Masui. The Japanese journal of anesthesiology
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Postoperative care following ambulatory surgery is done at home. Therefore, it is important to establish qualitative clinical discharge criteria that can be used to determine when patients can go home safely for the care by friend or relative. ⋯ A discharge scoring system is effective to determine the optimal length of stay in the ambulatory surgery unit and to achieve the prompt and safe discharge of patients. In order to popularize ambulatory surgery and reduce admission rate, it is necessary for us to make an effort to change patients' mind for ambulatory surgery.
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The Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC) established in 2000 (Guidelines 2000) are the standard for cardiopulmonary resuscitation (CPR) all over the world. Written guidelines based on Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) are widely available throughout Japan and are studied by physicians but ACLS training courses have been made available only recently. ⋯ In May, 2003 a total of 447 physicians from our hospital participated in a workshop on BLS which provided lectures, demonstrations and a written examination. After completion of this workshop, it has been concluded that standardization in the area of resuscitation is mandatory, and efforts to disseminate this workshop to health care practitioners are to be undertaken.
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We report a case of severe intraoperative pulmonary edema during living related liver transplantation (LRLT) surgery. A 60-year-old woman with end-stage primary biliary cirrhosis underwent LRLT. ⋯ Further deterioration of hypoxemia was observed after reperfuion of the portal vein. We conclude that this severe pulmonary edema was caused by transfusion related acute lung injury, and prolonged ahepatic phase with reperfusion injury deteriorated the lung condition.
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Rapid mobilization and rehabilitation after CABG has a potential benefit of reducing both costs and pulmonary complications (such as atelectasis and pulmonary embolism). Moreover, it improves the patient's emotional recovery. We performed fast-track cardiac anesthesia aiming toward early rehabilitation. ⋯ We can safely manage fast-track cardiac anesthesia and perioperative management aiming toward early rehabilitation after CABG surgery.
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Review Meta Analysis
[Anesthetic management of patients with hypertrophic obstructive cardiomyopathy undergoing non-cardiac surgery].
A considerable amount of data are available regarding cardiac risk in patients with coronary artery disease undergoing non-cardiac surgery, but few data are available regarding risk for patients with cardiomyopathy. ⋯ Careful planning is inevitable in anesthesia for patients with HOCM. Although the rate of major perioperative complications is relatively low, they can occur unexpectedly and resemble the natural course of HOCM. In order to clearly elucidate risk factors for adverse perioperative outcomes, further analysis will be necessary as more cases are documented.