Articles: postoperative.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2014
Case Reports[Hemorrhage after accidental overdosage of enoxaparin: monitoring and therapy].
At the morning of the sixth postoperative day after a complex cardiac surgery procedure, a patient accidentally received a subcutaneous injection of 450 mg Enoxaparin sodium (Clexane®, Sanofi GmbH, Frankfurt, Germany). A few hours later an excessive coagulopathy developed and necessitated the transfusion of allogenic blood products. The present case report describes and discusses our diagnostic and therapeutic approaches.
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Curr Opin Anaesthesiol · Jun 2014
ReviewDetection and management of perioperative myocardial ischemia.
To review the current evidence for detection and management of perioperative myocardial ischemia. ⋯ Perioperative physicians should refrain from the use of nonsurgical diagnostic criteria for myocardial infarction and adopt the clinical entity known as myocardial injury after noncardiac surgery in order to allow for better determination of the prevalence of this perioperative complication. Studies should focus on establishing the feasibility of broad postoperative troponin surveillance following noncardiac surgery. Clinical trials of potential therapies for myocardial injury after noncardiac surgery are urgently needed.
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Int Forum Allergy Rhinol · Jun 2014
Randomized Controlled TrialImpact of intranasal sodium hyaluronate on the short-term quality of life of patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis.
Functional endoscopic sinus surgery (FESS) has become the treatment of choice for patients with medically resistant chronic rhinosinusitis (CRS) and nasal polyps. Despite the consolidated use of different treatments, the postoperative period is often very painful and uncomfortable, especially during the first month. Although evidence on the effectiveness of sodium hyaluronate (SH) on postoperative care following FESS is available, data on the quality of life (QoL) from the patients' perspective are still lacking. This study aimed to evaluate for the first time the effectiveness of nasal douche with SH in reducing patients' discomfort during the first month following FESS. ⋯ Our data indicate that SH significantly improves patients' short-term QoL following FESS in terms of both general health and specific sinonasal status.
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J Clin Monit Comput · Jun 2014
Comparative StudyA comparison of the incidence of hypercapnea in non-obese and morbidly obese peri-operative patients using the SenTec transcutaneous pCO2 monitor.
Obese patients are at increased risk for hypoventilation, leading to hypercapnea and acidosis. The primary objective of this study was to compare the incidence of perioperative hypercapnea in non-obese and morbidly obese patients using the SenTec transcutaneous PCO2 (tcPCO2) monitor. 10 morbidly obese subjects (BMI > 40 kg/m(2)) undergoing laparoscopic bariatric surgery, and 10 non-obese subjects (BMI < 30 kg/m(2)) undergoing laparoscopic abdominal procedures were studied, using a standardized anesthesia regimen. TcPCO2 and SpO2 were monitored continuously intraoperatively, and during the first 24 h postoperatively. ⋯ End-tidal CO2 (EtCO2) values were similar between groups during the intraoperative period, but tcPCO2 was significantly higher in the obese group at specific time points, and trended towards being higher throughout the case. Our study did not show significant tcPCO2 differences between non-obese and obese post-surgical patients, however, it did allow for continuous, trendable, nonobtrusive monitoring throughout the perioperative period. As V/Q mismatch increases with the PaCO2/EtCO2 gradient, and this effect is most pronounced in morbidly obese patients, tcPCO2 monitoring may prove to be a useful additional monitor in these patients during the intraoperative period.