Duke Children ’s Hospital receives national designation for top surgical program
Treatment TermsChildren's health Overview Duke Children ’s Hospital&Health Center is one of only five centers in the country designated a top-level performer under a new certification program by the American College of Surgeons. The Level 1 designation recognizes Duke ’s commitment to providing the safest and highest-quality surgical care for pediatric patients. Content Blocks Header Validates Duke's commitment to children Content" Duke has made a strong and continuously growing commitment to providing specialized surgical care for children, ” saidDr. Allan D. Kirk, M.D., Ph.D., surgeon-in-chief for Duke Health. “This rigorous review process provides tangible validation of our commitment to children, and our unique capacity to deal with the many specialized needs that children and adolescents have. We are well prepared to deliver care from the routine to the most complicated, with a special ability to tre at each child in the manner dictated by their unique circumstance. I am very proud of the exceptional teamwork that has made this possible.”The ACS certification and accompanying standards stem from the organization ’s newChildren ’s Surgery Verification Program, which was developed in collaboration with the Task Force for Children ’s Surgical Care. The program is the nation’s first multi specialty standards for children’s surgical care.The program establishes three levels of certifica...
This study aimed to determine whether individualized goal-directed fluid therapy (IGDT) positively affects the initial renal function compared to a high-volume fluid therapy (HVFT) and to examine the effects on renal endothelial glycocalyx, inflammatory and oxidative stress markers, and medullary tissue oxygenation. The hypothesis was that IGDT improves early glomerular filtration rate (GFR) in pigs subjected to renal transplantation. METHODS: This was an experimental randomized study. Using a porcine renal transplantation model, animals were randomly assigned to receive IGDT or HVFT during and until 1 hour after tran...
Conditions: Opioid Use; Kidney Diseases; Pain, Postoperative; Postoperative Complications; Postoperative Nausea and Vomiting Interventions: Procedure: multimodal pain management; Other: goal directed fluid management; Other: preoperative carbohydrate loading; Procedure: Donor nephrectomy; Procedure: regional anesthesia Sponsor: Thomas Jefferson University Recruiting
CONCLUSION: Based on low or very low levels of evidence, we did not find any association between restrictive fluid management strategies and AKI, but we observed possible protective effects of intraoperative restrictive fluid management strategies on other outcomes. TRIAL REGISTRATION: PROSPERO (CRD42017054970); registered 18 May, 2017. PMID: 31556006 [PubMed - as supplied by publisher]
AbstractPurposeTo evaluate the feasibility of intraoperative continuous renal replacement therapy (IoCRRT) during liver transplantation (LT), in terms of recruitment, protocol adherence, and ascertainment of follow-up.MethodsIn this pilot randomized open-label controlled trial in adults receiving LT with a Model for End-Stage Liver Disease (MELD) score ≥ 25 and preoperative acute kidney injury (RIFLE - RISK or higher) and/or estimated glomerular filtration rate
The Double Triple A triple transplant — heart, liver, kidney — is an incredibly rare procedure. Up until recently, only 15 had ever been performed. Then, over a 48-hour stretch, UChicago Medicine did two back to back. www.chicagomag.com Prop-Roc-Tube?
Conclusions. The elevated baseline CVP, elevated baseline RVEDV after anesthesia induction, and decreased SvO2 during anhepatic phase were associated with postoperative AKI. Prospective trials are required to evaluate whether the optimization of these variables may decrease the risk of AKI after LDLT.
We report a case of extrahepatic biliary atresia with multiple anomalies involving the hepatic arteries, portal vein, cystic artery, arterioportal fistula and shunting, intrahepatic portal vein radicals, kidney, and external genitalia. The merits of the case from various standpoints including its implications for etiopathogenesis, caution during surgical anesthesia or postoperative management, and enrichment of the literature have been discussed.
Abstract Kidneys have an important role in regulating water volume, blood pressure, secretion of hormones and acid-base and electrolyte balance. Kidney dysfunction derived from acute injury can, under certain conditions, progress to chronic kidney disease. In the late stages of kidney disease, treatment is limited to replacement therapy: Dialysis and transplantation. After renal transplant, grafts suffer from activation of immune cells and generation of oxidant molecules. Anesthetic preconditioning has emerged as a promising strategy to ameliorate ischemia reperfusion injury. This review compiles some significant ...
CONCLUSION Despite the simultaneous administration of propofol infusion in both donors and recipients, no improvement in laboratory or surgical outcome was observed after LDLT compared with patients who received desflurane anaesthesia alone. TRIAL REGISTRATION NCT02504138 at clinicaltrials.gov.
This study aimed to evaluate the anesthetic management of patients undergoing surgical resection for rhino-orbito-cerebral mucormycosis (ROC).The study evaluated 12 patients that underwent surgical resection for ROC mucormycosis under general anesthesia. Demographic characteristics, hemodynamic parameters, invasive monitoring methods, surgical procedures, hospital records, and mortality rates were reviewed for each patient.The patients had a median age of 58 (range, 5-86) years. Two patients had an American Society of Anesthesiologists (ASA) score of II while the remaining 10 patients had a score of III. Eleven (91.7%) pat...
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