Articles: postoperative.
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Curr Opin Crit Care · Aug 2016
Postoperative complications in cardiac patients undergoing noncardiac surgery.
In this article we review the current knowledge on the underlying mechanisms of perioperative myocardial injury, the preoperative methods of predicting these complications, the diagnostic tools for detecting perioperative myocardial injuries, and the available protective strategies to prevent or attenuate the extent of myocardial injury. ⋯ These new insights will help to better tailor individual strategies to prevent or minimize perioperative cardiac complications. Especially, early diagnosis and intensification of treatment will get specific interest in the coming years.
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Intravenous patient-controlled analgesia (IVPCA) is often used to relieve pain after colorectal surgery. This study aimed to model the trajectory of analgesic demand over time after colorectal cancer surgery and explore potentially relevant influential factors using latent curve analysis, focusing on laparoscopic-assisted surgery and renal function. ⋯ Laparoscopic-assisted surgery and renal function affected the baseline trajectory of IVPCA demand over time, but had no significant effect on its shape.
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Pediatr Crit Care Me · Aug 2016
ReviewNeurodevelopmental Outcomes in Children With Congenital Heart Disease-What Can We Impact?
The objectives of this review are to discuss the scope of neurologic injuries in newborns with congenital heart disease, the mechanisms of injury, including prenatal, pre-, intra-, and postoperative factors, neurodevelopmental outcomes, and therapeutic strategies for the timely intervention and prevention of neurologic injury. ⋯ At the current time, important research is underway to 1) better understand the developing brain in the fetus with complex congenital heart disease, 2) to identify modifiable risk factors in the operating room and ICU to maximize long-term neurodevelopmental outcomes, and 3) develop strategies to improve family psychosocial health, childhood development, and health-related quality of life following hospital discharge. Crucial in this effort is the identification of an early postoperative surrogate variable with good predictive validity for long-term outcomes. If an appropriate surrogate variable for long-term outcomes can be identified, and measured relatively early after surgical intervention for complex congenital heart disease, reliable clinical trials can be undertaken to improve upon current outcomes.
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Randomized Controlled Trial
Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery: a randomized controlled double-blinded magnetic resonance imaging study.
Popliteal sciatic nerve catheters (PSNCs) are associated with a high frequency of displacement. We aimed to estimate the frequency of catheter displacement after 48 h with magnetic resonance imaging (MRI) in patients with PSNCs after major foot and ankle surgery randomized to catheter insertion either with a short-axis in-plane (SAX-IP) approach perpendicular to the nerve or with a short-axis out-of-plane (SAX-OOP) approach parallel to the nerve. ⋯ NCT02200016.