Successful management of rocuronium-induced anaphylaxis with sugammadex: A case report.

Although anaphylaxis during anaesthesia is a rare event, neuromuscular blocking drugs are responsible for 62% of anaesthesia-related anaphylaxis. However, sugammadex, a modified gamma-cyclodextrin, can encapsulate rocuronium molecules and cause the rapid reversal of the neuromuscular blockade. A 68-year-old man who presented for a radical prostatectomy was induced with IV fentanyl/propofol/rocuronium.

An Analysis of the Risk Factors for Postoperative Complications and Their Effects on Hospital Stay in Taiwanese Geriatric Surgical Patients.

Background: Surgical outcomes and complications in geriatric patients may be affected due to their increased number of underlying diseases. This study was conducted to evaluate the risk factors for postoperative complications and their effects on hospital stay in geriatric surgical patients (aged ≥ 80 years).

Methods: A total of 404 geriatric patients (aged ≥ 80 years) who underwent noncardiac surgery were enrolled in this study.

Impact of massive blood transfusion during adult extracorporeal membrane oxygenation support on long-term outcomes: a nationwide cohort study in Taiwan.

Objectives: Bleeding is a common problem during adult extracorporeal membranes oxygenation (ECMO) support, requiring blood transfusion for correction of volume depletion and coagulopathy. The goal of this study is to investigate the long-term outcomes for adults under support of ECMO with massive blood transfusion (MBT).

Design: Retrospective nationwide cohort study.

Nationwide cohort study of outcomes of acute myocardial infarction in patients with liver cirrhosis: A nationwide cohort study.

Liver cirrhotic predisposes patients to coagulopathy and bleeding. Little is known about outcomes of acute myocardial infarction (AMI) in cirrhotic patients.Data from Taiwan National Health Insurance Research Database during 2001 to 2013 were retrieved for patients admitted with cirrhosis and AMI.

Effect of massive blood transfusion on late outcomes after surgical repair of acute type A aortic dissection.

Massive blood transfusion (MBT) increased mortality and morbidity after cardiac surgery. However, a mid-term follow-up study on repair surgery of acute type A aortic dissection (AAAD) with MBT was lacking. This study aimed to assess the impact of perioperative MBT on late outcomes of surgical repair for AAAD.

Dual antiplatelet therapy in patients with cirrhosis and acute myocardial infarction - A 13-year nationwide cohort study.

Background: Patients with cirrhosis and acute myocardial infarction (AMI) present dilemma whether dual antiplatelet therapy (DAPT) should be used.

Methods: Electronic medical records between 2001-2013 were retrieved from Taiwan National Health Insurance Research Database. Patients were excluded for missing information, age <20 years old, history of AMI, liver transplant, autoimmune disease, coagulopathy, taking DAPT 3 months before index date, follow-up <3 months, anticoagulation user, without DAPT, and events of myocardial infarction (MI), ischemic stroke, major bleeding, and heart failure within 3-month of enrollment.

A population-based analysis of endovascular aortic stent graft therapy in patients with liver cirrhosis.

Background: Endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) are effective and minimally invasive treatments for high-risk surgical candidates. However, information about the management of EVAR and TEVAR in liver cirrhosis (LC) is lacking. The aim of our study was to evaluate outcomes after EVAR and TEVAR in patients with LC.

Selection of β-Blocker in Patients With Cirrhosis and Acute Myocardial Infarction: A 13-Year Nationwide Population-Based Study in Asia.

Background It is not clear whether β-selective or nonselective β-blockers should be used in patients with cirrhosis and acute myocardial infarction. Methods and Results Medical records were retrieved from Taiwan NHIRD (National Health Insurance Research Database) during 2001-2013. Patients were excluded for age <20, previous acute myocardial infarction, contraindication to β-blockers, chronic obstructive pulmonary disease, asthma, or atrioventricular conduction disease.

Non-invasive cardiac output measurement with electrical velocimetry in patients undergoing liver transplantation: comparison of an invasive method with pulmonary thermodilution.

Background: The goal of this study was to evaluate the accuracy and interchangeability between continuous cardiac output (CO) measured by electrical velocimetry (CO) and continuous cardiac output obtained using the pulmonary thermodilution method (CO) during living donor liver transplantation (LDLT).

Method: Twenty-three patients were enrolled in this prospective observational study. CO was recorded by both two methods and compared at nine specific time points.

Preoperative Right Ventricular Dysfunction Indicates High Vasoactive Support Needed After Cardiac Surgery.

Objective: The aim of this study was to explore the relationship between preoperative right ventricular (RV) function and high vasoactive-inotropic score (VIS) after cardiac surgery.

Design: Prospective observational study.

Setting: A single medical center setting.

Propensity Score Matched Analysis of Mechanical vs. Bioprosthetic Valve Replacement in Patients With Previous Stroke.

Background: This study compared the long-term outcomes of prosthetic heart valve replacement with mechanical or bioprosthetic valves in patients with prior stroke.

Methods and results: In total, 1,984 patients with previous stroke who had received valve replacement between 2000 and 2011 were identified using the Taiwan National Health Insurance Research Database. Propensity score matching analysis was used.

Immunosuppressants and new onset gallstone disease in patients having undergone renal transplantation.

Background: There are very few reports describing the development of gallstone disease after renal transplantation (GSDART) in Asia. The aim of this population-based study was to explore the prevalence, predictive factors, and outcomes of newly developed GSDART. The relationship between immunosuppressant and GSDART was also explored.

Evaluation of the use of the fourth version FloTrac system in cardiac output measurement before and after cardiopulmonary bypass.

The FloTrac system is a system for cardiac output (CO) measurement that is less invasive than the pulmonary artery catheter (PAC). The purposes of this study were to (1) compare the level of agreement and trending abilities of CO values measured using the fourth version of the FloTrac system (CCO-FloTrac) and PAC-originated continuous thermodilution (CCO-PAC) and (2) analyze the inadequate CO-discriminating ability of the FloTrac system before and after cardiopulmonary bypass (CPB). Fifty patients were included.

Comparison of right ventricular measurements by perioperative transesophageal echocardiography as a predictor of hemodynamic instability following cardiac surgery.

Background: The relationship between perioperative right ventricular (RV) performance and hemodynamic instability after cardiac surgery seemed less portrayed. Therefore, we sought to elucidate this relationship and compare the accuracy of different RV systolic indices in predicting outcome of cardiac surgery.

Methods: This study enrolled consecutive patients referred for cardiac surgeries.

Relationship Between Right Ventricular Function and Atrial Fibrillation After Cardiac Surgery.

Objective: The aim of this study was to explore the relationship between perioperative right ventricular (RV) function and postoperative atrial fibrillation (POAF) in the context of cardiac surgery.

Design: Prospective, observational study.

Setting: A single medical center setting.

The Effects of Volume-Controlled and Pressure-Controlled Ventilation on Lung Mechanics, Oxidative Stress, and Recovery in Gynecologic Laparoscopic Surgery.

Study Objective: To compare ventilation variables, changes in oxidative stress, and the quality of recovery in 2 different ventilation strategies (volume-controlled ventilation [VCV] and pressure-controlled ventilation [PCV]) during gynecologic laparoscopic surgery.

Design: A prospective randomized controlled trial (Canadian Task Force classification I).

Setting: One university teaching hospital in Taiwan.

Predictive risk index and prognosis of postoperative reintubation after planned extubation during general anesthesia: a single-center retrospective case-controlled study in Taiwan from 2005 to 2009.

Objectives: Postoperative reintubation after planned extubation (RAP) following general anesthesia is a major anesthetic morbidity. A previous study on RAP identified the various risk factors for RAP, including chronic obstructive pulmonary disease (COPD), pneumonia, systemic inflammatory response syndrome (SIRS), and airway surgery. However, the prognosis and predictive risk index of RAP were not investigated.

Postoperative reintubation after planned extubation: a review of 137,866 general anesthetics from 2005 to 2007 in a Medical Center of Taiwan.

Background: regarding general anesthesia, postoperative reintubation after planned extubation (RAP) is needed when circumstances compel us to do so, irrespective of prolongation of hospital stay and increase of medical expenditure. We describe here our implementation of a case-controlled model to identify the risk factors of RAP.

Methods: patients who saw RAP in the space from January 1, 2005 to December 31, 2007 were retrospectively sorted out from the Quality Assurance (QA) database of the Department of Anesthesiology.

Spontaneous remission of left bundle branch block immediately after denitrogenation with inhalation of 100% oxygen prior to anesthetic induction.

Complete left bundle branch blocks have focused our attention, primarily because they are a sign predictive of mortality and a predictor of coexisting cardiovascular disease. Left bundle branch block (LBBB) is usually permanent but may occur transiently or intermittently. Spontaneous remission of LBBB rarely occurs during anesthesia.