Perioperative non-invasive versus semi-invasive cardiac index monitoring in patients with bariatric surgery – a prospective observational study

Abstracts Background Patient outcomes are influenced by intraoperative temperature management. Oesophageal/pharyngeal temperature monitoring is the standard of care at our institute but is not well tolerated in awake patients. Many non-invasive temperature monitors have been studied. Only the TraxIt® Wearable Children’s Underarm Thermometer which contains liquid crystals that undergo phase changes according to temperature is available at our institution. We tested these non-invasive monitors against our standard of care which is the oesophageal/pharyngeal temperature monitor. Methods We conducted a prospective observational study of 100 patients receiving general anaesthesia for elective surgery. Patients were eligible for inclusion if they were ≥ 18 years old, were planned to have a general anaesthetic > 60 min during which no body cavity (chest or abdomen) would be opened. Patient temperature was measured with an oesophageal/pharyngeal thermistor probe and skin surface temperature monitors placed over the forehead, in the axilla, over the sternum, and behind the ear (over major vessels to the brain). Temperatures were recorded and then analysed using Altman-Bland plots. Pre-determined clinically relevant limits of agreement were set at −/+ 0.5 °C. Results From the 100 patients we collected 500 data points for each monitor with an average monitoring time of 102 min (30–300 min) across a range of surgical procedures. None of the skin surface temperature monitors achieved the pre-determined limits of agreement and results were impacted by the use of a forced air warmer. Conclusion The TraxIt® Wearable Children’s Underarm Thermometers are not suitable for temperature monitoring during general anaesthesia.

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IMPACT OF BARIATRIC SURGERY ON THE INFLAMMATORY STATE BASED ON CPR VALUE

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1402 ◽

2018 ◽

Vol 31 (4) ◽

Cited By ~ 1

Author(s):

Renato MIGLIORE ◽

João Kleber Almeida GENTILE ◽

Fabiana Tornincasa FRANCA ◽

Guilherme Tommasi KAPPAZ ◽

Pedro Marcos Santinho BUENO-DE-SOUZA ◽

...

Keyword(s):

Bariatric Surgery ◽

Gastric Bypass ◽

Observational Study ◽

Inflammatory Mediators ◽

Surgical Procedure ◽

Prospective Observational Study ◽

C Reactive Protein ◽

Reactive Protein ◽

Inflammatory State ◽

Gastric By Pass

ABSTRACT Background: PCR (C-reactive protein), produced in the liver after stimuli of inflammatory mediators, is determined as a marker of inflammatory activity (adipocytokines) and is present within adipocyte cells; besides being an inflammatory product, many studies have shown to be a predictor of complications. Aim: To determine if the inflammatory state of the obese patient decreases after bariatric surgery, based on pre and post-operative PCR. Methods: A prospective, observational study in patients undergoing Roux-en-Y gastric by-pass surgery followed up for three months after surgery, with serum preoperative CRP in 30, 60 and 90 days after surgery. Results: A total of 19 patients, who had a mean CRP value before the surgical procedure of 0.80(±0.54) mg/dl, were followed, and when compared to the CRP with 30 days of surgery, they presented a significant increase to 2.68 mg/dl (p=0.012). When compared with the PCR of 60 days after the surgical procedure, it was also higher with the value of 3.32 mg/dl (p=0.27). However, at three months after surgery, the CRP showed a decrease when compared to the preoperative mark, with value of 0.45 mg/dl (p=0.0042). Conclusion: Roux-en-Y gastric bypass was able to decrease the chronic inflammation status of these patients, based on the value of CRP, with three months of surgery.

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Obstructive sleep apnea syndrome in obese patients before bariatric surgery: A prospective observational study

10.1183/13993003.congress-2016.pa346 ◽

2016 ◽

Author(s):

Marion Dupuis ◽

Sandrine Pontier ◽

Pascal Debove ◽

Elise Noel-Savina ◽

Alain Didier

Keyword(s):

Bariatric Surgery ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Observational Study ◽

Obstructive Sleep Apnea Syndrome ◽

Prospective Observational Study ◽

Sleep Apnea Syndrome ◽

Obese Patients ◽

Obstructive Sleep ◽

Apnea Syndrome

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Safety and Success of Lumbar Puncture in Young Infants: A Prospective Observational Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.692652 ◽

2021 ◽

Vol 9 ◽

Author(s):

Luca Bedetti ◽

Licia Lugli ◽

Lucia Marrozzini ◽

Alessandro Baraldi ◽

Federica Leone ◽

...

Keyword(s):

Body Weight ◽

Adverse Events ◽

Observational Study ◽

Lumbar Puncture ◽

Intraventricular Hemorrhage ◽

Prospective Observational Study ◽

Respiratory Support ◽

Success Rates ◽

Non Invasive ◽

Young Infants

Objective: This study aims to evaluate safety and success rates of lumbar puncture (LP) and to identify factors associated with adverse events or failure of LP in infants.Methods: This two-center prospective observational study investigated infants younger than 90 days of age who underwent LP. Need for resuscitation oxygen desaturation (SpO2 < 90%), bradycardia and intraventricular hemorrhage were considered adverse events. LP failed if cerebrospinal spinal fluid was not collected or had traces of blood. Logistic regression analysis was used to evaluate whether corrected gestational age (GA), body weight at LP, position, and any respiratory support during LP affected SpO2 desaturation or failure of LP.Results: Among 204 LPs, 134 were performed in full-term and 70 in pre-term born infants. SpO2 desaturations occurred during 45 (22.4%) LPs. At multivariate analysis, lower GA at LP (p < 0.001), non-invasive respiratory support (p 0.007) and mechanical ventilation (p 0.004) were associated with SpO2 desaturations. Transient, self-resolving bradycardia occurred in 7 (3.4%) infants. Two infants had intraventricular hemorrhage detected within 72 h of LP. No further adverse events were registered. Failure of LP occurred in 38.2% of cases and was not associated with any of the factors evaluated.Conclusions: LP was safe in most infants. Body weight or GA at LP did not affect LP failure. These data are useful to clinicians, providing information on the safety of the procedure.

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