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Fracture-related infections are a significant burden to the patient, associated with high health care costs and use of resources. Therefore, prevention is more critical than treatment of infection. There are injury- and patient-related risk factors that are mostly not modifiable, with the exception of a few patient-specific ones such as control of blood glucose levels in patients with diabetes.
View Article and Find Full Text PDFEffect of Regional Anesthesia on Intraoperative Hyperkalemia in Patients With Chronic Kidney Disease: Two Case Reports.
Cureus
November 2024
Anesthesiology, Obihiro-Kosei General Hospital, Obihiro, JPN.
Intraoperative hyperkalemia is particularly common in patients with chronic kidney disease (CKD). We report two cases of intraoperative hyperkalemia occurring under general anesthesia, while potassium levels remained stable with regional anesthesia alone. Case 1 involved a 69-year-old male with CKD who underwent total thyroidectomy under general anesthesia and developed intraoperative hyperkalemia, requiring glucose-insulin (GI) therapy.
View Article and Find Full Text PDFRationale and strategies for improving glycaemic control in diabetic patients undergoing cardiac surgery: a narrative review.
J Thorac Dis
November 2024
Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK.
Background And Objective: The global prevalence of diabetes mellitus has markedly risen in recent years. Consequently, there has been a rise in the number of patients with diabetes undergoing cardiac surgery. Despite the existence of national and international guidelines to improve surgical outcomes in patients with diabetes, perioperative diabetes management optimisation remains inadequate resulting in these patients experiencing increased rates of surgical morbidity and mortality.
View Article and Find Full Text PDFPerioperative Outcomes in Congenital Heart Disease: A Review of Clinical Factors Associated With Prolonged Ventilation and Length of Stay in Four Common CHD Operations.
J Cardiothorac Vasc Anesth
November 2024
Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital; Department of Anaesthesia, Harvard Medical School, Boston, MA.
Objectives: Perioperative management strategies and outcomes for low-risk congenital heart disease (CHD) surgery vary between institutions. To date, no consensus exists on standardized management for pediatric patients undergoing cardiac surgery. This study seeks to benchmark the perioperative management of 4 common CHD lesions and explore clinical factors affecting postoperative outcomes.
View Article and Find Full Text PDFThe relationship between intraoperative glucose levels and length of hospital stay in patients with a femoral neck fracture: a retrospective study based on the MIMIC-IV database.
Front Surg
November 2024
Department of Operation Room, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Objective: This retrospective study aimed to explore the relationship between intraoperative glucose (IG) and the length of hospital stay (LOS) in patients with femoral neck fractures via the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database.
Methods: A generalized additive model was performed to explore the relationship between IG levels and LOS. Restricted cubic spline curves were used to analyze the dose-response relationship between IG levels and prolonged LOS (or 7-day LOS).
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