scholarly journals MANAGEMENT OF CEREBRAL OXYGENATION IN ORDER TO REDUCE THE DEVELOPMENT OF POST-OPERATIVE COMPLICATIONS IN HIGH-RISK PATIENTS UNDERGOING CARDIAC SURGERY

2019 ◽  
Vol 16 (3) ◽  
pp. 7-17
Author(s):  
P. P. PEROVSKIY ◽  
◽  
D. N. PONOMАREV ◽  
E. V. FOMINSKIY ◽  
S. M. ISMOILOV ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Cerebral Oxygenation ◽  
High Risk Patients ◽  
Operative Complications ◽  
Risk Patients ◽  
Post Operative Complications

scholarly journals Robotic Surgery for Non-Small Cell Lung Cancer Treatment in High-Risk Patients

2021 ◽  
Vol 10 (19) ◽  
pp. 4408
Author(s):  
Carmelina Cristina Zirafa ◽  
Gaetano Romano ◽  
Elisa Sicolo ◽  
Claudia Cariello ◽  
Riccardo Morganti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Robotic Surgery ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
Robotic Assisted ◽  
High Risk Patients ◽  
Operative Complications ◽  
Risk Patients ◽  
Post Operative Complications

Robotic-assisted pulmonary resection has greatly increased over the last few years, yet data on the application of robotic surgery in high-risk patients are still lacking. The objective of this study is to evaluate the perioperative outcomes in ASA III-IV patients who underwent robotic-assisted lung resection for NSCLC. Between January 2010 and December 2017, we retrospectively collected the data of 148 high-risk patients who underwent lung resection for NSCLC via a robotic approach at our institution. For this study, the prediction of operative risk was based on the ASA-PS score, considering patients in ASA III and IV classes as high-risk patients: of the 148 high-risk patients identified, 146 patients were classified as ASA III (44.8%) and two as ASA IV (0.2%). Possible prognostic factors were also analysed. The average hospital stay was 6 days (8–30). Post-operative complications were observed in 87 (58.8%) patients. Patients with moderate/severe COPD developed in 33 (80.5%) cases post-operative complications, while elderly patients in 25 (55%) cases, with a greater incidence of high-grade complications. No difference was observed when comparing the data of obese and non-obese patients. Robotic surgery appears to be associated with satisfying post-operative results in ASA III-IV patients. Both marginal respiratory function and advanced age represent negative prognostic factors. Due to its safety and efficacy, robotic surgery can be considered the treatment of choice in high-risk patients.

Perioperative nutritional support results in a reduction of major post operative complications especially in high risk patients

1990 ◽  
Vol 9 ◽  
pp. 55-56
Author(s):  
M.F. Von Meyenfeidt ◽  
W.J.H.J. Meijerink ◽  
P.B. Soeters ◽  
H. Veen ◽  
R. Buil-Maessen ◽  
...  
Keyword(s):  
High Risk ◽  
Nutritional Support ◽  
High Risk Patients ◽  
Operative Complications ◽  
Risk Patients ◽  
Post Operative Complications

scholarly journals Determination of comorbidity index for high-risk patients with coronary artery disease before cardiac surgery

2021 ◽  
Vol 23 (4) ◽  
pp. 485-491
Author(s):  
О. К. Gogayeva
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Surgery ◽  
High Risk ◽  
Normal Weight ◽  
High Risk Patients ◽  
Type 2 Dm ◽  
Risk Patients ◽  
Comorbidity Index ◽  
Artery Disease

The aim: to determine the comorbidity index before cardiac surgery in high-risk patients with coronary artery disease (CAD). Materials and methods. A retrospective analysis of data from 354 random high-risk patients who underwent a surgery and were discharged from National M. Amosov Institute of Cardiovascular Surgery affiliated to National Academy of Medical Sciences of Ukraine during the period 2009–2019. The mean age of patients was 61.9 ± 9.6 years. All the patients were examined: ECG, ECHO CG, coronary angiography before the surgery as well as Charlson comorbidity index was calculated and a risk on the scales EuroSCORE I, EuroSCORE II and STS was stratified. Results. I–III degree obesity was revealed in 133 (37.5 %) patients, patients with type 2 diabetes mellitus (DM) were more likely to have BMI >30 kg/m2 (P = 0.017). Patients with normal weight had a carotid artery stenosis >50 % (P = 0.014) and history of stroke (P = 0.043) significantly more frequently. No differences in comorbidity of overweight and normal weight patients were detected (5.73 ± 1.70 vs. 5.9 ± 1.8, P = 0.4638). Type 2 DM was diagnosed in 90 (25.4 %) patients. In the case of normoglycemia, the comorbidity index was significantly lower than in type 2 DM (4.88 ± 1.38 vs. 6.60 ± 2.03, P = 0.0001) and glucose intolerance 5.8 ± 1.5 (P < 0.0001). Chronic kidney disease (CKD) G3a–G4 stages was diagnosed in 132 (37.2 %) patients. Significant higher comorbidity was found in patients with G3a–G4 stages CKD in comparison to those with G1–G2 stages CKD – 6.33 ± 1.78 vs. 5.46 ± 1.60 (P < 0.0001). Among comorbidities in patients with gouty arthritis, type 2 DM (P < 0.0001), obesity (P = 0.0080), CKD G3a–G4 (P = 0.0020) and varicose veins of the lower extremities (P = 0.0214) were significantly more common. Preoperative risk stratification according to the EuroSCORE II scale averaged 8.8 %. Conclusions. Preoperative analysis of baseline status in CAD patients showed the high Charlson comorbidity index, which averaged 5.7 ± 1.7. The weak direct correlation between the comorbidity index and the high predicted cardiac risk on the ES II scale (r = 0.2356, P = 0.00001), length of stay in the intensive care unit (r = 0.1182, P = 0.0262) and discharge after the surgery (r = 0.1134, P = 0.0330) was found.

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