Articles: monitoring.
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Pol. Arch. Med. Wewn. · Jan 2025
ReviewAnticoagulation in patients with a history of heparin-induced thrombocytopenia who require cardiovascular surgery: is it okay to use heparin?
Heparin‑induced thrombocytopenia (HIT) is an adverse drug reaction with significant thromboembolic risk. Though there are models for use of nonheparin anticoagulants, heparin remains the preferred anticoagulant in many operative settings, especially cardiovascular surgery and percutaneous cardiac intervention. ⋯ If procedures cannot be delayed, approaches include intraoperative bivalirudin or intraoperative heparin with pre- or intraoperative plasma exchange or a potent antiplatelet agent, sometimes in combination with intravenous immunoglobulin. In subacute HIT B (immunoassay positive, functional assay negative) and remote HIT (immunoassay negative, functional assay negative), brief exposure to heparin in the intraoperative setting with close monitoring postoperatively is suggested due to the low risk of recurrent HIT.
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The prone position is commonly used in surgical procedures and is known to cause significant hemodynamic changes, particularly a reduction in cardiac output. This study aimed to explore the relationship between intra-abdominal pressure (IAP), airway pressure, and cardiac output during spine surgeries under general anesthesia. ⋯ Airway pressure is a reliable and noninvasive predictor of significant cardiac output reduction in patients undergoing prone position surgery. Monitoring airway pressure may help identify patients at risk for hemodynamic instability during surgery.
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Hyperoxia is associated with acute lung injury and atelectasis. Arterial blood gas measurement is an invasive method. The Oxygen Reserve Index (ORI) was developed to monitor the oxygen values of patients. In this study, we aimed to find out whether safe monitoring against hyperoxia could be achieved in Robotic-Assisted Radical Prostatectomy (RARP) operations by using ORI, which is an easier measurement method compared to arterial blood gas measurements. ⋯ The results of this study demonstrated a significant connection between ORI and PO2 values in their simultaneous interpretation at PO2 values lower than 240. Because the sensitivity of ORI to PO2 is low in cases of severe hyperoxia, blood gas analyses will be needed.
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Oral health is a crucial factor for service safety among military pilots, but studies specifically on pilots are still very few in Finland. The aim of this study was to assess the oral health status of military student pilots compared to other conscripts of the same age group. ⋯ The student pilots exhibited good overall oral health, which differed from that of other conscripts, mainly in terms of erosive changes. Continuous monitoring is crucial, as maintaining optimal oral health is vital for reducing the risk of barodontalgia and thus improving flight safety. Therefore, it is important to be aware that those who aspire to be military pilots are at an increased risk of erosive changes to their teeth.