Articles: surgery.
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Inadvertent hypothermia is not uncommon in the immediate postoperative period and it is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. The aim of this study was to estimate the prevalence, the predictive factors and outcome of core hypothermia on admission to a surgical ICU. ⋯ The prevalence of patient hypothermia on ICU arrival was high. Hypothermia at time of admission to the ICU was not an independent factor for mortality or for staying longer in ICU.
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Interact Cardiovasc Thorac Surg · Jun 2005
NT-proBNP in cardiac surgery: a new tool for the management of our patients?
Our aim was to determine NT-proBNP levels in patients undergoing cardiac surgery and if those levels are related to any of the baseline clinical characteristics of patients before surgery or any of the outcomes or events after surgery. ⋯ Preoperative NT-proBNP levels depend on preoperative patient status (Euroscore, NYHA class and cardiac rhythm) and they increase significantly after cardiac surgery. This increase is higher when postoperative inotropes are needed. We found no relation between NT-proBNP levels and complications rate. An association have been shown between NT-proBNP levels and the use of inotropes after cardiac surgery.
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Pulsed radiofrequency (PRF) has been used for the treatment of radicular pain, due to a herniated intervertebral disc, but so far the data are anecdotal. This is a retrospective study on 13 consecutive patients with this type of pain, at levels L3 to S1. All patients had a diagnosis confirmed by imaging, all had neurological abnormalities, and all were scheduled for surgical intervention. ⋯ Neurological abnormalities resolved except in one patient, who had decreased sensibility in a small area in the L3 dermatome at the last follow-up. All professionally active patients went back to work after 0.49 months (0.1 to 1). It is concluded that PRF may potentially be a viable alternative for epidural steroid injections in the treatment of acute radicular pain, due to a herniated intervertebral disc, and that further studies, including a control group, should be carried out to establish the value of this method.
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Medical image analysis · Jun 2005
Comparative StudyAssimilating intraoperative data with brain shift modeling using the adjoint equations.
Biomechanical models of brain deformation are increasingly being used to nonrigidly register preoperative MR (pMR) images of the brain to the surgical scene. These model estimates can potentially be improved by incorporating sparse displacement data available in the operating room (OR), but integrating the intraoperative information with model calculations is a nontrivial problem. We present an inverse method to estimate the unknown boundary and volumetric forces necessary to achieve a least-squares fit between the model and the data that is formulated in terms of the adjoint equations, which are solved directly by the method of representers. The scheme is illustrated in a 2D simulation and in a 2D approximation based on a patient case using actual OR data.
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An estimated 0.5-4% of pregnant patients have cardiac disease, such as rheumatic disease, which is decreasing in Western countries, uncorrected congenital heart disease, cardiomyopathy and ischaemic heart disease. There has been an increase in maternal mortality due to cardiac causes. Congenital heart disease is becoming the most common source of cardiac problems in the pregnant patient, because patients are increasingly likely to survive to childbearing age with the improvement of surgery. ⋯ We try to give a brief and comprehensive review on this topic.