A Case of Difficult Arterial Cannulation: Is Intra-Arterial Blood Pressure Monitoring an Absolute Requirement for Paediatric Liver Transplantation?

Invasive arterial blood pressure monitoring is the standard of practice in terms of intraoperative blood pressure surveillance during liver transplantation. While this is an ideal, achieving reliable arterial access can be extremely challenging in the paediatric and neonatal population, repeated attempts at arterial cannulation are not without risk and alternative best practice means of haemodynamic monitoring are not clearly established. We describe a case of paediatric liver transplantation in a 3.

Hemostatic Markers as Predictors of Massive Blood Transfusion in Orthotopic Liver Transplantation.

Background: The aim of this study was to determine which standard preoperative laboratory results correlate to intraoperative transfusion requirement during orthotopic liver transplantation (OLT).

Materials And Methods: We retrospectively analyzed data from 305 adult patients who underwent OLT between 2009 and 2013 using laboratory results: International Normalization Ratio, platelet count, fibrinogen, and hemoglobin and total blood transfusion requirements (group L ≤ 1 L, group M > 1 L). All statistical analyses were conducted using the Statistical Package for Social Sciences software (IBM Corp.

Efficacy of pro- and anticoagulant strategies in plasma of patients undergoing hepatobiliary surgery.

Background: In vitro efficacy of pro- and antihemostatic drugs is profoundly different in patients with compensated cirrhosis and in those who have cirrhosis and are critically ill.

Objectives: Here we assessed the efficacy of pro- and anticoagulant drugs in plasma of patients undergoing hepato-pancreato-biliary (HPB) surgery, which is associated with unique hemostatic changes.

Methods: We performed in vitro analyses on blood samples of 60 patients undergoing HPB surgery and liver transplantation: 20 orthotopic liver transplantations, 20 partial hepatectomies, and 20 pylorus-preserving pancreaticoduodenectomies.

The current state of bionic limbs from the surgeon's viewpoint.

Amputations have a devastating impact on patients' health with consequent psychological distress, economic loss, difficult reintegration into society, and often low embodiment of standard prosthetic replacement.The main characteristic of bionic limbs is that they establish an interface between the biological residuum and an electronic device, providing not only motor control of prosthesis but also sensitive feedback.Bionic limbs can be classified into three main groups, according to the type of the tissue interfaced: nerve-transferred muscle interfacing (targeted muscular reinnervation), direct muscle interfacing and direct nerve interfacing.

Anaesthetic management of organ transplant patients.

In this paper we will describe anaesthetic management of solid organ and reconstructive transplantation (RT) patients. We will focus on similar underlying principles of reperfusion, ischaemic-reperfusion injury, preconditioning and extracorporeal donor organ preservation. Special concerns for anaesthetic management of these patients need to focus on pre-assessment, pre-operative optimisation, vascular access, fluid management, blood and products replacement, cardiovascular monitoring, use of inotropes and vasoconstrictors, maintaining electrolyte balance and regional anaesthesia.

Impact of intraoperative blood pressure, blood pressure fluctuation, and pulse pressure on postoperative delirium in elderly patients with hip fracture: A prospective cohort study.

Aim: Postoperative delirium (PD) is a frequent complication of hip fracture surgery, but its pathophysiology remains poorly understood. We investigated the impact of a single episode of intraoperative hyper/hypotension, blood pressure (BP) fluctuation (ΔMAP), and pulse pressure (PP) on hyper/hypoactive PD in elderly patients undergoing surgery for hip fracture. We also assessed the effect of PD on clinical outcomes.

Trends in transfusion practice over 20 years in paediatric liver transplant programme.

Background: We investigated changes to transfusion practices over time in paediatric liver transplant centre and evaluated the effect of transfusion practice to mortality.

Methods: A pilot retrospective study included two cohorts each with 101 sequential paediatric LT recipients: an Early group (1994-1998) and a Recent group (2009-2013). Demographic characteristics and data on the intraoperative transfusion of red blood cells (RBC), fresh-frozen plasma (FFP), platelets and cryoprecipitate were collected.

Twenty-Eight-Day Mortality of Blunt Traumatic Brain Injury and Co-Injuries Requiring Mechanical Ventilation.

Objective: This paper aims to assess the impact of co-injuries and consequent emergency surgical interventions and nosocomial pneumonia on the 28-day mortality of patients with severe traumatic brain injuries (TBIs).

Subjects And Methods: One hundred and seventy-seven patients with TBI admitted to the emergency trauma intensive care unit at the Clinical Center of Serbia for more than 48 h were studied over a 1-year period. On admission, the Glasgow Coma Scale (GCS), Injury Severity Score (ISS) and Acute Physiology and Chronic Health Evaluation II score (APACHE II) were calculated.

Analgesia after liver transplantation.

This article addresses postoperative analgesia in patients with end-stage liver disease who have undergone liver transplantation (LT). Postoperative analgesia determines how patients perceive LT. Although important, this topic is underrepresented in the current literature.

Risk factors for ventilator-associated pneumonia in patients with severe traumatic brain injury in a Serbian trauma centre.

Introduction: The aims of this study were (1) to assess the incidence of ventilator-associated pneumonia (VAP) in patients with traumatic brain injury (TBI), (2) to identify risk factors for developing VAP, and (3) to assess the prevalence of the pathogens responsible.

Patients And Methods: The following data were collected prospectively from patients admitted to a 24-bed intensive care unit (ICU) during 2013/14: the mechanism of injury, trauma distribution by system, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the Abbreviated Injury Scale (AIS) score, the Injury Severity Score (ISS), underlying diseases, Glasgow Coma Scale (GCS) score, use of vasopressors, need for intubation or cardiopulmonary resuscitation upon admission, and presence of pulmonary contusions. All patients were managed with a standardized protocol if VAP was suspected.

Estimating the effect of incident delirium on short-term outcomes in aged hip fracture patients through propensity score analysis.

Aim: We aimed to evaluate the factors contributing to delirium after hip fracture and assess the effect of incident delirium on short-term clinical outcomes.

Methods: A total of 270 non-delirious, consecutive hip fracture patients 60 years and older were included in a prospective cohort study. The patients were assessed with respect to physical status according to the American Society of Anesthesiologists classification, medical comorbidities with the Charlson Comorbidity Index, cognitive function with the Portable Mental Status Questionnaire and depression with the Geriatric Depressive Scale.

Predictors of severe pain in the immediate postoperative period in elderly patients following hip fracture surgery.

Introduction: The aim of this study was to identify risk factors for severe postoperative pain immediately after hip-fracture surgery.

Patients And Methods: Three hundred forty-four elderly patients with an acute hip fracture were admitted to the hospital during a 12-months period. All patients who entered the study answered a structured questionnaire to assess demographic characteristics, previous diseases, drug use, previous surgery, and level of education.

Postoperative epidural analgesia in obese patients undergoing liver resection surgery.

Aim: To investigate the relation of body mass index (BMI) with postoperative pain scores and volume of local anaesthetic (LA) administered epidurally in patients undergoing liver resection surgery.

Methods: Retrospective data from 167 patients who had epidural analgesia (EA) for liver resection surgery were analysed: 123 with BMI < 30kgm-2 and 44 with BMI > 30kgm-2.

Results: Total volume of intraoperative bolus of epidural analgesia (EA) was not different between the BMI more than 30 kgm-2 and BMI less than 30 kgm-2 groups (p less 0.

Does epidural clonidine improve postoperative analgesia in major vascular surgery?

Aim: To determine the quality and duration of the analgesic and haemodynamic effects of clonidine when used as an additional analgesic for postoperative epidural analgesia in major vascular surgery.

Methods: The prospective, single-blinded study involved 60 patients randomised into three groups (20 patients each): Group BM- bupivacaine 0.125% and morphine 0.

A prospective, randomized, double-blinded comparison between multimodal thoracic paravertebral bupivacaine and levobupivacaine analgesia in patients undergoing lung surgery.

Objectives: To compare the effects of paravertebral analgesia with levobupivacaine or bupivacaine on intra- and postoperative pain for thoracic surgery.

Design: A prospective, randomized, and double-blinded study.

Setting: A university hospital.

Three different approaches to Transversus abdominis planeblock: a cadaveric study.

Aim: The transversus abdominis plane (TAP) block is a new technique for providing analgesia to the anterior abdominal wall. There is ongoing debate regarding access point for TAP block. The aim of this cadaveric study was to compare the spread of 40 mL of dye using three different approaches to TAP: subcostal , via the mid-axillary and via the lumbar triangle of Petit (LTOP).