Heated insufflation with or without humidification for laparoscopic abdominal surgery.

Background: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible.

Screening for thrombophilia does not identify patients at risk of portal or splenic vein thrombosis following laparoscopic splenectomy.

Background: Portal and/or splenic vein thrombosis (PSVT) is a potentially lethal complication of splenectomy for hematologic disease. Known risk factors for PSVT include malignancy and splenomegaly. While these patients are believed to be hypercoagulable, the specific mechanism is unclear.

Esophageal perforation after radiofrequency ablation for atrial fibrillation.

A 69-year-old man underwent left atrial radiofrequency ablation for atrial fibrillation. After 10 minutes, the procedure was terminated due to pericardial tamponade secondary to perforation during mapping. Pericardiocentesis resolved the tamponade.

Postresuscitation cyclosporine treatment attenuates myocardial and cardiac mitochondrial injury in newborn piglets with asphyxia-reoxygenation.

Objectives: Cardiovascular dysfunction occurs in the majority of asphyxiated neonates and has been suggested to be a major cause of neonatal morbidity and mortality. We previously demonstrated that cyclosporine A treatment during resuscitation can significantly improve cardiovascular performance in asphyxiated newborn piglets. However, the mechanisms through which cyclosporine elicits its protective effect in neonates have not yet been fully characterized.

A comparison of combination dopamine and epinephrine treatment with high-dose dopamine alone in asphyxiated newborn piglets after resuscitation.

Background: When asphyxiated neonates require additional cardiovascular support to moderate doses of dopamine infusion, controversy exists on the differential hemodynamic effects of two approaches (adding a second inotrope vs. increasing dopamine dosage). We hypothesized that high-dose dopamine (HD) would be detrimental to systemic and regional perfusion as compared with dopamine and epinephrine (D + E) combination therapy using a swine model of neonatal hypoxia-reoxygenation (H-R).

Infusing sodium bicarbonate suppresses hydrogen peroxide accumulation and superoxide dismutase activity in hypoxic-reoxygenated newborn piglets.

Background: The effectiveness of sodium bicarbonate (SB) has recently been questioned although it is often used to correct metabolic acidosis of neonates. The aim of the present study was to examine its effect on hemodynamic changes and hydrogen peroxide (H(2)O(2)) generation in the resuscitation of hypoxic newborn animals with severe acidosis.

Methods: Newborn piglets were block-randomized into a sham-operated control group without hypoxia (n = 6) and two hypoxia-reoxygenation groups (2 h normocapnic alveolar hypoxia followed by 4 h room-air reoxygenation, n = 8/group).

Cyclosporine treatment improves cardiac function and systemic hemodynamics during resuscitation in a newborn piglet model of asphyxia: a dose-response study.

Objectives: Asphyxiated neonates often have myocardial depression, which is a significant cause of morbidity and mortality. Cardioprotective effects of cyclosporine have been observed in adult patients and animals with myocardial infarction. However, the cardioprotective effect of cyclosporine in neonates has not yet been studied.

Milrinone is preferred to levosimendan for mesenteric perfusion in hypoxia-reoxygenated newborn piglets treated with dopamine.

Introduction: There is little information regarding the comparative hemodynamic effects of adding milrinone or levosimendan to dopamine infusion in hypoxia-reoxygenated (H-R) newborns.

Results: Severely hypoxic piglets had cardiogenic shock with depressed cardiac index (CI) and mean arterial pressure (MAP). The hemodynamics deteriorated gradually after initial recovery upon reoxygenation.

Cyclosporine treatment improves mesenteric perfusion and attenuates necrotizing enterocolitis (NEC)-like intestinal injury in asphyxiated newborn piglets during reoxygenation.

Purpose: Asphyxia-related intestinal injury in neonates may present similar to necrotizing enterocolitis (NEC) and is partially associated with hypoxia-reoxygenation injury. Cyclosporine has been shown to reduce myocardial cell death following ischemia-reperfusion. We hypothesize that cyclosporine treatment may attenuate NEC-like intestinal injury in asphyxiated newborn piglets during reoxygenation.

Vasopressin improves systemic hemodynamics without compromising mesenteric perfusion in the resuscitation of asphyxiated newborn piglets: a dose-response study.

Purpose: Hypoxia and reoxygenation (H-R) contributes to multi-organ failure in neonates, including cardiac and systemic complications. Use of vasopressin, an endogenous vasoconstrictive hormone commonly used to treat refractory hypotension in adults, in neonates with shock remains limited and not yet fully studied. We hypothesize that vasopressin will improve mean arterial pressure (MAP), without compromising cardiac, mesenteric, or carotid hemodynamics using a swine model of neonatal asphyxia.

Natural orifice surgery: endoluminal pouch reduction following failed vertical banded gastroplasty.

Background: Following vertical banded gastroplasty (VBG), patients may develop pouch complications such as dilation and staple-line dehiscence. This may contribute to weight regain, and if conservative measures are exhausted, traditionally, open revisional surgery of the pouch or conversion of the VBG to Roux-en-Y gastric bypass (RYGB) would be considered. StomaphyX(TM) is an endoscopic device used with a conventional gastroscope for the approximation of tissue in gastric pouches or across gastroenteric anastomoses to enhance restriction.

Heated CO(2) with or without humidification for minimally invasive abdominal surgery.

Background: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible.

Important returns on investment: an evaluation of a national research grants competition in emergency medicine.

Objective: We sought to examine scholarly outcomes of the projects receiving research grants from the Canadian Association of Emergency Physicians (CAEP) during the first 10 years of national funding (i.e., between 1996 and 2005).