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In some situations, tissue hypoxia may exist despite normal values obtained by conventional haemodynamic monitoring such as arterial blood pressure, central venous pressure, heart rate, and urine output. The study was performed in early postoperative period after major abdominal surgery in 160 patients and was conducted in the following stages: 1- admission from...
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including, specifically, hyperoxia during ECMO
management. We hypothesized that this effect may be
pronounced in patients with lower arterial oxygen
saturation at baseline, such as those with cyanotic CHD. We
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2) The primary survey follows an ABCDE approach and includes airway management, breathing and ventilation assessment, circulation assessment and intravenous access, disability assessment, and full body exposure/examination.
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This document discusses the implementation of an enhanced recovery after surgery (ERAS) protocol for lung surgery at Barnes-Jewish Hospital. It provides an overview of ERAS, the development of their lung surgery ERAS protocol, and the key elements of the preoperative, intraoperative, and postoperative protocol. The multidisciplinary team implemented the protocol in 2018 and continues monitoring outcomes through regular meetings and quality improvement audits to optimize recovery for patients undergoing lung surgery.
Early postoperative com
This study assessed early postoperative complications in 431 adult patients undergoing neurosurgery over four months. The most common complication was nausea and vomiting, which occurred in 38% of patients. Respiratory problems occurred in 2.8% of patients and cardiovascular complications in 6.7%. The highest rates of complications were for spinal (65%) and vascular (66%) surgeries compared to tumor (47%) and other (43%) surgeries. Younger patients undergoing elective spinal surgery had the highest risk of nausea and vomiting. The study found a high overall incidence of early postoperative complications for neurosurgery patients.
Artículo neuroanestesia
This study analyzed early postoperative complications in 145 adult patients who received total intravenous anesthesia (TIVA) with propofol and remifentanil for elective neurosurgery. The authors found:
1) The overall incidence of shivering was 30.3%, postoperative nausea and vomiting (PONV) was 16.6%, and postoperative hypertension (blood pressure over 25% of preoperative value) was 35.2%.
2) 51% of patients experienced at least one of these complications. Complication rates varied significantly between surgical groups.
3) The intracranial vascular surgery group had the highest rates of shivering (58.8%) and PONV (29.4
Artículo neuroanestesia
This study analyzed early postoperative complications in 145 adult patients who received total intravenous anesthesia (TIVA) with propofol and remifentanil for elective neurosurgery. The authors found:
1) The overall incidence of shivering was 30.3%, postoperative nausea and vomiting (PONV) was 16.6%, and postoperative hypertension (blood pressure over 25% of preoperative value) was 35.2%.
2) 51% of patients experienced at least one of these complications. Complication rates varied significantly between surgical groups.
3) The intracranial vascular surgery group had the highest rates of shivering (58.8%) and PONV (29.4
Sicu presentation
1. Three key elements must be assessed to determine a patient's surgical risk: underlying medical conditions and diseases, functional status, and type of surgery.
2. The American Society of Anesthesiologists (ASA) Physical Status classification is commonly used but is limited in only considering medical history and does not include other factors like surgery type. Higher ASA classes correlate with increased postoperative complications and mortality.
3. Other tools like the Goldman Cardiac Risk Index and Revised Cardiac Risk Index were developed to better evaluate cardiac risk, but have limitations and may not predict all-cause mortality risk.
Platelet rich plasma combined with core decompression and allogeneic fibula r...
Platelet rich plasma combined with core decompression and allogeneic fibula r...Clinical Surgery Research Communications
1) The study investigated the effectiveness of platelet-rich plasma (PRP) combined with core decompression and allogeneic fibula rod support for treating osteonecrosis of the femoral head (ONFH).
2) Patients treated with PRP in addition to core decompression and rod support showed significantly improved Harris hip scores after surgery, with no differences compared to the control group that did not receive PRP.
3) Imaging at 3 months post-surgery found no deformities or collapses in either group, with the fibula rods properly positioned and beginning to integrate with surrounding bone.Comparison of Shaker exercise with traditional therapy
This document describes a randomized study that compared the effects of the Shaker exercise versus traditional swallowing therapy in 19 patients with oropharyngeal dysphagia involving the upper esophageal sphincter (UES) and a history of aspiration. Patients received one of the two therapies twice per week for 6 weeks. Results found significantly less aspiration post-therapy in the Shaker exercise group. Both therapies improved swallowing physiology as measured by videofluorography, such as increased UES opening width. The Shaker exercise focuses on strengthening muscles that pull the hyoid and larynx upward and forward, while traditional therapy includes exercises like the Mendelsohn maneuver and tongue-base retraction.
Comparison of Ondansetron and Granisetron for Prevention of Nausea and Vomiti...
The most common and distressing symptoms, which follow anaesthesia and surgery, are pain and emesis. The consequences of PONV are physical, surgical and anesthetic complications for patients as well as financial implications for the hospitals or institutions. Sometimes nausea and vomiting may be more distressing especially after minor and ambulatory surgery, delaying the hospital discharge. Laparoscopic surgery is one condition, where risk of PONV is particularly pronounced due to pneumo-peritoneum causing stimulation of mechanoreceptors in the gut. In spite of plenty of anti-emetic drugs available no single drug is 100% effective in prevention of PNV and combination therapy has got a lot of side effects.
Elma mg out 2 jurnal
This study compared outcomes of early mobilization (out of bed after 52 hours) versus delayed mobilization (out of bed after 7 days) in 50 patients with ischemic stroke. There were fewer severe complications in the early mobilization group (2 patients, 8%) compared to the delayed group (8 patients, 47%). However, there were no differences in total complications or 3-month clinical outcomes between the groups. Cerebral blood flow measurements also did not differ between groups. The results suggest early mobilization reduces severe complications without increasing risk and supports larger trials to further evaluate optimal mobilization timing.
Elma mg out 3_jurnal
This study compared outcomes of early mobilization (out of bed after 52 hours) versus delayed mobilization (out of bed after 7 days) in 50 patients with ischemic stroke. There were fewer severe complications in the early mobilization group (2 patients, 8%) compared to the delayed group (8 patients, 47%). However, there were no differences in total complications or 3-month clinical outcomes between the groups. Cerebral blood flow measurements also did not differ between groups. The results suggest early mobilization reduces severe complications without increasing risk and supports larger trials to further evaluate optimal mobilization timing.
91024663-Perioperative-Evaluation
The document discusses peri-operative care, outlining the three phases: pre-operative, intra-operative, and post-operative care. It describes pre-operative care as including patient assessment, history, examinations, investigations, and preparation. Key aspects of pre-operative care are evaluating patient risk factors, medical history, and physical status to determine fitness for surgery and identify risks. The document also discusses classifications of surgery cleanliness and urgency, as well as common post-operative complications.
Journal Club Group fffffffffffffffffffffff1.pptx
This journal club discusses a randomized controlled trial that compared a restrictive fluid strategy with early vasopressor use to a liberal fluid strategy in patients with sepsis-induced hypotension. The trial found no significant difference in mortality before discharge home by day 90 between the two strategies. Some strengths were its randomized design and excellent safety outcome reporting. Limitations included being unblinded and possibly underpowered. The results do not strongly support changing clinical practice but add to evidence that a restrictive fluid approach may be safe.
Anestesia
1. An epidural hematoma is a rare but potentially catastrophic complication of neuraxial procedures due to bleeding outside the dura that can compress neural tissue. Risk factors include low platelet count, anticoagulant use, and the procedure itself.
2. During pregnancy, changes like decreased LES tone and delayed gastric emptying increase the risk of aspiration. All pregnant patients are considered at high risk of aspiration regardless of last oral intake.
3. To reduce aspiration risk, guidelines recommend following fasting times, limiting clear liquid intake before procedures, and considering aspiration prophylaxis medications due to the low gastric pH and increased gastric volume common in pregnancy. The risk of complications from both neuraxial procedures and general
megacolon.pdf
A 22-year-old male was admitted to the emergency room in a comatose state due to shock after being transferred from another hospital where he was being treated with high doses of antipsychotic medications for an acute psychotic episode from drug abuse. Imaging showed severe dilation of the intestines without obstruction or free air. The patient underwent surgery where necrosis of the right colon was found. The diagnosis was acute megacolon (Ogilvie's syndrome) likely caused by the antipsychotic medications, which is a known but rare risk. Literature review showed antipsychotics like clozapine can cause gastrointestinal hypomotility and this case highlights the need to monitor for constipation from these drugs.
Early X-ray Diagnosis Post-operative Peritonitis
The author proposes a simple method for early diagnosis of operating peritonitis, based on physiological abilities of the gastrointestinal tract to rebuild peristalsis on the second day after the operation, if the abdomen is not peritonitis. If this complication beginning to emerge, peristalsis is absent. After the operation, the monitoring function of the bowel is achieved by introducing during the operation in the lumen of the duodenum contrasting labels as gauze ball size 1 x 1 cm, stitched 3-4 Staples, which are used for mechanical gastro-intestinal stitch. Then superimposed a gastro-intestinal anastomosis. On postoperative day 2 reviews is performed abdominal radiography. If the patient began to develop peritonitis, the label does not leave the duodenum and must take action to save the patient’s life. If peritonitis has no, the label moves into the small intestine.
SOJ Anesthesiology & Pain Management
An 82-year-old female developed abdominal compartment syndrome immediately following a right hip arthroplasty. During the surgery, she received aggressive fluid resuscitation due to medical conditions. Post-operatively, she experienced hypotension despite vasopressors. Examination found a distended abdomen with ascites fluid buildup and elevated abdominal pressure. Exploratory laparotomy relieved the pressure and improved hemodynamics. Possible contributing factors included diminished abdominal wall compliance from surgical positioning, aggressive fluid resuscitation, and increased intra-abdominal pressure leading to organ damage. Early decompression prevented progression to multi-organ failure.
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Resuscitation Science tips: The NYC Project Hypothermia
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Comparison of BLUMGART vs. Dunking Pancreatico-Jejunostomy Anastomosis
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Comparison of BLUMGART vs. Dunking Pancreatico-Jejunostomy Anastomosis
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When I was asked to give a companion lecture in support of ‘The Philosophy of Science’ (https://shorturl.at/4pUXz) I decided not to walk through the detail of the many methodologies in order of use. Instead, I chose to employ a long standing, and ongoing, scientific development as an exemplar. And so, I chose the ever evolving story of Thermodynamics as a scientific investigation at its best.
Conducted over a period of >200 years, Thermodynamics R&D, and application, benefitted from the highest levels of professionalism, collaboration, and technical thoroughness. New layers of application, methodology, and practice were made possible by the progressive advance of technology. In turn, this has seen measurement and modelling accuracy continually improved at a micro and macro level.
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As the population is increasing and will reach about 9 billion upto 2050. Also due to climate change, it is difficult to meet the food requirement of such a large population. Facing the challenges presented by resource shortages, climate
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Nucleophilic addition is the most important reaction of carbonyls. Not just aldehydes and ketones, but also carboxylic acid derivatives in general.
Carbonyls undergo addition reactions with a large range of nucleophiles.
Comparing the relative basicity of the nucleophile and the product is extremely helpful in determining how reversible the addition reaction is. Reactions with Grignards and hydrides are irreversible. Reactions with weak bases like halides and carboxylates generally don’t happen.
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EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
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features-of-oxygen-extraction-ratio-and-temperature-homeostasis-during-early-postoperative-period-after-major-abdominal-surgery-global-journal-of-perioperative-medicine-peertechz-journals
- 1. Global Journal of Perioperative Medicine Peertechz Journals
- 2. Research Article Features of Oxygen Extraction Ratio and Temperature Homeostasis during Early Postoperative Period after Major Abdominal Surgery Musaeva TS* *Corresponding author: Musaeva TS, Assistant of Anesthesiology, Intensive Care and Transfusiology Department, Kuban State Medical University, Krasnodar, Russia, Tel: +78612224845, Dates: Received: 27 December, 2016; Accepted: 11 January, 2017; Published: 19 January, 2017 Citation: Musaeva TS (2017) Features of Oxygen Extraction Ratio and Temperature Homeostasis during Early Postoperative Period after Major Abdominal Surgery. Glob J Perioperative Med 1(1): 004-007.
- 3. Abstract In some situations, tissue hypoxia may exist despite normal values obtained by conventional haemodynamic monitoring such as arterial blood pressure, central venous pressure, heart rate, and urine output. The study was performed in early postoperative period after major abdominal surgery in 160 patients and was conducted in the following stages: 1- admission from operating room; 2 - in 1- 3 hours; 3 - 4-7 hours; 4 - 8-12 hours; 5 - after 13-24 hours after the surgery. Depend on rate of oxygen extraction index (ERO2 ) patients was divided in four groups depending on ERO2 on admission: group 1 (n=44) - low ERO2 (< 21%) followed by recovery to normal levels to stage 2-3 (ERO2 = 22-32%), group 2 (n=42) - normal level ERO2 (22-32%) in all the stages, group 3 (n=40) - high levels ERO2 (>33%) with recovery to normal levels to stage 2, group 4 (n=34) - high ERO2 (> 35%) in all the stages. Central hemodynamic, gas exchange, metabolic rate and temperature parameters were assessed.
- 4. Thank you For more information Read Online Article… https://www.peertechz.com/articles/features-of-oxygen- extraction-ratio-and-temperature-homeostasis-during-early- postoperative-period-after-major-abdominal-surgery.pdf For Full Article PDF