Lung ultrasound on first postoperative day predicts out-of-hospital pulmonary complications following video-assisted thoracic surgery: A prospective cohort study.

Background: The integration of enhanced recovery after surgery (ERAS) protocols into the peri-operative management of video-assisted thoracic surgery (VATS) has facilitated rapid patient recovery, enabling discharge within 48 h. However, postoperative pulmonary complications (PPCs) postdischarge pose significant concerns for patient welfare. Despite the established utility of lung ultrasound (LUS) in diagnosing the causes of dyspnoea, the effectiveness of quantitative LUS in predicting PPCs after VATS remains uncertain.

Airway Management in Microvascular Reconstruction of the Head and Neck: Current Practice Patterns.

Objective: To identify current airway management practice patterns during free tissue transfer (FTT) reconstruction of head and neck defects.

Methods: A 27-question survey distributed to American Head and Neck Society (AHNS) members. Correlation between surgeon and patient variables with likelihood to perform tracheotomy and tracheotomy technique were evaluated.

The Association Between Fluid Management and Intraoperative Blood Pressure and Patients' Outcome After Complex Spine Surgeries.

Background: Both intraoperative hypotension and excessive fluid administration can lead to detrimental perioperative complications. However, how much fluid is considered excessive and how is intraoperative hypotension related to major postoperative complications?

Methods: We conducted a single-center retrospective cohort study in 6243 patients undergoing complex spine surgery at the Cleveland Clinic Foundation between 2012 and 2022 and studied the relationship between intraoperative net fluid administration and intraoperative hypotension with major postoperative complications. The primary outcome was a collapsed composite of postoperative complications including acute kidney injury (AKI), myocardial infarction (MI), stroke, and intensive care unit (ICU) admissions.

Undiagnosed mirror syndrome with maternal hypoxemia onset during an emergency cesarean section: A case report.

Rationale: Mirror syndrome is a rare pregnancy condition in which maternal edema is associated with fetal hydrops. Because of its rarity and overlapping symptoms, this condition is often misdiagnosed as another pregnancy complication.

Patient Concerns: A 28-year-old pregnant Japanese woman presented with sudden 7.

From Crisis to Complications: A Nationwide Cohort Study Assessing One-Year Cardiovascular and Thromboembolic Risks After Severe COVID-19 Compared to Matched Controls.

The long-term risk of cardiovascular and thrombotic events following severe COVID-19 remains largely unknown. This study aimed to assess the risk of atherosclerotic cardiovascular disease (ASCVD) within one year after hospital discharge in patients who received intensive care for severe COVID-19. A register-based nationwide case-control study on a cohort of patients with severe COVID-19 (cases) requiring mechanical ventilation and discharged alive without experiencing cardiovascular or thrombotic events during their hospital stay.

Perioperative Lung Ultrasound Findings in Elective Intra-Abdominal Surgery: Associations with Postoperative Pulmonary Complications.

For patients undergoing abdominal surgery, postoperative pulmonary complications (PPCs) are a major source of morbidity and mortality. The use of point-of-care ultrasonography (POCUS), and specifically POCUS of the lungs, has seen many advancements in recent years. We hypothesize that perioperative lung ultrasonography can be used as a predictor for PPCs.

Anesthetic management of acute right heart failure in patients with pulmonary embolism undergoing AngioJet pulmonary embolectomy: a case report.

Background: Early mortality rate in patients with high-risk pulmonary embolism(PE) is extremely high. Prompt and effective reduction of the thrombus load, and restoration of pulmonary circulation may successfully treat such patients. For patients with hemodynamic instability and high-risk acute PE, the guidelines recommend catheter directed therapy (CDT).

Correlation of right ventricular outflow tract residual disease on post-op transesophageal echocardiography and discharge transthoracic echocardiography after tetralogy of fallot repair.

Post-operative transesophageal echocardiography (TEE) is standard of care to evaluate for residual disease and quality of surgical repair. The residual lesion score (RLS) as defined by the pediatric heart network explored the impact of residual lesions on outcomes using discharge transthoracic echocardiogram (TTE). In tetralogy of fallot with pulmonary stenosis (TOF/PS), the residual right ventricular outflow tract (RVOT) gradient is one marker of quality of repair.

Temporary microaxial transvalvular left ventricular assist device for post-myocardial infarction ventricular septal rupture: Bridging a paradigm shift.

Objective: To characterize the clinical courses and outcomes of patients presenting with post-myocardial infarction (MI) ventricular septal rupture (VSR) receiving temporary microaxial transvalvular left ventricular assist device (tVAD) support.

Methods: Between December 2019 and July 2023, 10 consecutive patients presented with a post-MI VSR. All 10 patients received a tVAD.

Perioperative outcomes in elderly patients undergoing pancreatoduodenectomy: a propensity-matched analysis.

Background: To investigate perioperative outcomes of pancreatoduodenectomy in elderly patients.

Method: Data for 977 patients who underwent pancreatoduodenectomy from January 2018 to January 2023 were retrospectively analysed. Patients aged 75 years or older (n = 81) were matched with patients younger than 75 years (n = 896) using nearest neighbour propensity scores matching in a 1:1 ratio.

Gastric ultrasound: Enhancing preoperative risk assessment and patient safety.

Perioperative pulmonary aspiration is a critical complication linked to significant morbidity and mortality, particularly in high-risk populations such as patients with diabetes, obesity, gastroparesis, or those using Glucagon-Like-Peptide-1 receptor agonists (GLP-1 RAs). Standard fasting protocols may not be appropriate for these patients, as they have increased propensity of delayed gastric emptying, hence increasing the complex of the preoperative risk assessment. Gastric ultrasound (GUS) provides a non-invasive, reliable method for assessing gastric content and volume, enabling anaesthesia professionals to make informed decisions regarding aspiration risk, airway management, and surgical scheduling.

SAGES guidelines for the management of comorbidities relevant to metabolic and bariatric surgery.

Background: Patients who are under consideration for or have undergone metabolic and bariatric surgery frequently have comorbid medical conditions that may make their perioperative care more complex. These recommendations address routine intraoperative cholangiography in patients with bypass-type anatomy, the management of reflux disease after sleeve gastrectomy, and the optimal bariatric procedure for patients with comorbid inflammatory bowel disease.

Methods: A systematic review was conducted including studies published from 1990 to 2022 to address these questions.

Posterior Instrumentation without Curettage Promotes Rapid Restoration of Adult Spinal Langerhans Cell Histiocytosis.

Introduction: Adult spinal Langerhans cell histiocytosis (LCH) presents a treatment challenge due to ongoing controversies. Traditional approaches such as curettage with bone grafting and internal fixation are preferred for severe cases involving mechanical instability, neurological deficits, or deformity. This study aimed to explore the efficacy of a customized approach involving simple posterior instrumentation without curettage or bone grafting in treating adult spinal LCH.

Preoperative interatrial block is associated with postoperative atrial fibrillation after cardiac surgery.

Objectives: Atrial fibrillation is common complication after heart surgery potentially leading to chronic atrial fibrillation, heart failure, and mortality. The aim of this study was to explore the relationship between preoperative interatrial block and the occurrence of postoperative atrial fibrillation.

Methods: Perioperative 12-channel ECGs of patients in sinus rhythm, scheduled for heart surgery including bypass and/or valve surgery were analysed.

Association between preoperative antifungal therapy and postoperative complications in patients with pulmonary aspergilloma: A national database study in Japan.

Postoperative complications of pulmonary resection in patients with pulmonary aspergilloma are common. Preoperative antifungal therapy is a perioperative management strategy to reduce postoperative complications; however, the benefit of the treatment remains controversial. A retrospective cohort study was conducted using data from the Diagnosis Procedure Combination database (July 2010-March 2021), a national inpatient database in Japan.

Safety of open airway reconstruction in high-risk post-COVID patients: A case-matched control study.

Objectives: COVID-19 pneumonia patients may have high rates of intubation and reduced pulmonary function once recovered. Poor pulmonary function is a relative contraindication to open airway reconstruction, post-COVID patients may extrapolate as high-risk for open airway reconstruction. This presents challenges in airway stenosis management of post-COVID pneumonia patients.

Laparoscopic Intraperitoneal Onlay Mesh Plus (IPOM Plus) With Mobilizing the Urinary Bladder for Suprapubic Incisional Hernia Repair: A Case Report.

Ventral hernias represent a prevalent surgical complication in contemporary medical practice, with incisional hernias being a common long-term outcome following abdominal surgery. There are many risk factors for abdominal incisional hernias, including surgical history, malnutrition, obesity, chronic obstructive pulmonary disease, abdominal closure technique, and surgical site infection. Laparoscopic repair of incisional hernias is the optimal surgical approach, as it is associated with reduced hospital stays, fewer perioperative complications, and lower recurrence rates.

GLP-1 receptor agonists and delayed gastric emptying: implications for invasive cardiac interventions and surgery.

Glucagon-like peptide-1 (GLP-1) is a hormone involved in glucose homeostasis and satiety regulation. The review highlights the importance of understanding the interplay between GLP-1 and gastric motility. This paper explores the intricate connection between GLP-1 and delayed gastric emptying, specifically gastroparesis, and its implications in the context of pulmonary aspiration during anesthesia along with the potential effects of GLP-1 medications on absorption of other medications.

Clinical Management and Transplant Considerations in Pediatric Pulmonary Hypertension Due to Left Heart Disease: A Scientific Statement From the American Heart Association.

Children with left heart disease are at risk for developing pulmonary hypertension, initially secondary to pulmonary venous hypertension that can progress to include elevated pulmonary vascular resistance, known as combined pre- and postcapillary pulmonary hypertension. Elevated pulmonary vascular resistance may pose a risk to the right ventricle of a newly transplanted heart because of increased afterload and is an important consideration for heart transplant eligibility. However, the epidemiology, pathophysiology, optimal diagnostic and treatment approaches, and thresholds for pulmonary vascular resistance in pulmonary hypertension associated with left heart disease remain unclear because of lack of evidence, particularly in pediatrics.

Global trends and research hotspots in perioperative management of lung cancer: a bibliometric analysis from 2004 to 2024.

Objective: This article aims to analyze the current status and research hotspots of literature related to perioperative management of patients with Lung Cancer and provide reference for future research directions.

Methods: This study conducted a bibliometric analysis of research literature related to perioperative management of Lung Cancer published between 2004 and 2024, retrieved from the Web of Science database. R software and VOSviewer were used for analyzing keyword clusters and research themes, revealing trends and frontiers in this field.

Thrombotic events in patients underwent simultaneous bilateral total knee arthroplasty with modern perioperative blood management strategy.

Background: Thrombotic events, the leading cause of death after total knee arthroplasty (TKA), occurred more frequently in simultaneous bilateral TKA than unilateral TKA under conventional perioperative management. The aim of the study was to determine whether the simultaneous bilateral TKA using contemporary blood management strategies would be associated with higher risk of thrombotic events than unilateral TKA.

Method: This propensity score-matched cohort study included 1,069 patients, with 324 undergoing simultaneous bilateral TKA and 745 undergoing unilateral TKA.