Articles: cations.
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Minerva anestesiologica · Jul 2018
Observational StudyIncidence and risk factors of ventilator-associated pneumonia in neonatal intensive care unit: a first French study.
Ventilator-associated pneumonia (VAP) is a severe intensive complication and remains under estimated in neonatal intensive care unit (NICU). Center for Disease Control defined criteria for adults and pediatrics without neonatal criteria. The objective of this article was to evaluate the rate, the risks factors and the outcome of neonates suffering from ventilator-associated pneumonia in a French NICU. ⋯ We describe the first French study on VAP in a neonatal population. Amongst nosocomial infections, VAP is a complication with severe consequences for NICU patients. Larger studies are needed to better define a diagnosis strategy and prevention bundle.
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This study sought to evaluate re-excision rates, patient satisfaction with their breasts, and healthcare costs before and after publication of 2014 Society of Surgical Oncology/American Society of Radiation Oncology consensus guideline on margins for breast conserving operation with whole-breast irradiation for stage I and II breast cancer at an academic institution. ⋯ Widespread implementation of the consensus guideline on margins for breast conserving operation will likely lead to the intended improvements in operative and financial outcomes, as well as patient satisfaction with breast conserving operation.
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Colorectal surgery is a focus of enhanced recovery protocols (ERP). The use of transversus abdominis plane (TAP) block for abdominal surgery has demonstrated effectiveness in ERP, however, no direct comparison of epidural vs TAP for nonanalgesic clinical factors has been published to date. The primary aim of this study was to compare epidural with TAP for length of stay in colorectal surgery. ⋯ Transversus abdominis plane block was associated with a 0.5-day reduction in length of stay in a standardized ERP compared with epidural. Early indication favors TAP in patients with a history of postoperative urinary retention, as a trend of urinary retention was associated with epidural. Transversus abdominis plane block offers an effective alternative to epidural in colorectal surgery, regardless of operative approach.
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Gastrointestinal leak remains one of the most dreaded complications in bariatric surgery. We aimed to evaluate risk factors and the impact of common perioperative interventions on the development of leak in patients who underwent laparoscopic bariatric surgery. ⋯ The overall rate of gastrointestinal leak in bariatric surgery is low. Certain preoperative factors, procedural type (LRYGB), and interventions (intraoperative provocative test and surgical drain placement) were associated with a higher risk for leaks.