Perioperative Management of Pancreaticoduodenectomy: Avoiding Admission to the Intensive Care Unit

Background: Tracheostomy is a technique used to treat patients with inadequate ventilation and upper airway obstruction by making air passage through the neck directly into the trachea. Percutaneous dilated tracheostomy is usually performed in patients requiring long-term use of a ventilator in an intensive care unit. Basic knowledge of perioperative management of percutaneous dilated tracheostomy is fundamental and must be mastered by anesthesiologists. Case: A woman, 45 years old is treated at dr. Moewardi hospital with decreased consciousness E2V2M3, non-communicant hydrocephalus, and intraventricular hemorrhage. The patient underwent ventriculoperitoneal shunt surgery and was admitted to the intensive care unit. Patients require long-term use of a ventilator and thus require percutaneous dilated tracheostomy. The percutaneous dilated tracheostomy procedure was successfully performed and there were no complications after the procedure. Conclusion: Percutaneous dilated tracheostomy is a minimally invasive tracheostomy technique as an alternative to conventional techniques, with lower complications and shorter time.

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Pheochromocytoma: Multidisciplinary Approach Perioperative Considerations

Revista de la Facultad de Medicina Humana ◽

10.25176/rfmh.v21i3.3923 ◽

2021 ◽

Vol 21 (3) ◽

pp. 674-680

Author(s):

Miryam Elizabeth Céspedes Morón ◽

Roxana Camargo-Román ◽

Nicanor Rodriguez-Gutarra ◽

Alicia Mispireta-Castañeda

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Adrenal Gland ◽

Multidisciplinary Approach ◽

Perioperative Management ◽

Perioperative Complications ◽

Laparoscopic Technique ◽

Left Adrenal Gland ◽

Surgical Preparation ◽

Rule Out

Patient scheduled for an adrenalectomy with laparoscopic technique, due to a tumor of the left adrenal gland. The diagnosis of chronic arterial hypertension was difficult to control, so a test was requested to rule out pheochromocytoma, resulting in a tumor of the left adrenal gland. The teamwork of the specialties involved in the care of the patient, effective communication, pre-surgical preparation and perioperative management, resulted in minimal perioperative complications in the patient, remaining in the intensive care unit for one day and reducing the hospital stay.

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Perioperative Management of Bleeding due to Uterine Atony/Rupture in a Parturient after Vaginal Delivery and Intensive Care Unit Follow-up: Pharmacological, surgical and interventional therapies

Turkish Journal of Intensive Care ◽

10.4274/tybd.galenos.2019.82473 ◽

2019 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Berrin Günaydın ◽

Gozde İnan ◽

Ezgi Turgut ◽

Deniz Karçaaltıncaba ◽

Ali Çin ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Vaginal Delivery ◽

Perioperative Management ◽

Uterine Atony ◽

Interventional Therapies

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Effectiveness of Closed-PICU Perioperative Management of Children with Congenital Tracheal Stenosis

10.22541/au.162810036.66565062/v1 ◽

2021 ◽

Author(s):

Kazunori Aoki ◽

Hiroshi Kurosawa ◽

Yusuke Seino ◽

Keiichi Morita ◽

Hironori Matsuhisa ◽

...

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Tracheal Stenosis ◽

Enteral Feeding ◽

Medical Records ◽

Retrospective Cohort ◽

Perioperative Management ◽

Pediatric Intensive Care ◽

Congenital Tracheal Stenosis

Perioperative management of congenital tracheal stenosis (CTS) is challenging. Objectives: We investigated the effect of closed-pediatric intensive care unit (PICU) perioperative management by pediatric intensivists, compared with open-PICU management by surgeons, on the ventilator-free days (VFD) and length of postoperative PICU stay in children with CTS. Methods: This retrospective cohort study was conducted in a PICU in Japan. Children with CTS who underwent slide tracheoplasty were grouped according to whether they were perioperatively managed in an open (January 2015 to April 2016) or a closed (May 2016 to July 2019) PICU. Data were extracted from patient medical records. Results: In total, 13 and 38 patients were included in the open- and closed-PICU groups, respectively. Compared to the open-PICU group, the closed-PICU group had shorter durations of muscle relaxant administration (median: 4 vs. 5 days; P < 0.001); earlier initiation of enteral feeding (median: postoperative day 1 vs. postoperative day 7; P < 0.001); more 28-day VFD (median: 21 vs. 20 days; P = 0.04); and shorter duration of postoperative PICU stay (median: 16 vs. 36 days; P = 0.002), but the mortality did not differ significantly (0/38 [0%] vs. 1/13 [8%]; P = 0.25). Conclusions: Closed-PICU perioperative management with pediatric intensivists’ participation significantly increased 28-day VFD and reduced the length of postoperative PICU stay in patients with CTS.

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The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00097 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1507-1515

Author(s):

Lauren L. Madhoun ◽

Robert Dempster

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Hospital Discharge ◽

Neonatal Intensive Care ◽

Oral Feeding ◽

Medical Attention ◽

Primary Role ◽

Speech Language Pathologists ◽

The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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