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Reducing postoperative blood product usage and costs in cardiothoracic surgery: the implementation of a multispecialty perioperative care model incorporating a haemostasis checklist.
BMJ Open Qual
January 2025
Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Transfusion of blood products following cardiothoracic surgery represents a significant proportion of national blood product usage, has significant cost implications and is associated with increased 30-day mortality. Following identification of an increase in blood product use, we implemented a healthcare improvement initiative using a perioperative care model and establishment of a new multispecialty cardiothoracic surgery taskforce to further define and tackle the problem. The initiative incorporated a bundle of preoperative identification of high-risk patients, an intraoperative haemostasis checklist, a programme of unit education focussing on bleeding postbypass and use of thromboelastography and introduction of postoperative protocols for identification and escalation of bleeding.
View Article and Find Full Text PDFPeri-operative mental health interventions for surgical oncology patients: a narrative synthesis and meta-analysis.
Anaesthesia
January 2025
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.
Introduction: Oncologic surgeries are common and rates of depression and anxiety are high in the peri-operative period, potentially interfering with successful recovery.
Methods: We conducted a narrative review and meta-analysis focusing on randomised controlled trials evaluating the effect of peri-operative mental health interventions on anxiety and/or depression in adult patients having oncological surgery. The review included studies published in the last 5 years, identified through EMBASE with no pre-specified criteria for the type of comparison or outcome.
A new therapy for microcystic lymphatic malformations: the combination of intralesional laser thermolysis and percutaneous sclerotherapy.
Front Cell Dev Biol
December 2024
Department of Plastic Surgery, Jiangxi Provincial Children's Hospital, Nanchang, China.
Background: Over the past few decades, percutaneous sclerotherapy has been proven to be efficacy in treating macrocystic lymphatic malformations (LMs). Unfortunately, there still remains challenging in the treatment of microcystic LMs given their size. We introduce the intralesional laser thermolysis (ILT) technique, a novel enhancement technique for the traditional percutaneous sclerotherapy in the treatment of microcystic LMs.
View Article and Find Full Text PDFA Quality Improvement Initiative to Reduce Surgical Site Infections in Pediatric Patients Undergoing Cardiothoracic Surgery.
Pediatr Qual Saf
January 2025
Division of Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Ga.
Article Synopsis
- The project focused on reducing surgical site infections (SSIs) in pediatric patients undergoing cardiothoracic surgery to less than 1 per 100 cases.
- A multidisciplinary team identified risk factors and created a quality improvement (QI) initiative, which included enhanced hygiene practices and wound care education.
- The result was a significant decrease in SSIs, dropping from 2.82 to 0.55 per 100 cases, without any increase in major complications or mortality.
Effect of Ropivacaine Combined with Nalbuphine in Erector Spinae Plane Block on Postoperative Analgesia in Lumbar Trauma Surgery: A Single-Center Randomized Controlled Trial.
J Pain Res
January 2025
Department of Anesthesiology, the Second People's Hospital of Wuhu, Wuhu, Anhui, 241000, People's Republic of China.
Background: The erector spinae plane block (ESPB) has been increasingly utilized for postoperative analgesia in thoracic, abdominal, and spinal surgeries. This study evaluated the postoperative analgesic outcomes of ESPB with nalbuphine as a ropivacaine adjuvant for lumbar trauma surgery.
Methods: This randomized double-blind clinical trial included 57 participants who underwent lumbar trauma surgery.
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