Search Our Scientific Publications & Authors

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

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

J Am Geriatr Soc 2018 Dec 7. Epub 2018 Dec 7.

Cardiovascular Division, Department of Internal Medicine, Washington University, St. Louis, Missouri.

Objectives: To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD).

Design: Consensus meeting.

Setting: Multidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6-7, 2017. Read More

Transplant Direct 2018 Nov 26;4(11):e403. Epub 2018 Oct 26.

Department of Anesthesiology and Perioperative Medicine, The Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA.

In this review, we analyze the epidemiology of thromboses related to end-stage liver disease (ESLD), discuss causes of hypercoagulability, describe susceptible populations, and critically evaluate proposed prophylaxis and treatment of thromboses. Classically, ESLD has been regarded as a model for coagulopathy, and patients were deemed to be at high risk for bleeding complications. Patients with ESLD are not auto-anticoagulated, and they do not have a lower risk of portal vein thrombosis, intracardiac thrombus formation, pulmonary embolism or hepatic artery thrombosis. Read More

Am J Case Rep 2018 Dec 6;19:1445-1448. Epub 2018 Dec 6.

Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

BACKGROUND Levo-transposition of the great arteries (L-TGA) is a rare form of congenital heart disease that may go unrecognized until adulthood. Parturient women with L-TGA have a high likelihood of developing acute pulmonary edema and cardiac dysrhythmias during the peri-partum period. CASE REPORT We present the case of a 32-year-old primigravida patient with previously unknown diagnosis of L-TGA, presenting with preeclampsia, whose peri-partum course was complicated by the development of acute pulmonary edema, complete heart block, and acute hypoxic respiratory failure. Read More

Ann Thorac Surg 2018 Nov 30. Epub 2018 Nov 30.

Division of Thoracic Surgery, S. Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy.

Background: Patent foramen ovale (PFO) is present in up to 25% of the general population and is considered an irrelevant condition in healthy subjects. Here we sought to determine an association between the presence of an asymptomatic PFO at baseline and postoperative short-term adverse events in patients undergoing major pulmonary resection for lung cancer. As well, we evaluated for the rate of PFO after pulmonary resections. Read More

Curr Opin Anaesthesiol 2019 Feb;32(1):29-38

Department of Anesthesiology, Yale University School of Medicine, VA Connecticut Healthcare System, West Haven, CT.

Purpose Of Review: Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates. In this review, we focus on the emergence of transpulmonary thermodilution (TPTD) and lung ultrasound with a focus on the clinical integration of these modalities into current intraoperative and critical care practices. Read More

J Thorac Dis 2018 Nov;10(Suppl 32):S3755-S3760

Division of Thoracic Surgery, McGill University Health Centre, Montreal, Canada.

The concept of surgical recovery encompasses the entire perioperative phase of the patient, beginning with the preoperative baseline and culminating in the long-term rehabilitation of the patient in the post-operative phase. Enhanced recovery pathways (ERPs) aim to encompass all phase of the patient trajectory, including the preoperative, perioperative, and postoperative management of surgical patients. While significant literature exists on standardizing and optimizing the perioperative phase, standardizing the pre and post-operative phases remains a topic of debate. Read More

Transplant Rev (Orlando) 2018 Nov 22. Epub 2018 Nov 22.

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Division of Transplantation Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States. Electronic address:

Combined liver-lung transplantation (CLLT) is a rare, life-saving procedure to treat concomitant lung and liver disease. There have been 93 combined lung and liver transplantations performed in the United States since 1994. Techniques include both lung first and liver first sequential transplants with selective extracorporeal circulation of either thoracic or abdominal portions, with either end-to-end or Roux-en-Y choledochojejunostomy for biliary reconstruction. Read More

Dig Surg 2018 Dec 5:1-8. Epub 2018 Dec 5.

Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City,

Background: Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes.

Methods: In all, 363 consecutive patients underwent elective hepatectomies between July 2008 and November 2013 and these were identified and analyzed retrospectively. Read More

J Intensive Care Med 2018 Dec 4:885066618815804. Epub 2018 Dec 4.

8 Pietermaritzburg Department of Anaesthesia, Critical Care and Pain Management, Pietermaritzburg, South Africa.

Objective:: To measure the association of intensive care unit (ICU) capacity strain with processes of care and outcomes of critical illness in a resource-limited setting.

Methods:: We performed a retrospective cohort study of 5332 patients referred to the ICUs at 2 public hospitals in South Africa using the country's first published multicenter electronic critical care database. We assessed the association between multiple ICU capacity strain metrics (ICU occupancy, turnover, census acuity, and referral burden) at different exposure time points (ICU referral, admission, and/or discharge) with clinical and process of care outcomes. Read More

Surg Today 2018 Dec 3. Epub 2018 Dec 3.

Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Nagoya, 467-8601, Japan.

Objectives: Video-assisted thoracoscopic surgery (VATS) lobectomy is performed widely for patients with clinical stage I non-small cell lung cancer (NSCLC) because of its superior short-term outcomes to those of thoracotomy lobectomy. However, the long-term outcomes of VATS lobectomy vs. thoracotomy lobectomy remain controversial. Read More

Semin Respir Crit Care Med 2018 Oct 28;39(5):609-624. Epub 2018 Nov 28.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.

Liver transplantation (LT) has the potential to cure patients with acute and chronic liver failure as well as a number of hepatic and biliary malignancies. Over time, due to the increasing demand for organs as well as improvements in the survival of LT recipients, patients awaiting LT have become sicker, and often undergo the procedure while critically ill. This trend has made the process of preoperative assessment and planning, intraoperative management, and postoperative management even more crucial to the success of LT programs. Read More

J Orthop Surg Res 2018 Nov 20;13(1):291. Epub 2018 Nov 20.

Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.

Background: Limited studies are available to investigate the prevalence of preoperative venous thromboembolism (VTE) in elderly patients with femoral neck fractures. Our primary aim was to determine the incidences of VTE and its risk or protective factors in such patient population. The secondary objective was to evaluate the need of therapeutic anticoagulation for isolated calf muscular venous thrombosis (ICMVT) prior to femoral neck fracture surgery. Read More

Neurosurg Focus 2018 Nov;45(5):E8

Departments of1Neurosurgery.

OBJECTIVEPituitary adenomas occur in a heterogeneous patient population with diverse perioperative risk factors, endocrinopathies, and other tumor-related comorbidities. This heterogeneity makes predicting postoperative outcomes challenging when using traditional scoring systems. Modern machine learning algorithms can automatically identify the most predictive risk factors and learn complex risk-factor interactions using training data to build a robust predictive model that can generalize to new patient cohorts. Read More

Transl Lung Cancer Res 2018 Oct;7(5):599-608

Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC, USA.

Malignant peritoneal mesothelioma (MPM) is a rare disease whose natural history is confined to the peritoneal space. Systemic chemotherapy has little impact on survival of patients with MPM. A surgical procedure with a goal of resection of all visible evidence of disease, called cytoreductive surgery (CRS) has been utilized in MPM patients. Read More

Eur J Intern Med 2018 Nov 15. Epub 2018 Nov 15.

Internal Medicine Department, Centro Hospitalar Lisboa Ocidental, NOVA Medical School/Faculdade de Ciências Médicas, Lisboa, Portugal.

With the increase of ageing population, rates of chronic diseases and complex medical conditions, the management of high-risk surgical patients is likely to become a great concern in most countries. Considering all these factors, it is certainly rational and intuitive that internists should be included into a collaborative model of medical and surgical co-management, where their multi-potentiality and synthesis capacity require them to coordinate the multidisciplinary team and to be the leading agent of change. In this regard, our aim was to present the official position and approach of the Working Group on Professional Issues and Quality of Care of the European Federation of Internal Medicine (EFIM), for implementation of this strategy of care, encouraging internists to assume an important role and to provide continuity of multidisciplinary care, from the decision to operate through to rehabilitation and recovery. Read More

Crit Care Clin 2019 Jan 25;35(1):45-60. Epub 2018 Oct 25.

Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, 110 South Paca Street, 7th Floor, Baltimore, MD 21201, USA. Electronic address:

Management of the cardiac transplant recipient includes careful titration of inotropes and vasopressors. Recipient pulmonary hypertension and ventilatory status must be optimized to prevent allograft right ventricular failure. Vasoplegia, coagulopathy, arrhythmias, and renal dysfunction also require careful management to achieve an optimal outcome. Read More

Crit Care Clin 2019 Jan 26;35(1):27-43. Epub 2018 Oct 26.

Department of Cardiothoracic Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue, J4-331, Cleveland, OH 44195, USA.

Perioperative management of patients undergoing lung transplantation is one of the most complex in cardiothoracic surgery. Certain perioperative interventions, such as mechanical ventilation, fluid management and blood transfusions, use of extracorporeal mechanical support, and pain management, may have significant impact on the lung graft function and clinical outcome. This article provides a review of perioperative interventions that have been shown to impact the perioperative course after lung transplantation. Read More

Clin Podiatr Med Surg 2019 Jan 25;36(1):115-130. Epub 2018 Oct 25.

Foot and Ankle Surgery Residency, SSM Health DePaul Hospital, 12303 DePaul Drive, Suite B1, St Louis, MO 63044, USA. Electronic address:

Rheumatoid arthritis is a complex disease state with multiple associated comorbidities. Perioperative evaluation of the rheumatoid patient from a multidisciplinary approach is necessary to achieve favorable outcomes. A complete history and physical, laboratory, cervical, cardiovascular, pulmonary, and medication assessment before surgery should be performed. Read More

Saudi J Anaesth 2018 Oct-Dec;12(4):658-659

Division of Critical Care, Department of Anesthesia, Pain Management and Perioperative Medicine, Henry Ford Hospital, Detroit, Michigan, USA.

Saudi J Anaesth 2018 Oct-Dec;12(4):626-628

Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan, USA.

The prevalence of tracheal stents has increased in the past two decades for the management of malignant and benign central airway diseases for either palliation or definitive therapy. Recent placement of a tracheal stent has been associated with edema of the upper airway; therefore, these patients are at a great risk for airway collapse, especially within the days most recent to the procedure. The authors present the case of a morbidly obese patient with a tracheal stent admitted to the Intensive Care Unit who developed acute respiratory failure and was found to be "unable to ventilate, unable to intubate. Read More

Saudi J Anaesth 2018 Oct-Dec;12(4):565-570

Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt.

Background: Thoracotomy needs adequate powerful postoperative analgesia. This study aims to compare the safety and efficacy of ultrasound (US)-guided serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) for perioperative analgesia in cancer patients having lung lobectomy.

Patients And Methods: This clinical trial involved 90 patients with lung cancer scheduled for lung lobectomy randomly divided into three groups according to the type of preemptive regional block. Read More

Int J Obstet Anesth 2018 Sep 27. Epub 2018 Sep 27.

Cardiovascular Division, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA.

Cardiovascular disease is the leading cause of maternal mortality in much of the developed world. Risk stratification models can predict which patients are at greatest risk for maternal or fetal morbidity or mortality. Particular cardiac diseases hold significant risk of mortality during pregnancy including pulmonary hypertension, aortic aneurysm, left-ventricular outflow tract obstruction, and severe cardiomyopathy. Read More

Adv Anesth 2018 Dec;36(1):201-230

Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-7208, USA.

Paediatr Anaesth 2018 Nov 10. Epub 2018 Nov 10.

Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.

Pediatric pulmonary hypertension is a complex disease with multiple, diverse etiologies affecting the premature neonate to the young adult. Pediatric pulmonary arterial hypertension, whether idiopathic or associated with congenital heart disease, is the most commonly discussed form of pediatric pulmonary hypertension, as it is progressive and lethal. However, neonatal forms of pulmonary hypertension are vastly more frequent, and while most cases are transient, the risk of morbidity and mortality in this group deserves recognition. Read More

J Cardiothorac Vasc Anesth 2018 Oct 10. Epub 2018 Oct 10.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ. Electronic address:

Panminerva Med 2018 Oct 31. Epub 2018 Oct 31.

Department of Anesthesiology, Resuscitation and Intensive Care, University of Chieti-Pescara, Chieti, Italy.

In the last decades, the use of flexible bronchoscopy (FB) has greatly increased in intensive care, anesthesia and thoracic surgery for diagnostic purpose, management of critical patients and to facilitate airway management for tracheal intubation, one lung ventilation and lung transplant management. The huge availability of endoscopic instruments and devices for airway management has amplified indications and possibilities for bronchoscopic procedures performed by intensive care physicians, anesthesiologist, endoscopists, and surgeons too. These practices need adequate technical skills that can be acquired only through defined learning pathways. Read More

Transfusion 2019 Jan 1;59(1):207-216. Epub 2018 Nov 1.

Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Background: Tranexamic acid (TXA) therapy is effective in reducing postoperative red blood cell (RBC) transfusion in total joint arthroplasty (TJA), yet uncertainty persists regarding comparative efficacy and safety among specific patient subgroups. We assessed the impact of a universal TXA protocol on RBC transfusion, postoperative hemoglobin (Hb), and adverse outcomes to determine whether TXA is safe and effective in TJA, both overall and in clinically relevant subgroups.

Study Design And Methods: A retrospective observational study was performed on patients undergoing TJA at our institution spanning 1 year before and after the implementation of a universal protocol to administer intravenous (IV) TXA. Read More

Paediatr Anaesth 2019 Jan 29;29(1):8-15. Epub 2018 Oct 29.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.

Cardiac catheterization is an integral part of medical management for pediatric patients with congenital heart disease. Owing to age and lack of cooperation in children who need this procedure, general anesthesia is typically required. These patients have increased anesthesia risk secondary to cardiac pathology. Read More

A A Pract 2018 Oct 26. Epub 2018 Oct 26.

From the Departments of Anesthesia.

We report the perioperative management of a patient with pulmonary hypertension under new-generation treatments who underwent laparoscopic surgery. Preoperatively, arterial catheter, central venous line, and transesophageal echocardiography probe were inserted in addition to standard monitoring. Intraoperatively, inhaled nitric oxide was used because of increasing pressure in the right heart chambers related to the Trendelenburg position and the pneumoperitoneum. Read More

Urology 2018 Oct 23. Epub 2018 Oct 23.

Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI; Division of Urology, Rhode Island Hospital and The Miriam Hospital, Providence, RI. Electronic address:

Objectives: To characterize the perioperative morbidity of transurethral resection of bladder tumor (TURBT) in order to identify important determinants of both quality and cost in the delivery bladder cancer care.

Methods: We identified 24,100 patients aged 18-89 years who underwent TURBT from 2010 to 2015 in the National Surgical Quality Improvement Program database. Multivariable logistic regression was performed to evaluate the associations of patient features and tumor size (<2 cm, 2-5 cm, or >5 cm) with 30-day perioperative outcomes. Read More

Int J Spine Surg 2018 Oct 15;12(5):533-542. Epub 2018 Oct 15.

Department of Neurological Surgery, University of California, San Diego, La Jolla, California.

Background: Operative management of lower back pain often necessitates anterior lumbar interbody fusion (ALIF) or transforaminal lumbar interbody fusion (TLIF). Specific pathoanatomic advantages and indications exist for both approaches, and few studies to date have characterized comparative early outcomes.

Methods: Adult patients undergoing elective ALIF or TLIF operations were abstracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) years 2011-2014. Read More

Am J Surg 2018 Oct 17. Epub 2018 Oct 17.

Lung Transplant Program, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Mail Stop F749, 1635 Aurora Court, Aurora, CO, 80045, USA. Electronic address:

Background: Alpha 1 Antitrypsin Deficiency (AATD) is a genetic cause of emphysema/chronic obstructive pulmonary disease (COPD) and liver disease, making AATD patients a high-risk surgical group. Additionally, patients may eventually require lung and/or liver transplantation or lung volume reduction surgery (LVRS). This narrative review discusses perioperative considerations for elective procedures in AATD patients, and reviews patient outcomes in AATD-related transplantation and LVRS. Read More

Case Rep Crit Care 2018 23;2018:1584134. Epub 2018 Sep 23.

Department of Critical Care Medicine, Mayo Clinic Florida, USA.

Postobstructive pulmonary edema (POPE) also known as negative pressure pulmonary edema (NPPE) is an underdiagnosed entity in clinical practice and can lead to life-threatening hypoxemia. A 64-year-old male patient's perioperative course was complicated by acute hypoxemic respiratory failure, after extubation following general anesthesia, following the excision of the right vocal cord papilloma. His chest X-ray showed features of pulmonary edema, EKG showed dynamic ST-T changes in the lateral leads, and echocardiography showed evidence of regional motion abnormalities. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2018 Oct;50(5):928-931

Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

To investigate the pathophysiology, screening, diagnosis and treatment of the systemic lupus erythematosus (SLE) in pregnancy complicated with pulmonary hypertension. Retrospective analysis was made of one case of SLE in pregnancy complicated with pulmonary hypertension in Peking University Third Hospital. Literature was reviewed to investigate the pathophysiology, screening, diagnosis and treatment of the SLE in pregnancy complicated with pulmonary hypertension. Read More