scholarly journals Magnetic levitation pump versus constrained vortex pump: a pilot study on the hemolysis effect during minimal invasive extracorporeal circulation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ignazio Condello ◽  
Giuseppe Santarpino ◽  
Giuseppe Filiberto Serraino ◽  
Pasquale Mastroroberto ◽  
Giuseppe Speziale ◽  
...  
Keyword(s):  
Pilot Study ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Extracorporeal Circulation ◽  
Magnetic Levitation ◽  
Control Group ◽  
Study Group ◽  
Centrifugal Pumps ◽  
Free Hemoglobin ◽  
Centrifugal Blood Pump

Abstract Background Elevated plasma free hemoglobin is associated with multi-organ injury. In this context, minimally invasive extracorporeal technologies represent a way to reduce this complication following cardiac surgery. Methods We present a pilot study focused on plasma free hemoglobin levels in 40 patients undergoing isolated coronary artery bypass grafting (CABG). The same circuits for minimally invasive extracorporeal circulation (MiECC) were used in all patients. The ECMOLIFE magnetic levitation pump was used in the study group (n = 20), and the AP40 Affinity CP centrifugal blood pump was used in the control group (n = 20). Results In the immediate postoperative period, plasma free hemoglobin (PFH) and lactate dehydrogenase (LDH) were significantly lower in the study group than in the control group (10.6 ± 0.7 vs 19.9 ± 0.3 mg/dL, p = 0.034; and 99.16 ± 1.7 vs 139.17 ± 1.5 IU/L, p = 0.027, respectively). Moreover, patients treated with the magnetic levitation pump showed lower creatinine and indirect bilirubin (0.92 vs 1.29 mg/dL, p = 0.030 and 0.6 ± 0.4 vs 1.5 ± 0.9 mg/dL, p = 0.022, respectively) at 24 h after the procedure, and received fewer transfusions during the whole postoperative period (3 vs 9 red blood cell units (RBC), p = 0.017). Conclusion Our pilot study suggests that the use of magnetically levitated centrifugal pumps for extracorporeal circulation support is associated with a lower risk of hemolysis, though larger studies are warranted to confirm our results.

scholarly journals Clinical Application of Minimally Invasive Surgery in Pain and Complications after Spinal Trauma

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tianhui Liu ◽  
Xiaoying Gao ◽  
Jianmin Cui
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Postoperative Recovery ◽  
Spinal Trauma ◽  
Minimally Invasive Treatment ◽  
Control Group ◽  
Study Group ◽  
Invasive Treatment ◽  
Treatment Scheme

Objective: To study and evaluate the incidence of pain and complications in patients with spinal trauma after minimally invasive treatment. Methods: The research period was selected from January 2018 to December 2020, and 40 patients with spinal trauma were selected. According to the random number table scheme, they were divided into the study group and the control group. The treatment scheme of the control group was traditional surgery, and the treatment scheme of the study group was minimally invasive surgery. The indicators of the two groups were compared and analyzed. Results: Compared with the two groups of surgery and postoperative recovery related indicators, the study group had more advantages (P<0.05); Compared two groups of postoperative NRS score, VAS score and the incidence of complications, the study group had more advantages(P<0.05). Conclusion: Minimally invasive treatment of spinal trauma has significant clinical effect, which can effectively relieve postoperative pain and reduce the incidence of various complications.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

EVALUATION OF THE EFFECTIVENESS OF A CLOSED CIRCUIT IN COMPARISON WITH AN OPEN CIRCUIT OF CARDIOPULMONARY BYPASS

2021 ◽  
pp. 44-47
Author(s):  
Berik Tuishiev ◽  
Gulzhan Bayzhan ◽  
Sabina Samitova
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Postoperative Period ◽  
Open Circuit ◽  
Closed Circuit ◽  
Control Group ◽  
Study Group ◽  
Valve Insufficiency ◽  
Group 5 ◽  
Group 2

Objective is to evaluate the effectiveness of closed-loop surgeries with the planned duration of cardiopulmonary bypass more than 2 hours in the immediate postoperative period. Materials and methods. A study was carried out in the clinic over 10 patients (average age 47-56 years) with Diagnoses: Ascending aortic aneurysm, FC 3 aortic valve insufficiency, who underwent surgery for ascending aorta replacement, aortic valve replacement with coronary artery reimplantation. The patients were divided into 2 groups, the 1st group (5 patients) is the control group using an open cardiopulmonary bypass circuit, the 2nd group (5 patients) is the patients using a closed cardiopulmonary bypass circuit. The total time of cardiopulmonary bypass in both groups was 125-187 minutes. Results. In the 2nd study group, drainage blood loss significantly decreased, on average 60-100 ml compared to the control group, where the average drainage loss was 600-1500 ml. The need for blood transfusion was 5.1% in the 2nd group, compared with 43.4% in the control group. In the study group 2, the number of platelets in the postoperative period in patients was higher than in the control group. Conclusion. This study shows that a closed circuit, compared to an open one, allows complex heart surgeries with a planned duration of extracorporeal circulation of more than 2-3 hours.

scholarly journals Postoperative analgesia with the use of peripheral nerve block of the foot and ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Gabriel Ferraz
Keyword(s):  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peripheral Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Foot And Ankle ◽  
The Mean

Category: Basic Sciences/Biologics Introduction/Purpose: Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia. Methods: A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%). Results: The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day. Conclusion: In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.

scholarly journals Oral Hygiene in a Sample of Children/Adolescents Living in Family-Homes from the Province of Milan (Italy): A Pilot Study

2020 ◽  
Vol 8 (2) ◽  
pp. 33 ◽  
Author(s):  
Alessandro Nota ◽  
Floriana Bosco ◽  
Shideh Ehsani ◽  
Francesca Giugliano ◽  
Giulia Moreo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Oral Hygiene ◽  
Clinical Results ◽  
Plaque Index ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Significant Difference ◽  
And Gender ◽  
Oral Hygiene Instructions

Objective: This pilot study is a prospective controlled clinical trial, designed to evaluate the short-term clinical results (the plaque index) of an educational/motivational program for home oral hygiene, directed to children and adolescents who live in family-homes. Methods: The setting of the project was the province of Milan (Italy), where two family-homes were selected. The study group included 26 children (16 females and 10 males) aged between 7 and 15 years, of Italian nationality, from the family-home communities. The control group included 26 children (15 females and 11 males, aged between 7 and 15 years) of Italian nationality, matched for age and gender distribution with the study group, that were not in a socially disadvantaged condition. Collection of the plaque index (PI) was performed at t0. Then, all basic oral hygiene instructions were given to all children/adolescents and their educators. Education and motivation were repeated in the same way after 4–7 weeks (T1), and after 10–12 weeks (T2). The PI was taken also at T1 and T2. Results: An improvement in the PI was generally found in both groups, but there was no statistically significant difference between the two groups over time. Multivariate analysis of variance (MANOVA) revealed a statistically significant effect of time [F (1, 52) = 90.73, p < 0.001], regardless of the assignment group, in consequence of which the plaque index presented a moderate and significant improvement. Conclusion: The present data confirm the validity of the educational/motivational program to improve oral hygiene in children/adolescents, regardless of the assignment group.

Complement consumption during cardiopulmonary bypass: comparison of Duraflo II heparin-coated and uncoated circuits in fully heparinized patients

Perfusion ◽  
1996 ◽  
Vol 11 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Ahmet Hamulu ◽  
Berent Discigil ◽  
Mustafa Özbaran ◽  
Tanzer Çalkavur ◽  
Erkan Kara ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Postoperative Period ◽  
Extracorporeal Circulation ◽  
Myocardial Revascularization ◽  
Control Group ◽  
Clotting Time ◽  
Normal Range ◽  
Activated Clotting Time ◽  
Systemic Heparinization

Heparin attachment to synthetic surfaces is one means of improving the biocompatibility of clinically used cardiopulmonary bypass (CPB) circuits. To assess the effect of heparin-coated circuits on complement consumption during CPB, 40 patients undergoing elective myocardial revascularization were prospectively randomized either to a group in which a completely Duraflo II heparin-coated circuit was used for perfusion (heparin-coated Group, n = 20 patients) or to a control group (n = 20 patients) in which an uncoated, but otherwise standard circuit was used. Full systemic heparinization was induced (activated clotting time, 480 seconds) in all the patients included in the study, regardless of which perfusion circuit was used. The two groups did not differ significantly in terms of bodyweight, aortic crossclamp and extracorporeal circulation times. No patient had difficulty in weaning from bypass and the postoperative period was uneventful in all patients. Concentrations of C3 and C4 were found to be within the 'normal' range in the prebypass period in both groups. There were no significant intergroup differences with regard to C3 and C4 consumption during CPB. We conclude that Duraflo II heparin- coated circuits have no effect in reducing complement consumption during CPB in fully heparinized patients.

scholarly journals Efficacy of minimally invasive therapy and laser therapy in the comprehensive treatment of endoperiodontal lesions

2021 ◽  
Author(s):  
Nurgul Zh. Zholdassova ◽  
Ainur Amanzholkyzy ◽  
Azamat I. Kaikan ◽  
Yerik S. Isbulatov ◽  
Albina M. Nurtileuova
Keyword(s):  
Minimally Invasive ◽  
Laser Therapy ◽  
Minimally Invasive Therapy ◽  
Apical Periodontitis ◽  
Solid Food ◽  
Control Group ◽  
Comprehensive Treatment ◽  
Study Group ◽  
Treatment Results ◽  
Invasive Therapy

Introduction: A strategy for comprehensive treatment of endoperiodontal lesions is discussed, depending on the severity of pathology in the endodontium and periodontium associated with mild chronic generalized periodontitis. Aim: The purpose of the study was to evaluate the efficiency of minimally invasive therapy and laser therapy in the comprehensive treatment of endoperiodontal lesions associated with chronic generalized periodontitis. Material and methods: Sixty patients with apical periodontitis were examined and received periodontal treatment using minimally invasive therapy and laser therapy in combination with endodontic stages of treatment. Results and discussion: Pain when biting down, sometimes aggravated with solid food, was reported for several days in 38% of cases in the control group. The patients of the study group did not report painful sensations; in 20% of cases, inconveniences only occurred with solid food during the first days. Conclusions: The study showed that in all clinical cases selected for this article, a comprehensive treatment including minimally invasive therapy and laser therapy was effective with both endodontic and periodontal sparing treatment.

scholarly journals THE INFLUENCE OF COMPLEX IMPLEMENTATION OF THE ERAS PROGRAM ON THE SURGICAL STRESS RESPONSE FACTORS IN PEDIATRIC PATIENTS UNDERGOING ELECTIVE LIMB SURGERY

2021 ◽  
pp. 28-37
Author(s):  
I.V. KYSELOVA ◽  
A.V. BILIAIEV
Keyword(s):  
Blood Glucose ◽  
Stress Response ◽  
Postoperative Period ◽  
Enhanced Recovery ◽  
Surgical Stress ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Study Group ◽  
Surgical Stress Response ◽  
Beta Hydroxybutyrate

Surgical stress response, fluid and nutritional balance, and pain management are among the key factors influencing on the postoperative period. These areas are reflected in the Enhanced Recovery After Surgery (ERAS) concept, which is based on a set of measures aimed at minimizing the surgical stress response. The lack of ERAS recommendations for the pediatric population of surgical patients prompts to search for a solution of adaptation and implementation of the ERAS programs in children. The aim of the study. To determine the effectiveness of the complex application of the enhanced recovery after surgery by studying its influence on the factors of the surgical stress response in pediatric patients undergoing limp surgery. Materials and methods. The prospective randomized study included 47 patients aged 1 to 17 years. In the study group (n = 22), the ERAS program was used, which consisted of 14 components of preoperative, intraoperative and postoperative measures. In the control group (n = 25), the complex of all ERAS components was not purposefully applied. We compared glycaemic stress index (GSI) and length of hospital stay after surgery (LOS) as a primary outcome; secondary outcomes were fasting time after drinking fluids before induction of anesthesia, estimated fluid deficiency just before induction of anesthesia, hemodynamic parameters, the need for opioids during and after surgery, blood glucose and beta-hydroxybutyrate in the beginning and in the end of the surgery and next day morning after surgery, postoperative nausea and vomiting. Results. GSI was significantly less in the study group (1,62 ± 0,78 vs 2,12 ± 0,93, р=0,046). LOS in the study group was 37.5% less than in the control group (p = 0.002). The period of preoperative fasting and fluid deficit in the patients of the study group were shorter. The needs of fentanyl intraoperatively in the study group was 47% less (p<0.001). At the beginning of surgery, the study group had a higher blood glucose concentration and a higher systolic blood pressure. At the end of surgery, blood glucose and beta-hydroxybutyrate in the study group was lower than in the control group. In the postoperative period, 9% of patients in the study group and 36% of patients in the control group complained of nausea (p = 0.041). Linear regression analysis showed a linear relationship between the LOS after surgery and the GSI (R=0,515, R2=0,266, B=2,156, 95% CI 1,04 – 3,27, p<0,001). Results. The implementation of the ERAS program to children 1-17 years old undergoing elective limp surgery may reduce the effect of the surgical stress reaction by reducing the period of preoperative fasting, fluid deficiency, the needs of opioids and postoperative nausea. Minimizing the surgical stress response may facilitate the achievement of hospital discharge criteria and shorten the length of hospital stay in the postoperative period.

scholarly journals Non-Conservative Therapy in the Prevention of Subepithelial Fibroplasia after LASEK Hypermetropia Correction

2018 ◽  
Vol 15 (2) ◽  
pp. 200-206
Author(s):  
S. A. Korotkikh ◽  
A. E. Bogachev ◽  
A. S. Shamkin
Keyword(s):  
Dry Eye ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Dry Eye Syndrome ◽  
Control Group ◽  
Study Group ◽  
Postoperative Therapy ◽  
Significant Difference

The results of observation of patients who underwent vision eximerlaser correction by the LASEK method regarding medium degree of hyperopia were analyzed.Purpose:to investigate the severity of the «dry eye» syndrome and corneal subepithelial fibroplasia in patients after laser correction of  hyperopia by the LASEK method, and their prevention by reducing  the preservative action on the eye surface.Patients and methods.The study included 40 patients (76 eyes), aged 21–46 years (32.98 ± 1.79) who underwent LASEK surgery for  moderate hyperopia (4.03 ± 0.38 D). Patients were divided into two  groups: 1) control group (20 patients, 37 eyes) — postoperative  therapy included the corneoprotector “Stilavit®” and the preparation  of hyaluronic acid “Oksial®”, containing preservatives;  2) the study group (20 patients, 39 eyes) — postoperative therapy  included the corneoprotector “Hilozar-comod®” and the artificial tear  preparation “Hilo-comod®”, which did not contain reservatives. Ophthalmic examination included, in addition to standard diagnostic  methods, the Norn test, the Schirmer test, the staining of the eye  surface with lissamine green. In addition, a questionnaire was  conducted on a modified OSDI questionnaire; there a section  characterizing the quality of vision (section B) was removed.Results.The analysis of the obtained data showed that in the study group there was less pronounced “dry eye” syndrome at 3,6,12  months after the operation. The maximum difference in the  indicators of the “dry eye” syndrome between the groups was at 3  and 6 months of the postoperative period. When evaluating corneal  subepithelial fibroplasia, maximum attention was paid to the  frequency and the intensity index. It was shown a significant  difference in the intensity of the haze between the study group and the control group by 26.1 % at 3 months, by 62.2 % at 6  months and by 65.3 % 12 months after the operation. Conclusion.Nonconservative therapy with sodium hyaluronate and  dexapanthenol in the early postoperative period and only sodium  hydrolurate allows to reduce the severity of the dry eye syndrome  after laser correction of hypermetropia and, as a result, to reduce  the intensity of haze development by 65.3 %, and its frequency on 11,5 %.

Use of Alendronate in Postoperative Period for Prevention of Hip Implant Aseptic Instability

2009 ◽  
Vol 16 (3) ◽  
pp. 36-44
Author(s):  
Svetlana Semenovna Rodionova ◽  
T N Turgumbaev ◽  
S S Rodionova ◽  
T N Turgumbaev
Keyword(s):  
Calcium Carbonate ◽  
Bone Density ◽  
Bone Tissue ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Study Group ◽  
Surgical Team ◽  
Tissue Mass ◽  
Mineral Bone Density

Assessment of the alendronate influence upon the course of adaptive remodeling of bone tissue adjacent to the implant was performed. Dynamics of mineral bone density (BMD) changes in Gruen zones was compared for 2 groups of female patients. The groups were similar by age, nosology. All operations were performed by the same surgical team with application of one type of implant (Zweymuller). During the first post-operative year patients from the study group (n=38) were taken alendronate (Fosamax-70) once a week and at least 1200 mg of calcium carbonate daily (either as calcium containing food products or calcium carbonate preparations). Patients from control group (n=94) were taken only calcium carbonate by the same scheme within the first postoperative year. It was detected that although by 6th postoperative month alendronate did not decraese BMD loss as compared to controls, within the interval of 6-15 months it significantly increased bone tissue mass accretion. In group of alendronate patients monthly accretion of bone tissue in some Gruen zones (except for R4) was twice and more higher than in control group. Fifteen months later patients from the main group showed BMD deficit only in R4 zone. In the rest of zones bone tissue mass exceeded the basic values and in the majority of zones that increase was trustworthy. In control group BMD deficit was preserved in two proximal zones (R6 and R7) and in zone R6 it even increased as compared to the results of the previous study (12 months after operation).

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