation of a Standardized Transfusion Protocol for Cardiac Patients Treated With Venoarterial ECMO Is Associated With Decreased Blood Component Utilization and May Improve Clinical Outcome
The data indicate that implementation of a standardized transfusion protocol, using more restrictive transfusion indications in cardiac ECMO patients, was associated with reduced blood product utilization, decreased complications,... read more
AKI in Critically Ill Patients After Noncardiac Major Surgery
Acute kidney injury (AKI) is a common complication of major surgery. However, acute kidney injury occurring within the first 48 hours after surgery (early acute kidney injury) and therefore likely related to the surgery itself... read more
Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients
Hypotension thresholds that provoke renal injury, myocardial injury, and mortality in critical care patients remain unknown. We primarily sought to determine the relationship between hypotension and a composite of myocardial... read more
Preventing Surgical Site Infections Related to Abdominal Drains in the ICU
Surgical site infections are significant contributors to health care–associated infections. Nursing interventions may help decrease the incidence of surgical site infections, particularly in regards to the management of... read more
12 Great Summer Reads for Intensivists
From fascinating medical memoirs to horrifying accounts of medical mistreatment in the past two centuries, these books will make you aware of how far medicine has come and how far it has yet to go. Surgeries without anesthesia,... read more
Circulating Secretoneurin Concentrations After Cardiac Surgery
Circulating postoperative secretoneurin concentrations provide incremental prognostic information to established risk indices in patients undergoing cardiac surgery. Preoperative and postoperative secretoneurin concentration... read more
Airway Closure during Surgical Pneumoperitoneum in Obese Patients
In obese patients, complete airway closure is frequent during anesthesia and is worsened by Trendelenburg pneumoperitoneum, which increases airway opening pressure and alveolar pressure: besides preventing alveolar derecruitment,... read more
Transcutaneous CO2 vs. End-tidal CO2 in Neonates and Infants Undergoing Surgery
EtCO2 underestimates PvCO2 values in neonates and infants under general anesthesia. TcPCO2 closely approximates venous blood gas values, in both the NICU and non-NICU samples. We, therefore, conclude that tcPCO2 is a more... read more
Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery
Intravenous lidocaine administered during and after cardiac surgery did not reduce postoperative cognitive decline at 6 weeks. Among the 420 allocated subjects who returned for 6-week follow-up, there was no difference in... read more
Thiamine Deficiency: Pearls and Pitfalls
Although thiamine would not be isolated until 1911, the clinical syndrome of thiamine deficiency was recognized as far back as 2700 BC, when the term "beriberi", meaning "wasted wasted" was first coined in China. Nearly 5,000... read more
