Integrating intraoperative physiology data into outcome analysis for the ACS Pediatric National Surgical Quality Improvement Program

ConclusionAdding intraoperative vital signs to P ‐NSQIP data allowed identification of two modifiable risk factors: hypothermia was associated with increased wound disruption, and hypotension with increased blood transfusions and unplanned returns to the operating room. These findings may motivate prospective studies and prompt other centers a nd P‐NSQIP to augment outcome data with intraoperative physiological data.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: RESEARCH REPORT Source Type: research

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Inadvertent perioperative hypothermia (IPH), where core body temperature is less than 36 °C or 96.8°F, occurs in 26-90% of patients undergoing elective surgery. This preventable anesthesia- and surgery-related complication affects patients’ outcome and is associated with increased risk for surgical site infections (SSIs), bleeding, blood transfusions, and decreased patient thermal c omfort.
Source: Journal of PeriAnesthesia Nursing - Category: Nursing Authors: Tags: ASPAN National Conference Abstract Source Type: research
CONCLUSIONS: Adding intraoperative vital signs to P-NSQIP data allowed identification of two modifiable risk factors: hypothermia was associated with increased wound disruption, and hypotension with increased blood transfusions and unplanned returns to the operating room. These findings may motivate prospective studies and prompt other centers and P-NSQIP to augment outcome data with intraoperative physiological data. This article is protected by copyright. All rights reserved. PMID: 30347497 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Authors: Pan L, Tan S, Cao L, Feng X Abstract Background: To investigate and analyze the risk factors of operating room-related infections after coronary artery bypass grafting (CABG), to propose corresponding infection control management strategies, and to verify and evaluate the effectiveness of the strategy implementation. Methods: Patients with coronary heart disease who underwent CABG in a hospital from January 2015 to December 2016 were selected for inclusion in this study. The following patient variables were documented: demographics, history of underlying diseases (hypertension and diabetes), preoperati...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
This study investigated the effect of intraoperative body temperature fluctuations on the prognosis of liver recipients.METHODSThe body temperatures of liver recipients recorded from the induction of anesthesia (T0) until the end of surgery (T14) were retrieved. The patients were divided into two groups: the hypothermia group ( 5 min) and the normothermia group (≥35 °C or
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
Authors: Thongsukh V, Kositratana C, Jandonpai A Abstract Introduction: In patients who require a massive intraoperative transfusion, cold fluid or blood transfusion can cause hypothermia and potential adverse effects. One method by which to prevent hypothermia in these patients is to warm the intravenous fluid before infusion. The aim of this study was to determine the effect of the fluid flow rate on the efficacy of a fluid warmer. Methods: The room air temperature was controlled at 24°C. Normal saline at room temperature was used for the experiment. The fluid was connected to an infusion pump and covered...
Source: Anesthesiology Research and Practice - Category: Anesthesiology Tags: Anesthesiol Res Pract Source Type: research
CONCLUSION: These patients had a relatively short intraoperative course with stable vital parameters during surgery. We report a low incidence of significant venous air embolism, a blood transfusion rate of 21% and only minor perioperative disturbances in vital parameters. PMID: 29851178 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Abstract Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis. Exclusion criteria were patients with Ejection Fraction(EF)
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
THE MORBIDITY AND MORTALITY associated with cardiac surgery using cardiopulmonary bypass (CPB) remains high despite advances in surgical technique and anesthetic management.1 Much of this morbidity can be attributed to tissue malperfusion and hypoxia in the perioperative period. Indeed, CPB-related microcirculatory heterogeneity, cardiac dysfunction, hypothermia, fluid shifts, and allogeneic blood transfusion all contribute to impaired tissue oxygenation.2 Traditionally, high partial pressures of oxygen (PaO2) have been used to maximize tissue oxygen delivery during cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
​BY KEVAL PATEL, &AHMED RAZIUDDIN, MDA 41-year-old man with a past medical history of bipolar disorder, PTSD, and alcohol abuse presented to the emergency department for an erection that wouldn't go away. He said his erection had persisted for 28 hours and was starting to be painful. He had taken trazodone the day before but was unable to recall the dosage. He denied any erectile dysfunction in the past when he was on trazodone a year before.Physical examination showed an uncomfortable-appearing man lying supine in bed but in no acute distress. The physical exam was normal except for the genitourinary exam, which rev...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Abstract Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperati...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
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