Prognosis for major abdominal surgeries based on intraoperative low-dose nutrition: A metabolic perspective.

Background & Aims: The optimal nutrition intake during surgery is unknown. This study aimed to investigate the prognosis of low-dose nutrition during laparoscopic colorectal cancer surgery.

Methods: In the glucose and amino acids (GA) group, 20 patients were infused with glucose (75 g/L) and amino acids (30 g/L) at 60 mL/h and bicarbonate Ringer's solution.

Incidences of and risk factors for clinical and subclinical contrast-associated acute kidney injury in patients who underwent neuroendovascular surgery.

Background: Contrast-associated acute kidney injury (CA-AKI) can develop after intravascular administration of iodinated contrast media. Neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI that helps to detect subclinical CA-AKI. We investigated the incidence of and risk factors for clinical and subclinical CA-AKI in patients who underwent neuroendovascular surgery.

Comparison of desflurane and propofol in the speed and the quality of emergence from anesthesia in patients undergoing lung cancer surgery-a prospective, randomized study.

Background: Anesthesia with desflurane or propofol enables rapid emergence. In patients undergoing lung cancer surgery, however, the speed of emergence from desflurane, but not from propofol, may be affected by the deteriorated postoperative respiratory function. We prospectively compared the speed and quality of emergence between desflurane and propofol.

Dilutional acidosis during whole lung lavage under general anesthesia due to excessive absorption of normal saline.

Background: Whole lung lavage (WLL) is an effective therapy for pulmonary alveolar proteinosis. We report a rare dilutional acidosis following WLL in a female patient.

Case Presentation: Under general anesthesia, a left-sided double-lumen tube was inserted with its bronchial lumen connected to the saline delivery system.

Effect of Recombinant Human Soluble Thrombomodulin on Coagulation-Related Variables in Patients With Sepsis-Induced Disseminated Intravascular Coagulation: A Retrospective Observational Study.

To evaluate associations among coagulation-related variables, resolution of disseminated intravascular coagulation (DIC) and mortality, we retrospectively investigated 123 patients with sepsis-induced DIC treated with recombinant human soluble thrombomodulin (rTM). Changes in coagulation-related variables before and after treatment with rTM were examined. Further, associations between coagulation-related variables and DIC resolution were evaluated.

Unique strategy using a standard double lumen tube during one lung ventilation for successful intraoperative airway management in patients with a giant bulla on the ventilated side: case series.

Giant lung bullae are usually seen in patients with severe chronic obstructive pulmonary disease. Over time, air trapping leads to severe dyspnea and CO accumulation. In severe cases, overinflation and rupture of the bulla can cause secondary life-threatening tension pneumothorax.

Impact of Extended Duration of Polymyxin B-Immobilized Fiber Column Direct Hemoperfusion on Hemodynamics, Vasoactive Substance Requirement, and Pulmonary Oxygenation in Patients with Sepsis: An Observational Study.

Introduction: Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) is used for patients with septic shock, and the recommended hemoperfusion period is 2 h. However, it remains unclear whether the optimal duration is 2 h or longer. The purpose of this study was to compare the effects of PMX-DHP between conventional and longer duration of PMX-DHP.

Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock.

Endotoxin adsorption therapy by polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) has been used for the treatment of septic shock patients. Endotoxin, an outer membrane component of Gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin triggers a signaling cascade for leukocytes, macrophage, and endothelial cells to secrete various mediators including cytokines and nitric oxide, leading to septic shock and multiple organ dysfunction syndrome.

Well leg compartment syndrome following robot-assisted radical cystectomy in the lithotomy position: a case report.

Background: The indications for robot-assisted urologic surgeries have expanded due to their low invasiveness. However, complicated surgical procedures lead to prolonged surgical duration, requiring patients to remain in the lithotomy position for an extended time. Well leg compartment syndrome (WLCS) is a known severe postoperative complication related to the lithotomy position.

Postoperative analgesia in patients undergoing robot-assisted thoracic surgery: a comparison between thoracic epidural analgesia and intercostal nerve block combined with intravenous patient-controlled analgesia.

Background: Recently, robot-assisted thoracic surgery (RATS) is increasingly applied to lung or mediastinal tumor surgery. However, appropriate methods of postoperative analgesia for RATS have not been studied.

Methods: Patients who underwent RATS at a single university hospital between January, 2017 and March, 2018 were studied retrospectively.

Specific airway management for SVC replacement during giant anterior mediastinal tumor resection.

Background: Giant anterior mediastinal tumor (GAMT) resection is a challenging procedure, for which anesthesiologist might take to need special precautions.

Case Presentation: A 48-year-old male patient had been scheduled to undergo GAMT resection and superior vena cava (SVC) replacement. The tumor spread surrounding SVC and left main bronchus (LMB), resulting in small volume of his left lung.

Intercostal misplacement of a thoracic epidural catheter discovered during lung cancer surgery: a case report.

Background: Blind epidural catheter placement can lead to inadvertent misplacement. We present a case of intercostal misplacement of a thoracic epidural catheter.

Case Presentation: A 67-year-old male underwent left lung cancer surgery via thoracotomy with epidural analgesia via the Th 5-6 intervertebral space, although with some difficulty.

Correlation between urinary biomarker and organ failure in patients with sepsis and patients after esophagectomy: a prospective observational study.

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a diagnostic marker for acute kidney injury (AKI). NGAL expression is highly induced not only in kidney injury but also in bacterial infection, inflammation, and cancer. The factors regulating NGAL expression are proinflammatory cytokines, and plasma NGAL levels have been increased in septic shock.

The effects of a recruitment manoeuvre with positive end-expiratory pressure on lung compliance in patients undergoing robot-assisted laparoscopic radical prostatectomy.

The effects of a recruitment manoeuvre (RM) with positive end-expiratory pressure (PEEP) on lung compliance (C) are not well characterised in robot-assisted laparoscopic radical prostatectomy (RARP). Patients were allocated to group R (n = 10; with an RM) or C (n = 9; without an RM). An RM involved sustained inflation of 30 cmHO for 30 s.

High-flow oxygen via tracheostomy facilitates weaning from prolonged mechanical ventilation in patients with restrictive pulmonary dysfunction: two case reports.

Background: Weaning from prolonged mechanical ventilation is extremely difficult in tracheostomized patients with restrictive pulmonary dysfunction. High-flow oxygen via tracheostomy supplies heated and humidified oxygen gas at > 10 L/minute. However, little has been reported on the use of high-flow oxygen via tracheostomy during weaning from ventilators in patients with restrictive pulmonary dysfunction.

Ventilation failure after lateral jackknife positioning for robot-assisted lung cancer surgery in a patient after lingula-sparing left upper lobectomy.

Background: Ventilation failure commonly occurs when a standard left-sided double-lumen tube is used in patients after left upper lobectomy having remarkable angulation of the left main bronchus. We present a female without remarkable angulation, in whom ventilation failure occurred after lateral jackknife positioning.

Case Presentation: A 73-year-old female after lingula-sparing left upper lobectomy without remarkable angulation was scheduled for robot-assisted right upper lobectomy.

Effects of intraoperative nutrients administration on energy expenditure during general anesthesia.

Objectives: Recent reports have shown that intraoperative infusions of glucose and amino acids exert anticatabolic effects. The appropriate dosages of these amino acids and glucose during general anesthesia remain unknown.

Methods: Patients who underwent esophagectomy for thoracic esophageal cancer were infused with acetated Ringer's solution that contained glucose and amino acids (B1 group [10 patients]: glucose, 3 g/h; amino acids, 1.

[Successful One-lung Ventilation with a Right-sided Double-lumen Tube in a Patient with a Right Upper Tracheal Bronchus, who Underwent Left Pneumonectomy for Left Hilar Lung Cancer].

A 60-year-old male patient with left hilar lung cancer was scheduled to undergo left pneumonectomy or left sleeve lower lobectomy. Preoperative computer tomographic and bronchoscopic examinations revealed that the bronchus (B1) to the right apical segment (S1) was a tracheal bronchus (TB) originating from the trachea approximately 10 mm above the carina. Because the left main bronchus was to be dissected, a right-sided double-lumen tube (DLT) was selected to completely protect the right lung from spillage of secretions or cancer cells from the left lung.

Anesthetic Management of Patients Undergoing Right Lung Surgery After Left Upper Lobectomy: Selection of Tubes for One-Lung Ventilation (OLV) and Oxygenation During OLV.

Objective: To investigate anesthesia management in patients undergoing right lung surgery after a previous left upper lobectomy (LUL) that may require special precautions since angulation of the left bronchus can hamper correct placement of a left-sided double-lumen tube (DLT), and one-lung ventilation (OLV) depending solely on the left lower lobe may lead to inadequate oxygenation.

Design: A retrospective data analysis.

Setting: Single university hospital.

Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: a meta-analysis of randomized controlled trials.

Background: Emergence agitation (EA) from general anesthesia has been reported as an adverse effect of sevoflurane in children. We describe a meta-analysis of randomized controlled trials that compared the incidence of EA between children who underwent sevoflurane anesthesia and those who underwent propofol anesthesia.

Methods: A literature search was conducted to identify clinical trials that met our inclusion criteria.

Higher fraction of inspired oxygen in anesthesia induction does not affect functional residual capacity reduction after intubation: a comparative study of higher and lower oxygen concentration.

Background: Low fraction of inspired oxygen (FIO2) reduces the atelectasis area during anesthesia induction. However, atelectasis may occur during laryngoscopy and endotracheal intubation because lungs can collapse within a fraction of a second. We assessed the effects of ventilation with 100 and 40 % oxygen on functional residual capacity (FRC) in patients undergoing general anesthesia.

Impact of changes of positive end-expiratory pressure on functional residual capacity at low tidal volume ventilation during general anesthesia.

Purpose: Several reports in the literature have described the effects of positive end-expiratory pressure (PEEP) level upon functional residual capacity (FRC) in ventilated patients during general anesthesia. This study compares FRC in mechanically low tidal volume ventilation with different PEEP levels during upper abdominal surgery.

Methods: Before induction of anesthesia (awake) for nine patients with upper abdominal surgery, a tight-seal facemask was applied with 2 cmH(2)O pressure support ventilation and 100 % O(2) during FRC measurements conducted on patients in a supine position.

[Influence of tidal volume on functional residual capacity during general anesthesia].

Background: Ventilation with lower tidal volume improves outcome in acute respiratory distress syndrome (ARDS). However, it is questionable if ventilation strategy using lower tidal volumes created for patients with ARDS can be transferred to healthy patients undergoing general anesthesia. We assessed the effects of ventilation with lower tidal volumes and conventional tidal volumes on functional residual capacity (FRC) and Pa(O2)/FI(O2) (P/F) ratio in patients undergoing general anesthesia for upper abdominal surgery.