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Anesth Analg 2019 Mar 7. Epub 2019 Mar 7.

Division of Pulmonary, Critical Care and Sleep Medicine, Metro Health Medical Center, Case Western Reserve University, Cleveland, Ohio.

There is increasing awareness that sleep disorders may be associated with increased perioperative risk. The Society of Anesthesia and Sleep Medicine created the Narcolepsy Perioperative Task Force: (1) to investigate the current state of knowledge of the perioperative risk for patients with narcolepsy, (2) to determine the viability of developing perioperative guidelines for the management of patients with narcolepsy, and (3) to delineate future research goals and clinically relevant outcomes. The Narcolepsy Perioperative Task Force established that there is evidence for increased perioperative risk in patients with narcolepsy; however, this evidence is sparse and based on case reviews, case series, and retrospective reviews. Read More

Curr Treat Options Oncol 2019 Mar 14;20(4):27. Epub 2019 Mar 14.

Section of Thoracic Surgery, Department of Surgery, The University of Chicago Medicine and Biological Sciences, 5841 S. Maryland Ave, Chicago, IL, USA.

Opinion Statement: Patients with locally advanced non-small cell lung cancer (NSCLC) are treated for cure, but treatment decisions are not straightforward. Chemotherapy is essential due to the high risk of systemic relapse, but local therapy is also required for cure. In the small subset of stage III patients with N0 or N1 disease, surgery is typically the initial therapy and extended resections are frequent. Read More

Curr Pain Headache Rep 2019 Mar 14;23(4):28. Epub 2019 Mar 14.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Purpose Of Review: Enhanced recovery after surgery (ERAS) has become a widespread topic in perioperative medicine over the past 20 years. The goals of ERAS are to improve patient outcomes and perioperative experience, reduce length of hospital stay, minimize complications, and reduce cost. Interventions and factors before, during, and after surgery all potentially play a role with the cumulative effect being superior quality of patient care. Read More

Thorac Cancer 2019 Mar 12. Epub 2019 Mar 12.

Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

This report describes the surgical management of a male patient with early-stage lung cancer who underwent thoracoscopic completion right lower lobectomy after previously undergoing sublobar resection for multifocal ground glass nodules of the lung. Perioperative considerations associated with the management of dense pulmonary hilar adhesions and the techniques used are discussed. Read More

J Vasc Surg 2019 Mar 5. Epub 2019 Mar 5.

Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, Mass. Electronic address:

Objective: Management of significant carotid stenosis in those with symptomatic coronary disease remains controversial. Staged and combined carotid endarterectomy (CEA) with coronary artery bypass grafting has been described. Yet, an understanding of the additive risks of these approaches is poor. Read More

Heart Lung Circ 2019 Feb 2. Epub 2019 Feb 2.

Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, UK. Electronic address:

Sternal wound infection (SWI) is one of the potential complications post cardiac surgery, and despite refined surgical techniques such as smaller incisions, antibiotic therapy, and optimised glycaemic control, the incidence rate is between <1% in elective cases with low risk factors and as high as 25% in patients with extensive risk factors. The presence of SWI will increase the perioperative morbidity and mortality rates and prolong the patient's hospital stay, therefore the prevention and diagnosis with appropriate management of such adverse outcomes at an early stage is important to prevent further progression as it can be fatal when the mediastinal structures are affected. Currently, the diagnosis typically consists of three main stages: clinical, biochemical including microbiology studies and imaging studies. Read More

J Pediatr Surg 2019 Feb 8. Epub 2019 Feb 8.

ECMO Center Karolinska, Department of Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.

Background: Support on Extracorporeal oxygenation membrane (ECMO) represents the last therapeutic option in the management of respiratory failure and pulmonary hypertension refractory to treatment in patients with congenital diaphragmatic hernia (CDH).

Aim: The objective of this work was to present our experience of all the cases of CDH that we have transported on ECMO.

Material And Methods: Medical records of patients, national and international, with CDH transported by our service on ECMO from 1997 to 2018 were reviewed. Read More

Semin Pediatr Surg 2019 Feb 18;28(1):3-10. Epub 2019 Jan 18.

Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, 1001 Decarie Blvd, Room B04.2318, Montreal, QC, Canada. Electronic address:

Preoperative assessment of surgical neonates often relates to issues of prematurity, low birth weight, or associated malformations. This review explores the preoperative cardiopulmonary evaluation in specific newborn surgical populations, the role of echocardiography in congenital diaphragmatic hernia perioperative management, the impact of bronchopulmonary dysplasia in the ex-preterm surgical neonate and a brief discussion on the risk of general anesthesia and specific anesthetic considerations for any surgical neonate. Newborns with congenital anomalies requiring early general surgical intervention should have an assessment for congenital heart disease. Read More

Indian J Anaesth 2019 Feb;63(2):134-137

Gastro-Intestinal Services, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Peritoneal carcinomatosis is intraperitoneal spread of gastrointestinal and gynaecological cancers. Cytoreductive surgeries and hyperthermic intraperitoneal chemotherapy offers survival benefits in these cases. Spread of peritoneal carcinomatosis to thorax pose challenges to surgeon and anaesthesiologist. Read More

Medicine (Baltimore) 2019 Feb;98(8):e14630

Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.

Rationale: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune disease that mainly affects the lungs and kidneys. Limited reports of perioperative management of such patients were primarily concerned with airway stenosis. Here, we report a patient with AAV who developed diffuse alveolar hemorrhage (DAH) early after radical thyroidectomy. Read More

J Cardiothorac Vasc Anesth 2018 Sep 8. Epub 2018 Sep 8.

Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address:

Objective: Surgery-related infection remains a major complication for patients undergoing cardiac surgery, and its association with thrombosis is unclear. This study aimed to examine the association of postoperative infection with thrombosis and major adverse cardiovascular and cerebral events (MACCEs) in patients undergoing coronary artery bypass grafting (CABG).

Design: Retrospective cohort study. Read More

J Surg Oncol 2019 Apr 25;119(5):623-628. Epub 2019 Feb 25.

Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

Management of multisite colorectal metastases is expanding to make curative resection possible for more patients who present with advanced disease. Patient selection, tumor biology, meticulous surgical technique, and thoughtful perioperative care are essential to extending the benefit to patients previously treated with palliative goals of care. Read More

SAGE Open Med Case Rep 2019 7;7:2050313X19827737. Epub 2019 Feb 7.

Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.

Diaphragmatic eventration is a rare anomaly. When patients with this condition undergo general anesthesia, anesthetic management should be performed with particular care owing to the risk of diaphragmatic rupture. Such a rupture can be perioperatively diagnosed using multiple tools including lung ultrasonography. Read More

Health Secur 2019 Jan/Feb;17(1):18-26

Brian T. Garibaldi, MD, is Director, Johns Hopkins Biocontainment Unit, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD.

This article describes a large-scale scenario designed to test the capabilities of a US biocontainment unit to manage a pregnant woman infected with a high-consequence pathogen, and to care for a newborn following labor and spontaneous vaginal delivery. We created and executed a multidisciplinary functional exercise with simulation to test the ability of the Johns Hopkins Hospital biocontainment unit (BCU) to manage a pregnant patient in labor with an unknown respiratory illness and to deliver and stabilize her neonate. The BCU Exercise and Drill Committee established drill objectives and executed the exercise in partnership with the Johns Hopkins Simulation Center in accordance with Homeland Security and Exercise Program guidelines. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Feb 15;54(2):90-106. Epub 2019 Feb 15.

With focused transthoracic echocardiography (TTE) we rapidly and non-invasively receive up-to-date information on a patient's hemodynamic status. These can subsequently influence our therapy and thus our risk management. Postoperatively, TTE has proved its worth as an examination method in the recovery room and in the intensive care unit to promptly diagnose life-threatening causes of circulatory depression. Read More

J Crit Care Med (Targu Mures) 2019 Jan 4;5(1):19-27. Epub 2019 Feb 4.

University of Szeged, Department of Anaesthesiology and Intensive Therapy, Szeged, Hungary.

Lung protective mechanical ventilation (LPV) even in patients with healthy lungs is associated with a lower incidence of postoperative pulmonary complications (PPC). The pathophysiology of ventilator-induced lung injury and the risk factors of PPCs have been widely identified, and a perioperative lung protective concept has been elaborated. Despite the well-known advantages, results of recent studies indicated that intraoperative LPV is still not widely implemented in current anaesthesia practice. Read More

Surgery 2019 Feb 11. Epub 2019 Feb 11.

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan.

Background: Postoperative pneumonia can be a fatal complication that may occur after lung resection in cancer patients. Some reports have shown that the incidence of postoperative pneumonia is decreased after esophageal surgery by perioperative oral care; however, there exist no data to suggest that a lack of perioperative oral care can be a risk factor for postoperative pneumonia after lung resection. To investigate the association between the preventive effect of oral care and postoperative pneumonia, we conducted a multicenter, retrospective study of lung cancer patients who underwent lung resection. Read More

Curr Opin Organ Transplant 2019 Apr;24(2):121-130

Department of Anesthesiology, Keck Medical School of USC, Los Angeles, California, USA.

Purpose Of Review: Liver transplantation in patients with portopulmonary hypertension (POPH) is associated with increased perioperative risk. Important recent advances in the management of liver transplantation recipients with POPH are discussed.

Recent Findings: The presence of POPH at the time of liver transplantation should not be a contraindication for liver transplantation, as POPH is common and may be related to volume overload and/or high cardiac output (CO). Read More

Am Surg 2019 Jan;85(1):23-28

Metastatic adrenocortical carcinoma (ACC) is associated with a poor 5-year survival rate and high rate of recurrence. Outcomes after resection for patients with limited disease remain poorly described. We conducted a PubMed search for articles published between 1950 and 2017 using the terms "ACC," "recurrence," and "surgery. Read More

J Thorac Cardiovasc Surg 2018 Dec 18. Epub 2018 Dec 18.

Duke University Medical Center, Durham, NC. Electronic address:

Objective: The objective of this study was to evaluate the impact of the video-assisted thoracoscopic (VATS) approach on the outcomes of patients who underwent pneumonectomy.

Methods: The effect of the surgical approach on perioperative complications and survival in patients who underwent pneumonectomy for nonmetastatic non-small cell lung cancer across 3 institutions (2000-2016) was assessed using multivariable logistic regression, Cox proportional hazards analysis, and propensity-score matching. Completion pneumonectomies were excluded from this study, and an "intent-to-treat" analysis was performed. Read More

Medicine (Baltimore) 2019 Feb;98(6):e14388

Department of Respiratory Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi.

Introduction: Chronic obstructive pulmonary disease (COPD) is a frequent comorbid disease in patients undergoing coronary artery bypass grafting (CABG) surgery, with an incidence ranging from 4% to 20.5%. Conventionally, COPD was recognized as a surgical contraindication to CABG. Read More

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Medical University of South Carolina Department of Orthopaedics 96 Jonathan Lucas Dr CSB 708 Charleston, SC 29425.

Introduction: While the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures.

Methods: The NSQIP database was queried for patients aged 60 years and older who underwent surgical management for hip fractures between 2005-2016. Read More

ERJ Open Res 2019 Feb 1;5(1). Epub 2019 Feb 1.

Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK.

Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. Read More

Crit Care Nurse 2019 Feb;39(1):46-60

Michele Balas is an associate professor, Center of Excellence in Critical and Complex Care, College of Nursing, and a nurse scientist, Wexner Medical Center, The Ohio State University, Columbus.

Although growing evidence supports the safety and effectiveness of the ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment), intensive care unit providers often struggle with how to reliably and consistently incorporate this interprofessional, evidence-based intervention into everyday clinical practice. Recently, the Society of Critical Care Medicine completed the ICU Liberation ABCDEF Bundle Improvement Collaborative, a 20-month, nationwide, multicenter quality improvement initiative that formalized dissemination and implementation strategies and tracked key performance metrics to overcome barriers to ABCDEF bundle adoption. The purpose of this article is to discuss some of the most challenging implementation issues that Collaborative teams experienced, and to provide some practical advice from leading experts on ways to overcome these barriers. Read More

J Thorac Cardiovasc Surg 2018 Dec 15. Epub 2018 Dec 15.

Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Mass. Electronic address:

Objectives: Complete resection of neoplasms involving the carina are technically challenging and have high operative morbidity and mortality. This study examines the last 2 decades of clinical experience at our institution.

Methods: Medical records were retrospectively reviewed between 1997 and 2017 to identify all patients who underwent carinal resection. Read More

Zhonghua Fu Chan Ke Za Zhi 2019 Jan;54(1):33-37

Departmemt of Gynecology, Peking University People's Hospital, Beijing 100044, China.

To study perioperative period conditions of total and partial colpocleisis with severe pelvic organ prolapse (POP) in elderly patients. From Jan. 2014 to Oct. Read More

J Surg Res 2019 Mar 30;235:202-209. Epub 2018 Oct 30.

Division of Cardiac Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California. Electronic address:

Background: Cardiovascular complications contribute significantly to the morbidity and resource utilization after pulmonary resections. Maturation of less-invasive technologies, such as video and robot-assisted thoracoscopic surgery, aims at improving postoperative outcomes by reducing the trauma of surgery. The present work aimed to evaluate changes in cardiovascular complications after open and minimally invasive lobectomies in the United States. Read More

J Cardiothorac Vasc Anesth 2018 Nov 22. Epub 2018 Nov 22.

Department of Anaesthesia and Intensive Care, Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. Electronic address:

J Neurosurg Spine 2019 Jan 25:1-6. Epub 2019 Jan 25.

Departments of1Neurosurgery and.

Tranexamic acid (TXA) is an antifibrinolytic agent with demonstrated efficacy in reducing blood loss when administered systemically. However, in patients with contraindications to systemic or intravenous TXA, topical TXA (tTXA) has been shown to reduce perioperative blood loss, with some studies suggesting equivalence compared to systemic TXA. However, these studies have been conducted in healthy cohorts without contraindications to systemic TXA. Read More

World Neurosurg 2019 Jan 23. Epub 2019 Jan 23.

Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Background: Venous thromboembolism (VTE) is an appreciable burden on health care. The protracted recumbency experienced by many spinal patients juxtaposed with concerns for postoperative hemorrhage from early anticoagulation results in conflicting stances regarding chemoprophylaxis. Identifying risk factors associated with VTE is therefore instrumental in guiding management. Read More

Ann Intensive Care 2019 Jan 18;9(1). Epub 2019 Jan 18.

Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Huispost CA 80, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

Background: High-frequency oscillatory ventilation (HFOV) is a common but unproven management strategy in paediatric critical care. Oscillator settings have been traditionally guided by patient age and/or weight rather than by lung mechanics, thereby potentially negating any beneficial effects. We have adopted an open-lung HFOV strategy based on a corner frequency approach using an initial incremental-decremental mean airway pressure titration manoeuvre, a high frequency (8-15 Hz), and high power to initially target a proximal pressure amplitude (∆P) of 70-90 cm HO, irrespective of age or weight. Read More

Ann Card Anaesth 2019 Jan-Mar;22(1):86-88

Department of Cardiac Anaesthesia, Fortis Memorial Research Institute, Gurgaon, Haryana, India.

Pulmonary complications are common in cardiac surgical patients. Limited respiratory reserves along with the pain associated with sternotomy add to the morbidity. Patients undergoing cardiac surgery who have had a pneumonectomy done before can be even more challenging to manage perioperatively due to a single-functioning lung. Read More

Ann Card Anaesth 2019 Jan-Mar;22(1):6-17

Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

The accurate quantification of cardiac output (CO) is given vital importance in modern medical practice, especially in high-risk surgical and critically ill patients. CO monitoring together with perioperative protocols to guide intravenous fluid therapy and inotropic support with the aim of improving CO and oxygen delivery has shown to improve perioperative outcomes in high-risk surgical patients. Understanding of the underlying principles of CO measuring devices helps in knowing the limitations of their use and allows more effective and safer utilization. Read More

F1000Res 2018 31;7:1373. Epub 2018 Aug 31.

Department of Pediatric Anesthesia, Alberta Children's Hospital, Calgary, Alberta, T3B 6A8, Canada.

This case report describes a previously healthy 14 year-old patient undergoing elective outpatient adenotonsillectomy that was complicated by acute postoperative pulmonary edema requiring 12 hours of high frequency oscillatory ventilation (HFOV) support.  We describe the clinical findings that led us to this rare diagnosis and management of post obstructive pulmonary edema (POPE) Type II, a rare but recognized complication following the surgical relief of an upper airway obstruction. This case is unique in that no previously published case report or review of POPE Type II has described the need for HFOV support. Read More

J Clin Med 2019 Jan 11;8(1). Epub 2019 Jan 11.

Department of Anaesthesia and Intensive Care, University Hospital "G.Rodolico", University of Catania, via Santa Sofia 78, 95123 Catania, Italy.

Background: Kidney transplantation is considered the first-choice therapy in end-stage renal disease (ESRD) patients. Despite recent improvements in terms of outcomes and graft survival in recipients, postoperative complications still concern the health-care providers involved in the management of those patients. Particularly challenging are cardiovascular complications. Read More

Reg Anesth Pain Med 2019 Jan 11. Epub 2019 Jan 11.

Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA

Background And Objectives: Obstructive sleep apnea (OSA) is a risk factor for adverse postoperative outcome and perioperative professional societies recommend the use of regional anesthesia to minimize perioperative detriment. We studied the impact of OSA on postoperative complications in a high-volume orthopedic surgery practice, with a strong focus on regional anesthesia.

Methods: After Institutional Review Board approval, 41 766 cases of primary total hip and knee arthroplasties (THAs/TKAs) from 2005 to 2014 were extracted from institutional data of the Hospital for Special Surgery (approximately 5000 THAs and 5000 TKAs annually, of which around 90% under neuraxial anesthesia). Read More

Cancers (Basel) 2019 Jan 8;11(1). Epub 2019 Jan 8.

Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia.

Prevention of cancer-associated thromboembolism (TE) remains a significant clinical challenge and priority world-wide safety initiative. In this prospective non-small cell lung cancer (NSCLC) cohort, longitudinal TE risk profiling (clinical and biomarker) was undertaken to develop risk stratification models for targeted TE prevention. These were compared with published models from Khorana, CATS, PROTECHT, CONKO, and CATS/MICA. Read More

BMC Cancer 2019 Jan 5;19(1). Epub 2019 Jan 5.

Department of Thoracic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang road, Hangzhou, Zhejiang Province, China.

Background: In this retrospective study, we aimed to demonstrated that three-port single-intercostal (SIC) thoracoscopic lobectomy is an effective choice for lung cancer by comparing the perioperative outcomes of patients with non-small-cell lung cancer treated with three-port SIC and conventional multiple-intercostal (MIC) thoracoscopic lobectomy.

Methods: From January 2013 to January 2018, 642 non-small-cell lung cancer patients underwent thoracoscopic lobectomy via a three-port SIC or MIC technique. Propensity-matched analysis incorporating preoperative clinical variables was used to compare the perioperative outcomes between the two groups. Read More

J Cardiothorac Vasc Anesth 2018 Nov 22. Epub 2018 Nov 22.

University Hospitals Birmingham National Health Service Foundation Trust, Department of Critical Care Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK; Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, Centre of Translational Inflammation Research, University of Birmingham, Birmingham, UK.

The right ventricle (RV) has been an area of evolving interest after decades of being ignored and considered less important than the left ventricle. Right ventricular dysfunction/failure is an independent predictor of mortality and morbidity in cardiac surgery; however, very little is known about the incidence or impact of RV dysfunction/failure in thoracic surgery. The pathophysiology of RV dysfunction/failure has been studied in the context of acute respiratory distress syndrome (ARDS), cardiac surgery, pulmonary hypertension, and left ventricular failure, but limited data exist in literature addressing the issue of RV dysfunction/failure in the context of thoracic surgery and one-lung ventilation (OLV). Read More

Am J Surg 2018 Dec 16. Epub 2018 Dec 16.

Department of Surgery, Centre Hospitalier de l'Université de Montreal (CHUM), Surgical Division, Montreal University, 850 rue Saint-Denis, Montreal, Quebec, H2X 0A9, Canada. Electronic address:

Background: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Certain abdominopelvic cancer surgeries are associated with a six to 14-fold increased risk of DVT versus surgeries for benign disease, and extended thromboprophylaxis using perioperative LMWHs may further reduce VTE rates over standard duration administration. This review assesses the value of extended low molecular weight heparin (LMWH) thromboprophylaxis as a recommended strategy after abdominopelvic cancer surgery. Read More

Eur Urol Focus 2018 Dec 26. Epub 2018 Dec 26.

Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Québec, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada.

Background: Radical prostatectomy (RP) represents one standard of care for patients with localized prostate cancer and is associated with several established postoperative complications.

Objective: We tested the relationship between RP early postoperative outcomes and age within a population-based data repository.

Design, Setting, And Participants: Within the National Inpatient Sample database (2008-2013), we identified patients who underwent robotically assisted or open RP. Read More

BMC Anesthesiol 2018 Dec 27;18(1):206. Epub 2018 Dec 27.

Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, South Australia, 5011, Australia.

Background: Endoscopic lung volume reduction using one or more endobronchial valves is a treatment option for a select group of patients with severe emphysema. Patients presenting for this procedure pose various challenges to the anaesthetist; in addition to their lung condition, they are often elderly with multiple comorbidities. The procedure is usually performed outside the operating room. Read More

Curr Opin Anaesthesiol 2019 Feb;32(1):17-22

Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Purpose Of Review: Guidelines for enhanced recovery after surgery (ERAS) have recently been published for lung surgery. Although some of the recommendations are generic or focused on anesthetic and nursing care, other recommendations are more specific to a thoracic surgeon's practice. The present review concentrates on the surgical approach, optimal chest drain management, and the importance of early mobilization. Read More

J Cardiothorac Vasc Anesth 2018 Nov 2. Epub 2018 Nov 2.

Department of Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, MI. Electronic address:

Ann Thorac Surg 2018 Dec 19. Epub 2018 Dec 19.

Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197, Ruijin 2nd road, Shanghai, 200025, China. Electronic address:

Background: Robotic segmentectomy has been suggested as a safe and effective management for early lung cancer and benign lung diseases. However, no large case series have documented the learning curve for this technically demanding procedure.

Methods: We conducted a retrospective study for robotic segmentectomy performed by the same surgeon between June 2015 and November 2017. Read More

Global Spine J 2018 Dec 19;8(8):887-891. Epub 2018 Apr 19.

Nagoya University Graduate School of Medicine, Nagoya, Japan.

Study Design: A review of a prospective database.

Objectives: Surgery for elderly patients is increasing yearly due to aging of society and the desire for higher quality of life. The goal of the study was to examine perioperative complications in spine surgery in such patients. Read More

Int J Pediatr Otorhinolaryngol 2019 Jan 3;116:181-185. Epub 2018 Nov 3.

Dept. Otolaryngology - Head & Neck Surgery, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital, Houston, TX, USA. Electronic address:

Objective: To evaluate the feasibility and the outcomes for step-down (SD) unit admission as an alternative to intensive care unit (ICU) admission after supraglottoplasty in the pediatric patient.

Methods: A review of 98 patients who underwent supraglottoplasty from 2012 to 2017 at a tertiary referral pediatric hospital was performed. An SD unit had 1-to-3 nurse-to-patient ratio with noninvasive positive pressure ventilation capability. Read More

BMJ Open 2018 Dec 14;8(12):e024086. Epub 2018 Dec 14.

Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Objective: This systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD).

Design: Systematic review and meta-analysis.

Data Sources: PubMed-MEDLINE, MEDLINE in-process, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Clinicaltrials. Read More

Curr Opin Anaesthesiol 2019 Feb;32(1):44-49

Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

Purpose Of Review: Patients undergoing thoracic surgery are at high risk for pulmonary and extra pulmonary complications, and may develop impairment of gas exchange during surgery and in the postoperative period. This review focuses on the potential benefits of high-flow nasal cannula (HFNC) oxygen therapy in those patients.

Recent Findings: HFNC oxygen therapy can be used pre, intra and postoperatively. Read More

Local Reg Anesth 2018 22;11:115-121. Epub 2018 Nov 22.

Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam,

Background: Paravertebral block has been proven to be an efficient method to provide post-thoracotomy pain management. This study aimed to compare patient-controlled paravertebral analgesia (PCPA) and intravenous patient-controlled analgesia (IVPCA) in terms of analgesic efficiency, respiratory function, and adverse effects after video-assisted thoracoscopic surgery (VATS) lobectomy.

Patients And Methods: The prospective randomized trial study was carried out on 60 patients who underwent VATS lobectomy (randomly allocated 30 patients in each group). Read More