scholarly journals Management of Postoperative Neurosurgical Patients

2019 ◽  
Vol 06 (02) ◽  
pp. 080-086
Author(s):  
Nidhi B. Panda ◽  
Shalvi Mahajan ◽  
Rajeev Chauhan
Keyword(s):  
Postoperative Care ◽  
Fluid Management ◽  
Surgical Techniques ◽  
Postoperative Management ◽  
Therapeutic Interventions ◽  
Team Collaboration ◽  
Good Communication ◽  
Neurosurgical Patients ◽  
Special Subset ◽  
Unique Individual

AbstractNeurosurgical patients are a special subset of patients requiring postoperative care. Challenging neurosurgical disease processes, advanced surgical techniques, and unique individual patient requirements advocate the need for meticulous postoperative care to ensure safe transition toward recovery. Timely detection of systemic and neurological changes allows early diagnostic and therapeutic interventions. The mainstay of postoperative care revolves around airway, maintenance of hemodynamics, sedation, analgesia, nutrition, fluid management, and management of disease-specific complications. In addition to standard monitoring, multimodal neuromonitoring should be used in neurosurgical patients. Hence, four key elements in the postoperative management of neurosurgical patients involve profound insight, rapid response, good communication skills, and team collaboration.

Paediatric renal transplantation

2015 ◽  
Author(s):  
Minnie M. Sarwal ◽  
Ron Shapiro
Keyword(s):  
Fluid Management ◽  
Surgical Techniques ◽  
Normal Growth ◽  
Paediatric Population ◽  
The United States ◽  
Immunosuppressive Drugs ◽  
Postoperative Management ◽  
Paediatric Renal Transplantation ◽  
Stage Renal Disease ◽  
End Stage

Approximately 1 in 65,000 children develops end-stage renal disease (ESRD) each year with almost 1200 children (aged 0–19 years) in the United States developing ESRD annually. Kidney transplantation is the primary method of treating ESRD in the paediatric population. The special issues in children and adolescents with ESRD include achieving normal growth and cognitive development. This chapter discusses the advances in surgical techniques, patient selection, transplant evaluation/preparing for transplantation, postoperative management (including fluid management in infants and small children), and the evolution of immunosuppressive drugs that have resulted in improved quality of life and a reduction in the mortality rate of children with chronic renal failure.

An Update on Airway Management

2020 ◽  
Keyword(s):  
Airway Management ◽  
Surgical Techniques ◽  
Daily Practice ◽  
Postoperative Management ◽  
Diagnostic Methods ◽  
Emergency Rooms ◽  
Specific Patient ◽  
Medical Practitioners ◽  
Preoperative Diagnostic ◽  
Airway Devices

In recent years, there have been many advances in the safe management of the patient's airway, a cornerstone of anesthetic practice. An Update on Airway Management brings forth information about new approaches in airway management in many clinical settings. This volume analyzes and explains new preoperative diagnostic methods, algorithms, intubation devices, extubation procedures, novelties in postoperative management in resuscitation and intensive care units, while providing a simple, accessible and applicable reading experience that helps medical practitioners in daily practice. The comprehensive updates presented in this volume make this a useful reference for anesthesiologists, surgeons and EMTs at all levels. Key topics reviewed in this reference include: New airway devices, clinical management techniques, pharmacology updates (ASA guidelines, DAS algorithms, Vortex approach, etc.), Induced and awake approaches in different settings Updates on diagnostic accuracy of perioperative radiology and ultrasonography Airway management in different settings (nonoperating room locations and emergency rooms) Airway management in specific patient groups (for example, patients suffering from morbid obesity, obstetric patients and critical patients) Algorithms and traditional surgical techniques that include emergency cricothyrotomy and tracheostomy in ‘Cannot Intubate, Cannot Ventilate’ scenarios. Learning techniques to manage airways correctly, focusing on the combination of knowledge, technical abilities, decision making, communication skills and leadership Special topics such as difficult airway management registry, organization, documentation, dissemination of critical information, big data and databases

The postoperative management of pain from intracranial surgery in pediatric neurosurgical patients

2014 ◽  
Vol 24 (7) ◽  
pp. 724-733 ◽  
Author(s):  
Joanne E. Shay ◽  
Deepa Kattail ◽  
Athir Morad ◽  
Myron Yaster
Keyword(s):  
Postoperative Management ◽  
Intracranial Surgery ◽  
Neurosurgical Patients

Heart and Heart-Lung Transplantation: An Update

1996 ◽  
Vol 4 (1) ◽  
pp. 4-13
Author(s):  
David D Yuh ◽  
Robert C Robbins ◽  
Bruce A Reitz
Keyword(s):  
Lung Transplantation ◽  
Postoperative Care ◽  
Organ Preservation ◽  
Surgical Techniques ◽  
Organ Shortage ◽  
Transplant Recipients ◽  
Donor Organ ◽  
The West ◽  
Thoracic Transplantation ◽  
End Stage

Heart and heart-lung transplantation have been established as effective treatments for a wide variety of end-stage cardiopulmonary diseases. Recent years have seen refinements in surgical techniques for cardiopulmonary replacement as well as the selection and postoperative care of thoracic transplant recipients. Despite substantial clinical progress, however, significant problems remain, particularly donor organ shortage, graft rejection, opportunistic infection, and limited organ preservation techniques. Basic and clinical research are currently addressing these problems. In this brief review, we provide an update of our experiences with heart and heart-lung transplantation in the West (particularly at Stanford University), an outline of the active issues in the field, and some thoughts about the development of thoracic transplantation in Asia.

scholarly journals CURRENT PHARMACOLOGICAL STATUS OF CARDIOPROTECTIVE PLANTS AGAINST ISOPROTERENOL INDUCED MYOCARDIAL INFARCTION

2018 ◽  
Vol 11 (4) ◽  
pp. 17
Author(s):  
Syeda Nishat Fathima ◽  
Vasudeva Murthy S
Keyword(s):  
Myocardial Infarction ◽  
Lifestyle Modification ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Cardiac Biomarkers ◽  
Therapeutic Interventions ◽  
Current Status ◽  
Plant Parts ◽  
Heart Muscle Cells ◽  
Modern Era

 Objective: Cardiovascular diseases are the major cause of morbidity and mortality in the modern era. Myocardial infarction is a condition where there is a significant decrease or block in the blood (oxygen) supply to the part of heart, leading to degeneration of a portion of the myocardium which triggers a cascade of cellular, inflammatory and biochemical events, leading eventually to the irreversible death (necrosis) of heart muscle cells. Various therapeutic interventions, including lifestyle modification, pharmacological treatment options, and surgical techniques are available. The present review focus on the plants that have been evaluated for cardioprotective activity against isoproterenol-induced myocardial infarction.Method: The current status of Cardioprotective plants was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2017 for publications on medicinal plants used against isoproterenol-induced myocardial infarction. Isoproterenol, Isoprenaline, myocardial infarction, cardioprotective were used as keywords for the searching.Result: A total of 117 different plant parts and their extracts have till now been published to possess cardioprotection against isoproterenol-induced myocardial infarction. Isoproterenol a beta-adrenergic receptors agonist causes severe stress in myocardium resulting in the infarct-like lesion and produced cardiotoxic effects by elevating the levels of cardiac biomarkers and causing changes in ECG. Plant-based medicines with their antioxidant, antiapoptotic, antihyperlipidemic, platelet antiaggregatory, anti-lipid peroxidation property provide substantial evidence for the management of Ischemia.Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants that have cardioprotective activity against isoproterenol-induced myocardial infarction.

Postoperative Care of Neurosurgical Patients

2016 ◽  
Vol 6 (3) ◽  
pp. 257-266 ◽  
Author(s):  
Lionel Velly ◽  
Pierre Simeone ◽  
Nicolas Bruder
Keyword(s):  
Postoperative Care ◽  
Neurosurgical Patients

scholarly journals Manajemen Low Flow Anesthesia pada Pasien Kraniosinostosis dengan Hipertelorisme yang menjalani Four Box Wall Osteotomy, dan Eksisi Redundant Skin Fronto Nasal

2021 ◽  
Vol 10 (3) ◽  
pp. 172-181
Author(s):  
Syarif Afif ◽  
◽  
Dewi Yulianti Bisri ◽  
M. Sofyan Harahap ◽  
Syafruddin Gaus ◽  
...  
Keyword(s):  
Fluid Management ◽  
Coagulation Factor ◽  
Massive Bleeding ◽  
Low Flow ◽  
First Year ◽  
Inhalation Anesthesia ◽  
Good Communication ◽  
Post Operative Pain ◽  
Low Flow Anesthesia ◽  
First Year Of Life

Craniosynostosis is a case that diagnosed in the first year of life and can need surgical in young age. Craniosynostosis is a part of hypertelorism with incidence rate around 20%. Boy, 13 years old with hypertelorism had undergone multiple surgery for correction of hypertelorism before. Patient was planned to advance surgical correction of four box wall osteotomy which consist frontal part correction and part of it is release craniosynostosis in coronal suture. Risk of massive bleeding because patient already in teen age and length of surgery can be prolonged. Difficult airway management due to fascial deformity, use of low flow anesthesia to preserve temperature and reduce inhalation anesthesia usage, intraoperative fluid management in consideration maintenance and replacement blood loss and post operative pain management has become another consideration. Covid-19 as part of problems post operatively being known before extubation made the process is delayed. Massive bleeding needs massive transfusion protocol to speed up blood availability. Blood product such as PRC, FFP and TC should be available because coagulation factor is part of consideration. Anesthesia management in hypertelorism with four box wall osteotomy need good communication between anesthesiologist, neurosurgeon, plastic surgeon and pediatric intensivist to reduce perioperative risk including covid-19 in pandemic era.

scholarly journals MANAGEMENT OF THE SURGICAL SOLUTIONS FOR FEEDING – A PREVENTION FACTOR FOR NUTRIENT BALANCE IMPAIRMENT

2017 ◽  
Vol 64 (3) ◽  
pp. 194-200
Author(s):  
Corneliu Tudor ◽  
◽  
Costel Şavlovschi ◽  
Cristian Brănescu ◽  
Ahed El-Khatib ◽  
...  
Keyword(s):  
Nutrient Balance ◽  
Surgical Techniques ◽  
Postoperative Management ◽  
Postoperative Surveillance ◽  
Feeding Tubes ◽  
Term Evolution ◽  
Long Run ◽  
Nursing Services ◽  
Limited Period

Aim. The paper aims, thanks to the long-standing practice, to synthesize the clinical experience gained during the surgery for feeding tubes management and highlight the details we had to deal with in order to overcome the local and general difficulties. Materials and method. A retrospective study was carried out over a period of 20 years (1996-2016), on the patients who underwent surgery for placing feeding tubes in our clinic. They were analyzed: the techniques used, the long-term evolution, the complications and the incidents and the way they were solved. Results. A total of 329 patients were enrolled in the study. The surgical techniques used were: classic surgical solutions (300 cases) and percutaneous endoscopic gatrostomy (PEG, 29 cases). For classical interventions, post-operative evolution was good in 219 patients (73%) and was complicated by various accidents and incidents in 81 cases (23%). The study presents the causes that may lead to these complications, the local and general, clinical and paraclinical consequences and the correct surgical attitude, as well as particular cases that required the adaptation of the surgical techniques to local anatomical and functional polymorphism. In the long run, the jejunostomy appears to be relatively inferior to gastrostomy, in terms of toland efficiency. PEG complications were minor and transient, but the reduced number of cases and the limited period of postoperative surveillance did not allow statistically significant conclusions to be drawn. Conclusions. The postoperative management of surgical feeding solutions requires permanent collaboration between surgeon, patient and outpatient nursing services at home and requires knowing and observing of a specific nursing protocol to avoid disturbing the nutrient balance of the patient.

scholarly journals Standardizing preoperative preparation to reduce surgical site infections among pediatric neurosurgical patients

2017 ◽  
Vol 19 (4) ◽  
pp. 399-406 ◽  
Author(s):  
Joshua K. Schaffzin ◽  
Katherine Simon ◽  
Beverly L. Connelly ◽  
Francesco T. Mangano
Keyword(s):  
Surgical Site Infections ◽  
Pediatric Neurosurgery ◽  
Postoperative Management ◽  
Neurosurgical Procedure ◽  
Protocol Adherence ◽  
Protocol Development ◽  
Published Evidence ◽  
Neurosurgical Patients ◽  
Before And After ◽  
Prevention Protocol

OBJECTIVE Surgical site infections (SSIs) are costly to patients and the health care system. Pediatric neurosurgery SSI risk factors are not well defined. Intraoperative protocols have reduced, but have not eliminated, SSIs. The effect of preoperative intervention is unknown. Using quality improvement methods, a preoperative SSI prevention protocol for pediatric neurosurgical patients was implemented to assess its effect on SSI rate. METHODS Patients who underwent a scheduled neurosurgical procedure between January 2014 and December 2015 were included. Published evidence and provider consensus were used to guide preoperative protocol development. The Model for Improvement was used to test interventions. Intraoperative and postoperative management was not standardized or modified systematically. Staff, family, and overall adherence was measured as all-or-nothing. In addition, SSI rates among eligible procedures were measured before and after protocol implementation. RESULTS Within 4 months, overall protocol adherence increased from 51.3% to a sustained 85.7%. SSI rates decreased from 2.9 per 100 procedures preintervention to 0.62 infections postintervention (p = 0.003). An approximate 79% reduction in SSI risk was identified (risk ratio 0.21, 95% CI 0.08–0.56; p = 0.001). CONCLUSIONS Clinical staff and families successfully collaborated on a standardized preoperative protocol for pediatric neurosurgical patients. Standardization of the preoperative phase of care alone reduced SSI rates. Attention to the preoperative in addition to the intraoperative and postoperative phases of care may lead to further reduction in SSI rates.

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