Articles: postoperative.
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Anesthesia and analgesia · Sep 2022
Association Between Left Ventricular Relative Wall Thickness and Acute Kidney Injury After Noncardiac Surgery.
Acute kidney injury (AKI) after major noncardiac surgery is commonly attributed to cardiovascular dysfunction. Identifying novel associations between preoperative cardiovascular markers and kidney injury may guide risk stratification and perioperative intervention. Increased left ventricular relative wall thickness (RWT), routinely measured on echocardiography, is associated with myocardial dysfunction and long-term risk of heart failure in patients with preserved left ventricular ejection fraction (LVEF); however, its relationship to postoperative complications has not been studied. We evaluated the association between preoperative RWT and AKI in high-risk noncardiac surgical patients with preserved LVEF. ⋯ Left ventricular RWT is a novel cardiovascular factor associated with AKI within 7 days after high-risk noncardiac surgery among patients with preserved LVEF. Application of this commonly available measurement of risk stratification or perioperative intervention warrants further investigation.
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Acta Anaesthesiol Scand · Sep 2022
Observational StudyOrthostatic intolerance after fast-track knee arthroplasty: Incidence and hemodynamic pathophysiology.
Early postoperative mobilization can be hindered by orthostatic intolerance (OI) due to failed orthostatic cardiovascular regulation. The underlying mechanisms are not fully understood and specific data after total knee arthroplasty (TKA) are lacking. Therefore, we evaluated the incidence of OI and the cardiovascular response to mobilization in fast-track TKA. ⋯ Early postoperative OI is common following fast-track TKA. Pathophysiologic mechanisms include impaired orthostatic cardiovascular responses. The progression to severe OI symptoms appears to be primarily due to inadequate heart rate response.
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Case Reports
A Software-Guided Approach to Hemodynamic Management in a Renal Transplant Recipient: A Case Report.
The function of renal allografts in the perioperative period is partly dependent on minimizing hemodynamic instability. We have developed hemodynamic monitoring software-named the "pressure field"-that was utilized in a 68-year-old high-risk kidney transplant recipient. ⋯ The patient received net zero fluid intraoperatively and had an uneventful postoperative course. We found the pressure field method helpful to manage perioperative hemodynamics in this high-risk patient.
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Spinal cystic echinococcosis (CE) is a rare but devastating form of a neglected parasitic disease caused by the larval stage of the cestode Echinococcus granulosus. CE or hydatid disease most commonly affects the liver and lungs. Spinal CE occurs in less than 1% of all cases. ⋯ She was treated with surgical removal of the cystic lesions by laminectomy and instrumentation. Long-term oral albendazole was recommended postoperatively. Her status was medically stable at 5-year follow-up, but lower limbs paralysis, urinary retention, and bowel dysfunction persisted.