Intraoperative cardiopulmonary variables are well-known predictors of postoperative pulmonary complications (PPC), traditionally quantified by median values over the duration of surgery. However, it is unknown whether cardiopulmonary instability, or wider intra-operative variability of the same metrics, is distinctly associated with PPC risk and severity. We leveraged a retrospective cohort of adults (n = 1202) undergoing major non-cardiothoracic surgery.
View Article and Find Full Text PDFBackground: Adjuvant regional anesthesia is often selected for patients or procedures with high risk of pulmonary complications after general anesthesia. The benefit of adjuvant regional anesthesia to reduce postoperative pulmonary complications remains uncertain. In a prospective observational multicenter study, patients scheduled for non-cardiothoracic surgery with at least one postoperative pulmonary complication surprisingly received adjuvant regional anesthesia more frequently than those with no complications.
View Article and Find Full Text PDFImportance: Postoperative pulmonary complications (PPCs), a leading cause of poor surgical outcomes, are heterogeneous in their pathophysiology, severity, and reporting accuracy.
Objective: To prospectively study clinical and radiological PPCs and respiratory insufficiency therapies in a high-risk surgical population.
Design, Setting, And Participants: We performed a multicenter prospective observational study in 7 US academic institutions.
Purpose: Venous air embolism (VAE) during pars plana vitrectomy (PPV) can occur owing to improper positioning of the infusion cannula in the suprachoroidal space and may lead to sudden compromise of cardiac circulation and death. This was an in vivo demonstration of fatal VAE during PPV to show that air can travel from the suprachoroidal space into the central circulation.
Design: Experimental in vivo surgical study on porcine eyes.
Perioperative management of a patient with ischemic heart disease with coexisting abdominal aortic aneurysm and pheochromocytoma creates a difficult management dilemma, and surgical intervention in these patients carries a significant risk. The state of catecholamine excess and various other coexisting factors can lead to simultaneous occurrence of abdominal aortic aneurysm and pheocromocytoma. The purpose of this report is to present an integrated approach to the management of concomitant abdominal aortic aneurysm and pheochromocytoma, where a combined surgical approach in addressing these two lesions was preferable due to patient comorbidities and surgical implications without significant complication.
View Article and Find Full Text PDFAbdominal compartment syndrome can result from many different causes. We present a case where this dangerous syndrome occurred in the operating room during a transurethral resection of a bladder tumor. It was initially recognized by an elevation in the peak inspiratory pressure.
View Article and Find Full Text PDFAcquired tracheoesophageal fistulae (TEF) are commonly due to malignancy (M. F. Reed and D.
View Article and Find Full Text PDFTransfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality in the United States. Management is usually supportive, including supplemental oxygen, intravenous fluids, and mechanical ventilation if necessary. Most patients recover within 72 hours.
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