Read by QxMD icon Read

Critical care

shared collection
18 papers 25 to 100 followers
By Giovanni Gambino M.D. Ph.D.
M L Krajewski, K Raghunathan, S M Paluszkiewicz, C R Schermer, A D Shaw
BACKGROUND: The objective of this systematic review and meta-analysis was to assess the relationship between the chloride content of intravenous resuscitation fluids and patient outcomes in the perioperative or intensive care setting. METHODS: Systematic searches were performed of PubMed/MEDLINE, Embase and Cochrane Library (CENTRAL) databases in accordance with PRISMA guidelines. Randomized clinical trials, controlled clinical trials and observational studies were included if they compared outcomes in acutely ill or surgical patients receiving either high-chloride (ion concentration greater than 111 mmol/l up to and including 154 mmol/l) or lower-chloride (concentration 111 mmol/l or less) crystalloids for resuscitation...
January 2015: British Journal of Surgery
Demetrios Demetriades, Ali Salim
The open abdomen has become the standard of care in damage-control procedures, the management of intra-abdominal hypertension, and in severe intra-abdominal sepsis. This approach has saved many lives but has also created new problems, such as severe fluid and protein loss, nutritional problems, enteroatmospheric fistulas, fascial retraction with loss of abdominal domain, and development of massive incisional hernias. Early definitive closure is the basis of preventing or reducing the risk of these complications...
February 2014: Surgical Clinics of North America
Kevin R Kasten, Emily F Midura, Bradley R Davis, Janice F Rafferty, Ian M Paquette
BACKGROUND: Complete obstruction of the distal colon or rectum often presents as a surgical emergency. This study evaluated the efficacy of blowhole colostomy versus transverse loop colostomy for the emergent management of distal large intestinal obstruction. METHODS: Retrospective chart review of all colostomy procedures (CPT 44320) performed for complete distal large bowel obstruction during the past 6 y in a university hospital practice was undertaken. Blowhole was compared with loop colostomy with a primary endpoint of successful colonic decompression...
May 1, 2014: Journal of Surgical Research
Bram Rochwerg, Waleed Alhazzani, Anees Sindi, Diane Heels-Ansdell, Lehana Thabane, Alison Fox-Robichaud, Lawrence Mbuagbaw, Wojciech Szczeklik, Fayez Alshamsi, Sultan Altayyar, Wang-Chun Ip, Guowei Li, Michael Wang, Anna Wludarczyk, Qi Zhou, Gordon H Guyatt, Deborah J Cook, Roman Jaeschke, Djillali Annane
BACKGROUND: Fluid resuscitation is the cornerstone of sepsis treatment. However, whether balanced or unbalanced crystalloids or natural or synthetic colloids confer a survival advantage is unclear. PURPOSE: To examine the effect of different resuscitative fluids on mortality in patients with sepsis. DATA SOURCES: MEDLINE, EMBASE, ACP Journal Club, CINAHL, HealthSTAR, the Allied and Complementary Medicine Database, and the Cochrane Central Register of Controlled Trials through March 2014...
September 2, 2014: Annals of Internal Medicine
Michael P Casaer, Dieter Mesotten, Greet Hermans, Pieter J Wouters, Miet Schetz, Geert Meyfroidt, Sophie Van Cromphaut, Catherine Ingels, Philippe Meersseman, Jan Muller, Dirk Vlasselaers, Yves Debaveye, Lars Desmet, Jasperina Dubois, Aime Van Assche, Simon Vanderheyden, Alexander Wilmer, Greet Van den Berghe
BACKGROUND: Controversy exists about the timing of the initiation of parenteral nutrition in critically ill adults in whom caloric targets cannot be met by enteral nutrition alone. METHODS: In this randomized, multicenter trial, we compared early initiation of parenteral nutrition (European guidelines) with late initiation (American and Canadian guidelines) in adults in the intensive care unit (ICU) to supplement insufficient enteral nutrition. In 2312 patients, parenteral nutrition was initiated within 48 hours after ICU admission (early-initiation group), whereas in 2328 patients, parenteral nutrition was not initiated before day 8 (late-initiation group)...
August 11, 2011: New England Journal of Medicine
John A Myburgh, Michael G Mythen
New England Journal of Medicine, Volume 369, Issue 13, Page 1243-1251, September 2013.
September 26, 2013: New England Journal of Medicine
Konstantinos Blouhos, Konstantinos A Boulas, Anna Konstantinidou, Ilias I Salpigktidis, Stavroula P Katsaouni, Konstantinos Ioannidis, Anestis Hatzigeorgiadis
When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes) adenocarcinoma of the antrum...
2013: Case Reports in Surgery
Husham Abdelrahman, Ahmad Ajaj, Sajid Atique, Ayman El-Menyar, Hassan Al-Thani
Management of liver injury is challenging particularly for the advanced grades. Increased utility of nonoperative management strategies increases the risk of developing massive liver necrosis (MLN). We reported a case of a 19-year-old male who presented with a history of motor vehicle crash. Abdominal computerized tomography (CT) scan revealed large liver laceration (Grade 4) with blush and moderate free hemoperitoneum in 3 quadrants. Patient was managed nonoperatively by angioembolization. Two anomalies in hepatic arteries origin were reported and both vessels were selectively cannulated and bilateral gel foam embolization was achieved successfully...
2013: Case Reports in Surgery
Peeyush Varshney, Bhupen Songra, Shivank Mathur, Sudarshan Gothwal, Puneet Malik, Mahnedra Rathi, Rajveer Arya
Introduction. Splenic artery Pseudoaneurysm, a complication of chronic pancreatitis, presenting as massive hematemesis is a rare presentation. Case Report. We present a case of 38-year-old male admitted with chief complaints of pain in the upper abdomen and massive hematemesis for the last 15 days. On examination there was severe pallor. On investigating the patient, Hb was 4.0 gm/dL, upper GI endoscopy revealed a leiomyoma in fundus of stomach, and EUS Doppler also supported the UGI findings. On further investigation of the patient, CECT of the abdomen revealed a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure...
2014: Case Reports in Surgery
Ari Leppäniemi
No abstract text is available yet for this article.
2013: Scandinavian Journal of Surgery: SJS
B Robert, T Yzet, J M Regimbeau
Since the initial studies published in the eighties, percutaneous radiologic drainage, is considered the first-line treatment of infected post-operative collections and is successful in over 80% of patients. Mortality due to undrained abscesses is estimated between 45 and 100%. Radiology-guided percutaneous drainage can be performed either with curative intent or to improve patient status prior to re-operation under better conditions. Cross-sectional imaging, using either ultrasound or computed tomography (CT), has changed the management of post-operative complications...
June 2013: Journal of Visceral Surgery
C Mouly, R Chati, M Scotté, J-M Regimbeau
BACKGROUND: Management of perforated gastro-duodenal ulcer (GDU) is not consensual, from no operative treatment to surgery by simple closure, gastrectomy and vagotomy. The purpose of this study is to report results of the literature concerning management of perforated GDU. METHODS: Two authors, identified in the databases Pubmed and Embase studies, related to the therapeutic management of perforated GDU. The data were extracted from articles published between 1940 and 2012...
November 2013: Journal of Visceral Surgery
P Zareba, C Wu, J Agzarian, D Rodriguez, C Kearon
BACKGROUND: Although venous thromboembolism (VTE) is an important cause of postoperative morbidity and mortality, there is still no consensus on the optimal strategy for VTE prevention after major surgery. The objective of this review was to determine the benefits and risks of thromboprophylaxis with both compression and anticoagulation, compared with either modality alone. METHODS: A systematic review of MEDLINE, CENTRAL and Embase databases was performed to identify eligible randomized trials...
August 2014: British Journal of Surgery
J De Siqueira, O Tawfiq, J Garner
INTRODUCTION: The need to manage an open abdomen is becoming more common in general surgical practice and a variety of methods of temporary abdominal closure (TAC) are available. The evidence for the efficacy of the various forms of TAC as well as the subsequent definitive fascial closure (DFC) rates and complications comes mainly from large trauma series in the US, which represent a different patient population to those in the UK in whom TAC is usually required. METHODS: All cases of open abdomen management in our hospital over a five-year period were reviewed to ascertain the methods of TAC used, our success in achieving DFC and the applicability of managing such cases in a district hospital environment...
April 2014: Annals of the Royal College of Surgeons of England
J B Haddow, H Adwan, S E Clark, S Tayeh, S S Antonowicz, P Jayia, D W Chicken, T Wiggins, R Davenport, S Kaptanis, M Fakhry, C H Knowles, A S Elmetwally, E Geddoa, M S Nair, I Naeem, S Adegbola, L J Muirhead
INTRODUCTION: The surgical Apgar score (SAS) can predict 30-day major complications or death after surgery. Studies have validated the score in different patient populations and suggest it should be used to objectively guide postoperative care. We aimed to see whether using the SAS in a decisive approach in a future randomised controlled trial (RCT) would be likely to demonstrate an effect on postoperative care and clinical outcome. METHODS: A total of 143 adults undergoing general/vascular surgery in 9 National Health Service hospitals were recruited to a pilot single blinded RCT and the data for 139 of these were analysed...
July 2014: Annals of the Royal College of Surgeons of England
Bellal Joseph, Viraj Pandit, Caitlyn Harrison, Dafney Lubin, Narong Kulvatunyou, Bardiya Zangbar, Andrew Tang, Terence O'Keeffe, Donald J Green, Lynn Gries, Randall S Friese, Peter Rhee
BACKGROUND: The aim of this study was to compare the safety of early (≤48 hours), intermediate (48 to 72 hours), and late (≥72 hours) venous thromboembolism prophylaxis in patients with blunt abdominal solid organ injury managed nonoperatively. METHODS: We performed a 6-year (2006 to 2011) retrospective review of all trauma patients with blunt abdominal solid organ injuries. Patients were matched using propensity score matching in a 2:1:1 (early:intermediate:late) for age, gender, systolic blood pressure, Glasgow Coma Scale, Injury Severity Score, and type and grade of organs injured...
January 2015: American Journal of Surgery
Feng Cao, Jia Li, Ang Li, Yu Fang, Ya-Jun Wang, Fei Li
BACKGROUND: Although nonoperative management for perforated peptic ulcer (PPU) has been used for several decades, the indication is still unclear. A clinicoradiological score was sought to predict who can benefit from it. METHODS: A clinicoradiological protocol for the assessment of patients presenting with PPU was used. A logistic regression model was applied to identify determinant variables and construct a clinical score that would identify patients who can be successfully treated with nonoperative management...
July 2014: Asian Journal of Surgery
Jordy J S Kiewiet, Oddeke van Ruler, Marja A Boermeester, Johannes B Reitsma
BACKGROUND: Accurate and timely identification of patients in need of a relaparotomy is challenging since there are no readily available strongholds. The aim of this study is to develop a prediction model to aid the decision-making process in whom to perform a relaparotomy. METHODS: Data from a randomized trial comparing surgical strategies for relaparotomy were used. Variables were selected based on previous reports and common clinical sense and screened in a univariable regression analysis to identify those associated with the need for relaparotomy...
2013: BMC Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"