scholarly journals Postoperative Vomiting Following Laparoscopic Cholecystectomy Is Associated with Intraoperative Fluid Administration: A Retrospective Cohort Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5305
Author(s):  
Chia-Yu Hsieh ◽  
Yan-Yuen Poon ◽  
Ting-Yu Ke ◽  
Min-Hsien Chiang ◽  
Yan-Yi Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Infusion Rate ◽  
Lower Body ◽  
Postoperative Vomiting ◽  
Physical Status ◽  
Lower Body Weight ◽  
Crystalloid Infusion

Potential risk factors for postoperative vomiting (POV) are important for daily anesthesia practice. To identify the risk factors associated with POV we retrospectively reviewed 553 adult patients who underwent scheduled simple laparoscopic cholecystectomy under sevoflurane-based general anesthesia between January and December 2018. Patients who experienced POV were predominantly women, had lower body weight, and higher ASA (American Society of Anesthesiologists) physical status. The POV group showed female sex predominance, lower body weight, and higher ASA physical status, with a significant difference when compared with the non-POV group. In univariate analysis, female sex and Apfel scores of 2, 3, and 4 were associated with a higher POV incidence. Age > 70 years, higher body weight, and ASA physical status III were associated with a lower POV incidence. In multivariate logistic regression, sex, age, Apfel score, and intraoperative crystalloid infusion rate were POV predictive factors. Receiver operating characteristic analysis showed a negative association between the intraoperative crystalloid infusion rate and POV occurrence with an area under the curve of 0.73 (p = 0.001). The cutoff intraoperative crystalloid infusion rate was 2 mL/kg/h with 82% sensitivity and 49% specificity (≥2 mL/kg/h was associated with a lower POV incidence vs. <2 mL/kg/h (OR, 95% CI; 0.52 [0.33–0.83])). To decrease POV in these patients, identifying high-risk factors and an intraoperative crystalloid administration of ≥2 mL/kg/h should be considered in patients undergoing LC under sevoflurane-based general anesthesia.

scholarly journals Junctional Ectopic Tachycardia after Complete Repair of Tetralogy of Fallot in Children less than 1 Year

2019 ◽  
pp. 40-42
Author(s):  
A. Petrenko ◽  
E. Yakimishin ◽  
S. Boyko
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Tetralogy Of Fallot ◽  
Beta Blockers ◽  
Early Postoperative Period ◽  
Lower Body ◽  
Junctional Ectopic Tachycardia ◽  
Complete Repair ◽  
Lower Body Weight ◽  
Correlated Factors

Junctional ectopic tachycardia (JET) is frequent acceleration of rhythm after complete repair of Tetralogy of Fallot. JET is associated with prolongation of been in the ICU and worsening of the prognosis. The present ways of preventing of JET cannot be routinely applied for all patients, so it needs to identify patients with high risk of JET emergence. Purpose. It needs to analyze cases of JET and identify risk factors for patients requiring Tetralogy of Fallot complete repair. Methods and materials. It was analyzed 81 patients with Tetralogy of Fallot after complete repair from 2014 until 2019 in National Amosov Institute of Cardiovascular Surgery. Results and discussion. Post-operative analysis shows that magnesium and potassium levels in blood were lower in patients with JET than in patients without JET (0.9 ± 0.41 and 1.14 ± 0.43, respectively, p < 0.05). Patients with JET were younger (7.8 ± 1.4 and 9.9 ± 1.6, respectively, p < 0.05), had lower body weight (8.1 ± 1.0 and 9.3 ± 0.9, respectively, p < 0.05) and higher heart rate in the pre-operative period (147.6 ± 11.4 and 124.9 ± 13.9, respectively, p < 0.05). It was found out that pre-operative respiratory cyanotic attacks are independent risk factors for JET. During the work we also found that the administration of beta-blockers in the pre-operative period significantly reduces the JET development (4 (26.6%) and 27 (40.9%) respectively, p <0.05). Conclusion.Younger age, lower body weight, and respiratory cyanotic attacks in the pre-operative period are unadjusted risk factors of the JET development in the early postoperative period. Blood magnesium and potassium concentrations are correlated factors in the JET development. Beta-blockers may be recommended for the prevention of JET in the early post-operative period in patients who have risk factors.

scholarly journals Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Si Chen ◽  
Yuelun Zhang ◽  
Lu Che ◽  
Le Shen ◽  
Yuguang Huang
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Case Control Study ◽  
Case Control ◽  
Airway Compromise ◽  
Physical Status ◽  
Fluid Load ◽  
High Fluid ◽  
Head Neck ◽  
Control Study

Abstract Background This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia. Methods This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls. Results A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age > 65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age > 65 (OR = 7.50, 95% CI 2.47–22.81, P < 0.001), ASA physical status 3 (OR = 6.51, 95% CI 1.18–35.92, P = 0.032), head-neck surgery (OR = 4.94, 95% CI 1.33–18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI 2.93–53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16–7.99, P = 0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR = 5.26, 95% CI 1.57–8.95, P < 0.001) and intensive care unit days (OR = 3.94, 95% CI 1.69–6.18, P < 0.001). Conclusions Age > 65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.

The effect of lower body weight support on arterial wave reflection in healthy adults

2014 ◽  
Vol 8 (6) ◽  
pp. 388-393 ◽  
Author(s):  
Atif Afzal ◽  
Daniel Fung ◽  
Sean Galligan ◽  
Ellen M. Godwin ◽  
John G. Kral ◽  
...  
Keyword(s):  
Body Weight ◽  
Wave Reflection ◽  
Healthy Adults ◽  
Body Weight Support ◽  
Lower Body ◽  
Weight Support ◽  
Lower Body Weight ◽  
Arterial Wave Reflection

scholarly journals Fryl deficiency is associated with defective kidney development and function in mice

2018 ◽  
Vol 243 (5) ◽  
pp. 408-417 ◽  
Author(s):  
Yong-Sub Byun ◽  
Eun-Kyoung Kim ◽  
Kimi Araki ◽  
Ken-ichi Yamamura ◽  
Kihoon Lee ◽  
...  
Keyword(s):  
Body Weight ◽  
Growth Retardation ◽  
Normal Development ◽  
Full Term ◽  
Lower Body ◽  
Mouse Line ◽  
Lower Body Weight ◽  
Gene Functions ◽  
Convoluted Tubules

FRY like transcription coactivator ( Fryl) gene located on chromosome 5 is a paralog of FRY microtubule binding protein ( Fry) in vertebrates. It encodes a protein with unknown functions. Fryl gene is conserved in various species ranging from eukaryotes to human. Although there are several reports on functions of Fry gene, functions of Fryl gene remain unclear. A mouse line containing null mutation in Fryl gene by gene trapping was produced in this study for the first time. The survival and growth of Fryl−/− mice were observed. Fryl gene expression levels in mouse tissues were determined and histopathologic analyses were conducted. Most Fryl−/− mice died soon after birth. Rare Fryl−/− survivors showed growth retardation with significantly lower body weight compared to their littermate controls. Although they could breed, more than half of Fryl−/− survivors died of hydronephrosis before age 1. No abnormal histopathologic lesion was apparent in full-term embryo or adult tissues except the kidney. Abnormal lining cell layer detachments from walls of collecting and convoluted tubules in kidneys were apparent in Fryl−/− neonates and full-term embryos. Fryl gene was expressed in renal tubular tissues including the glomeruli and convoluted and collecting tubules. This indicates that defects in tubular systems are associated with Fryl functions and death of Fryl−/− neonates. Fryl protein is required for normal development and functional maintenance of kidney in mice. This is the first report of in vivo Fryl gene functions. Impact statement FRY like transcription coactivator ( Fryl) gene is conserved in various species ranging from eukaryotes to human. It expresses a protein with unknown function. We generated a Fryl gene mutant mouse line and found that most homozygous mice died soon after their birth. Rare Fryl−/− survivors showed growth retardation with significantly lower body weight compared to their littermate controls. Although they could breed, more than half of Fryl−/− survivors died of hydronephrosis before age 1. Full-term mutant embryos showed abnormal collecting and convoluted tubules in kidneys where Fryl gene was expressed. Collectively, these results indicate that Fryl protein is required for normal development and functional maintenance of kidney in mice. To the best of our knowledge, this is the first report on in vivo Fryl gene functions.

scholarly journals Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study

2020 ◽  
Author(s):  
Si Chen ◽  
Yuelun Zhang ◽  
Lu Che ◽  
Le Shen ◽  
Yuguang Huang
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Case Control Study ◽  
Case Control ◽  
Airway Compromise ◽  
Physical Status ◽  
Fluid Load ◽  
High Fluid ◽  
Head Neck ◽  
Control Study

Abstract Background: This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia.Methods: This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls.Results: A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age >65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age >65 (OR=7.50, 95% CI 2.47-22.81, P<0.001), ASA physical status 3 (OR=6.51, 95% CI 1.18-35.92, P=0.032), head-neck surgery (OR=4.94, 95% CI 1.33-18.36, P=0.017) or thoracic surgery (OR=12.56, 95% CI 2.93-53.90, P<0.001) and a high fluid load (OR=3.04, 95% CI 1.16-7.99, P=0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR=5.26, 95% CI 1.57-8.95, P<0.001) and intensive care unit days (OR=3.94, 95% CI 1.69-6.18, P<0.001).Conclusions: Age>65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.

Prevalence and predictors of postoperative peritoneal dialysis in infants

2020 ◽  
Vol 28 (8) ◽  
pp. 476-481
Author(s):  
Michael Caesario ◽  
Dicky Fakhri ◽  
Pribadi Wiranda Busro ◽  
Salomo Purba ◽  
Liza Fitria ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Cardiopulmonary Bypass ◽  
Risk Adjustment ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Lower Body ◽  
Cardiopulmonary Bypass Time ◽  
Lower Body Weight ◽  
Younger Age

Background Data regarding predictors of the eventual need for postoperative peritoneal dialysis in infants undergoing open heart surgery is still limited. We aimed to determine whether prolonged cardiopulmonary bypass time, surgical complexity classified according to Risk Adjustment for Congenital Heart Surgery category, younger age, and lower body weight increase the probability of requiring postoperative peritoneal dialysis. Methods We retrospectively analyzed data of 181 infants who underwent open heart surgery at our institution from January 1 to December 31, 2018. Cardiopulmonary bypass time, Risk Adjustment for Congenital Heart Surgery category, age, body weight, and the need for postoperative peritoneal dialysis were recorded and analyzed. Results Thirteen (7.2%) of the 181 patients required postoperative peritoneal dialysis. This group was found to have a longer cardiopulmonary bypass time, younger age, and lower body weight. Longer cardiopulmonary bypass time ( p = 0.001), higher Risk Adjustment for Congenital Heart Surgery category ( p = 0.018), younger age ( p < 0.001), and lower body weight ( p < 0.001) significantly increased the risk of postoperative peritoneal dialysis. Conclusion Longer cardiopulmonary bypass time, more complex surgery, younger age, and lower body weight increase the probability of requiring postoperative peritoneal dialysis in infants undergoing open heart surgery.

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