Respiratory function following major emergency abdominal surgery

2020 ◽  
Vol 30 (12) ◽  
pp. 389-394
Author(s):  
Jakob Burcharth ◽  
Jakob Ohm Oreskov ◽  
Andreas Falkenberg ◽  
Anders Schack ◽  
Sarah Ekeloef ◽  
...  
Keyword(s):  
Linear Regression ◽  
Confidence Interval ◽  
Abdominal Surgery ◽  
Respiratory Function ◽  
Peak Flow ◽  
Forced Expiratory Volume ◽  
Mean Values ◽  
Pain Scores ◽  
Emergency Abdominal Surgery

The purpose of this study was to evaluate the timewise postoperative respiratory function measured by spirometry and peak flow during the first postoperative week after major emergency abdominal surgery. Patients were tested daily with forced expiratory volume (FEV) and peak flow (PEF) from postoperative day (POD) 1 through to POD7. FEV1, FEV6, FEV1/FEV6 ratio and PEF were analysed by unadjusted linear regression with 95% confidence interval (CI) on mean values for each postoperative day. A total of 35 consecutive patients were included in the study. The FEV at 1 second was 51% of predicted at POD1, which increased to 67% at POD7 (p = 0.005), whereas FEV6 was 55% of predicted at POD1, which increased to 70% at POD7 (p = .008). Respiratory function was not significantly correlated to synchronous pain scores. In conclusion, respiratory function following major emergency abdominal surgery was reduced throughout the first postoperative week irrespective of pain scores.

scholarly journals Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1312
Author(s):  
So-Hyun Kim ◽  
Sung-Hyoun Cho
Keyword(s):  
Growth Rate ◽  
Linear Model ◽  
Respiratory Function ◽  
Hierarchical Linear Model ◽  
Forced Expiratory Volume ◽  
Forced Expiration ◽  
Stroke Patients ◽  
Mean Values ◽  
Intergroup Comparison ◽  
Neck Stabilization

Background and Objectives: This study aimed to assess the effect of neck stabilization exercise on respiratory function in stroke patients through longitudinal observation and determine whether there is a difference in its effect based on the side of paralysis in the patients. It is difficult to observe the amount of change observed in individuals and groups as most intergroup comparison studies only use mean values. To address these shortcomings, this study adopted a hierarchical linear model (HLM) in our trajectory analysis. Materials and Methods: We conducted neck stabilization training three times a week for four weeks in a single group of 21 stroke patients. To evaluate respiratory function, their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiration ratio (FEV1/FVC), and peak cough flow (PCF) were measured. Data analysis was performed using HLM 8.0. Results: A significant increase was found in the respiratory function after neck stabilization training (p < 0.05). While neck stabilization training overall was longitudinally effective, the growth rate of respiratory function in left-sided paralytic patients was less than the whole group value. Conversely, the growth rate of respiratory function in right-sided paralytic patients was greater than the whole group value. Conclusions: This study demonstrated that neck stabilization training is longitudinally effective in improving respiratory function in stroke patients. Additionally, the growth rate of respiratory function was greater in patients with right side paralysis than in patients with left side paralysis.

Airway Obstruction and Perioperative Complications in Smokers Undergoing Abdominal Surgery 

1999 ◽  
Vol 90 (2) ◽  
pp. 372-379 ◽  
Author(s):  
David O. Warner ◽  
Mark A. Warner ◽  
Kenneth P. Offord ◽  
Darrell R. Schroeder ◽  
Pamela Maxson ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Abdominal Surgery ◽  
Airway Obstruction ◽  
Endotracheal Intubation ◽  
Odds Ratio ◽  
Perioperative Complications ◽  
Conditional Logistic Regression ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Clinical Practices

Background The goal of this study was to determine whether airway obstruction determined by preoperative spirometry predicts perioperative complications in smokers undergoing abdominal surgery whose treatment is managed according to current clinical practice. Methods A pulmonary function database identified patients undergoing abdominal surgery who met the following criteria for airway obstruction (n = 135): a forced expiratory volume less than 40% of predicted normal value, a forced expiratory volume:forced vital capacity ratio less than the lower limit of predicted normal, a smoking history of more than 20 pack-years, and an age older than 35 yr. A group of patients without airway obstruction (n = 135) was matched for gender, surgical site (upper vs. lower abdominal), smoking history, and age. Medical records were reviewed by an abstractor to identify perioperative complications that occurred within 30 days after surgery. Results The forced expiratory volume values were 0.9+/-0.21 (mean +/- SD) and 2.9+/-0.61 in patients with and without airway obstruction, respectively. When analyzed by conditional logistic regression using the 1:1 matched-pairs feature, including age, pack-year smoking history, site of incision, and current smoking status as covariates, in patients with airway obstruction bronchospasm was more likely to develop (odds ratio, 6.9 [95% confidence interval, 1.2 to 38.4]) but the patients were not more likely to need prolonged endotracheal intubation (odds ratio, 1.1 [95% confidence interval, 0.4 to 3.2]). They were also no more likely to need prolonged intensive care admission or readmission. The frequency of other complications was less than 5%. Conclusion When other factors were considered, preoperative airway obstruction predicted the occurrence of bronchospasm, but not prolonged endotracheal intubation, in smokers undergoing abdominal surgery who are treated according to current clinical practices.

scholarly journals A rare case of Pseudomonas aeruginosa bacteremia in a newborn with 58 perforations in the small intestine

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuanyuan Xu ◽  
Danqun Jin ◽  
Huan Ye ◽  
Youfeng Liang
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Small Intestine ◽  
Early Detection ◽  
Abdominal Surgery ◽  
Rare Case ◽  
Venous Blood ◽  
Case Presentation ◽  
Systemic Infections ◽  
Emergency Abdominal Surgery ◽  
Timely Treatment

Abstract Background Community-acquired infections of Pseudomonas aeruginosa (P. aeruginosa) occur very rarely. Case presentation P. aeruginos was detected in cultures of venous blood and peritoneal exudate of a newborn with 58 perforations in the small intestine. Intravenous administration of imipenem cilastratin sodium and emergency abdominal surgery were performed. The patient fully recovered and was discharged 17 days after the operation. Conclusions Mild symptoms of systemic infections in newborns may delay the diagnosis. Early detection and timely treatment are the key to improved prognosis.

Non-traumatic emergency abdominal surgery in nonagenarian patients: a retrospective study

2021 ◽  
Author(s):  
Mattia Portinari ◽  
Lara Bianchi ◽  
Alessandro De Troia ◽  
Giorgia Valpiani ◽  
Savino Spadaro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Abdominal Surgery ◽  
Emergency Abdominal Surgery

Association Between Perioperative Fluid Balance and 30-Day Unplanned Readmission After Major Abdominal Surgery

2019 ◽  
Vol 26 (4) ◽  
pp. 401-407
Author(s):  
Tak Kyu Oh ◽  
Ah-Young Oh ◽  
Jung-Won Hwang
Keyword(s):  
Confidence Interval ◽  
Abdominal Surgery ◽  
Fluid Balance ◽  
Odds Ratio ◽  
Readmission Rate ◽  
Major Abdominal Surgery ◽  
Unplanned Readmission ◽  
Academic Hospital ◽  
Relative Value ◽  
Duration Of Surgery

Perioperative positive fluid balance (FB) increases postoperative complication and length of hospital stay. We aimed to investigate 30-day unplanned readmission after major abdominal surgery based on perioperative FB (%) on postoperative days (POD) 0 to 3. This retrospective cohort study analyzed medical records of patients who underwent elective major abdominal surgery (surgery time >2 hours, estimated blood loss >500 mL) at a single tertiary academic hospital from January 2010 to December 2017. Cumulative FB was calculated by total input fluid − output fluid in liters × weight (kg)−1 on admission × 100 during POD 0 (24 hours), 0 to 1 (48 hours), 0 to 2 (72 hours), and 0 to 3 (96 hours). Of the 3650 patients in the final analysis, 503 (13.8%) had unplanned readmission within 30 days. In the multivariable logistic regression analysis, FB on POD 0 (24 hours), 0 to 1 (48 hours), 0 to 2 (72 hours), and 0 to 3 (96 hours) showed no significant association with 30-day unplanned readmission (all P > .05). However, an increase of 10 000 points in the total relative value unit scores was associated with 5% increase in 30-day unplanned readmission (odds ratio = 1.05, 95% confidence interval = 1.02-1.07; P = .001), and 1-hour increase in surgery time was associated with 10% increase in 30-day unplanned readmission (odds ratio = 1.10, 95% confidence interval = 1.05-1.15; P < .001). This study showed that perioperative FB is not associated with 30-day unplanned readmission rate after a major abdominal surgery. Total relative value unit scores and duration of surgery were significantly associated with 30-day unplanned readmission rate after major abdominal surgery in a single tertiary academic hospital.

scholarly journals Dezocine Prevents Postoperative Hyperalgesia in Patients Undergoing Open Abdominal Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Fang Yu ◽  
Jie Zhou ◽  
Suyun Xia ◽  
Huan Xu ◽  
Xiangrui Wang
Keyword(s):  
Treatment Group ◽  
Abdominal Surgery ◽  
Pain Threshold ◽  
Controlled Trial ◽  
Thermal Hyperalgesia ◽  
Postoperative Nausea And Vomiting ◽  
Open Gastrectomy ◽  
Sham Treatment ◽  
Pain Scores ◽  
Open Abdominal Surgery

Objective. Postoperative hyperalgesia is very frequent and hard to treat. Dezocine is widely used and has a modulatory effect for thermal hyperalgesia in animal models. So, this study was designed to investigate the potential role of dezocine in decreasing postoperative hyperalgesia for patients undergoing open abdominal surgery.Methods. This is a randomized, double-blinded, and placebo-controlled trial. 50 patients for elective open gastrectomy were randomly allocated to either a true treatment group (0.15 mg/kg intravenous dezocine at the end of surgery) or a sham treatment group (equivalent volume of saline) in a 1 : 1 ratio. Patients were followed up for 48 hours postoperatively and pain threshold to Von Frey filaments, pain scores, PCIA consumption, rescue analgesics use, sedation score, and occurrence of postoperative nausea and vomiting were recorded.Results. Patients in the true treatment group experienced statistically significantly higher pain threshold on forearm and smaller extent of peri-incisional hyperalgesia than the sham treatment group. Rescue analgesic use, cumulative PCIA consumption, and pain scores were statistically significantly decreased in the true treatment group compared to the sham treatment group.Conclusions. Dezocine offers a significant antihyperalgesic and analgesic effect in patients undergoing elective open gastrectomy for up to 48 hours postoperatively.

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