Articles: postoperative.
-
Pediatr Crit Care Me · Jul 2016
Severe Acute Kidney Injury Following Stage 1 Norwood Palliation: Effect on Outcomes and Risk of Severe Acute Kidney Injury at Subsequent Surgical Stages.
To identify associations of severe acute kidney injury early after stage 1 (Norwood) operation with risk of severe acute kidney injury and comorbidities at subsequent palliative stages in patients with hypoplastic left heart syndrome and other single ventricle lesions with left-sided obstruction. ⋯ Severe acute kidney injury after stage 1 palliation was an independent risk factor for developing severe acute kidney injury at stage 2, and was associated with prolonged duration of mechanical ventilation following stage 3. Information on the incidence and associated risk factors for postoperative acute kidney injury in hypoplastic left heart syndrome patients from multiple congenital heart centers is a necessary next step to further understand the long-term burden of severe acute kidney injury after staged palliation.
-
The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases. ⋯ Use of CT-guided PFP was associated with a low risk of complications and improvement in patients' quality of life. CT guidance made the operation easy and safe, and thus, this approach represents a potential treatment option for proximal femoral metastases if indications are observed closely.
-
Pediatr Crit Care Me · Jul 2016
Observational StudyProcalcitonin in the Early Course Post Pediatric Cardiac Surgery.
Procalcitonin has emerged as a promising infection marker, but previous reports from small-sized studies suggest nonspecific elevation of procalcitonin after pediatric heart surgery. As procalcitonin is increasingly used as a marker for infection in the PICU, the aim of this study was to identify factors associated with postoperative procalcitonin elevation and to investigate the role of procalcitonin as an early marker of outcome after cardiac surgery. ⋯ Elevated levels of procalcitonin in the early phase after pediatric cardiac surgery are a marker for increased risk for major adverse events and postoperative renal failure and increased postoperative morbidity.
-
With the evolution of surgical and anesthetic techniques, liver transplantation has become "routine," allowing for modifications of practice to decrease perioperative complications and costs. There is debate over the necessity for intensive care unit admission for patients with satisfactory preoperative status and a smooth intraoperative course. ⋯ Assessment of graft function, vigilance for complications after the major surgical insult, and optimization of multiple systems affected by liver disease are essential aspects of postoperative care. The intensivist plays a vital role in an integrated multidisciplinary transplant team.
-
Anesthesia and analgesia · Jul 2016
Total Joint Replacement Perioperative Surgical Home Program: 2-Year Follow-Up.
Previously, our group successfully established one of the nation's first Perioperative Surgical Homes (PSHs) aimed at coordinating services to patients undergoing primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). As we now focus on extending the PSH to other service lines within the hospital, the long-term sustainability of this practice model is an important factor to consider moving forward. ⋯ Data for the second year of implementation demonstrate similarly positive results in LOS, pain control, discharge destination, readmission, transfusion rates, and complications.