Academic literature on the topic 'Palliative procedure'
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Journal articles on the topic "Palliative procedure"
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Rodriguez, Rodrigo Andres, Molly McClain, Bridget N. Fahy, and Katherine Teresa Morris. "Estimation of risk in cancer patients undergoing palliative procedures by the American College of Surgeons risk calculator." Journal of Clinical Oncology 32, no. 31_suppl (2014): 93. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.93.
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93 Background: Surgical palliation is defined as the use of a procedure in patients with incurable disease to relieve symptoms. The American College of Surgeons Risk Calculator (ACSRC) was created based on data from the National Surgical Quality Improvement Program to predict the risk of surgical complications on a patient specific level. Whether the ACSRC can accurately predict the risk of postoperative complications following palliative procedures in cancer patients is unknown. The purpose of this study was to determine if the ACSRC accurately predicted postoperative complication rates in this setting. Methods: Our surgical oncology database of patients treated from 2011 to 2013 was queried. Thirty-two patients who underwent palliative procedures were identified. Data extracted included: demographics, comorbidities, site and stage of cancer, type of procedure and post-operative complication rate and type. Risk assessment was performed for each patient using the ACSRC. Actual frequency of complications and length of stay (LOS) were compared to ACSRC predicted rate of complications and LOS. Results: See Table. Conclusions: The ACSRC is a powerful tool for aid in surgical decision-making; however, in the case of palliative procedures, it overestimated the risk of postoperative complications and underestimated the LOS. Overestimation of postoperative complications could result in fewer patients being offered potentially beneficial palliative procedures. [Table: see text]
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Deo, S. V. S., Naveen Kumar, Vinaya Kumar J. Rajendra, et al. "Palliative Surgery for Advanced Cancer: Clinical Profile, Spectrum of Surgery and Outcomes from a Tertiary Care Cancer Centre in Low-Middle-Income Country." Indian Journal of Palliative Care 27 (August 12, 2021): 281–85. http://dx.doi.org/10.25259/ijpc_399_20.
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Objectives: Palliative surgery for cancer plays an important role in the overall management, especially in low-middle countries with a significant burden of advanced cancers. There is a paucity of literature related to the field of palliative surgery. In this study, we present the clinical spectrum, profile of surgical interventions and outcomes of palliative surgical procedures performed at a tertiary cancer centre involving multiple organ systems. Materials and Methods: A retrospective analysis of prospectively maintained surgical oncology database of a tertiary care cancer centre was performed. Patients fulfilling the criteria of palliative surgery were analysed for clinical spectrum, indications for surgery, palliative surgical procedures and post-operative outcomes. Results: A total of 678 out of 8300 patients fulfilled the criteria for palliative surgery. Palliative surgical procedures were performed most commonly for gastro-oesophageal malignancies (36.4%) followed by colorectal cancers (24%) and breast cancer (12%). Palliative mastectomy was the most common procedure performed for advanced breast cancer and 7% of sarcoma patients had amputations. Symptom relief could be achieved in 80–90% of patients and post-operative morbidity was relatively high among hepatobiliary, gastrointestinal and gynaecological cancer patients. Conclusion: Globally, a significant number of cancer patients need palliative surgical intervention, especially in LMIC with a high burden of advanced cancers. Results of the current study indicate that gastrointestinal cancer patients constitute a major proportion of patients undergoing palliative surgery. Overall results of the current study indicate that excellent palliation can be achieved in majority of patients with acceptable morbidity and hospital stay.
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Plevová, Ilona, and Lenka Kadlubová. "Standard operating procedure - palliative care." Central European Journal of Nursing and Midwifery 14, no. 1 (2023): 823–32. http://dx.doi.org/10.15452/cejnm.2022.13.0022.
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Miner, T. J., J. Gaydos-Gabriel, and D. P. Jaques. "Palliative procedures in patients with advanced lung cancer: Analysis from a prospective outcomes database." Journal of Clinical Oncology 24, no. 18_suppl (2006): 8606. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.8606.
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8606 Background: Decisions regarding the appropriate use of palliative procedures continue to challenge those who care for patients with advanced cancer. This study examines the outcomes of palliative procedures performed for lung cancer compared to other primary malignancies. Methods: Procedures to explicitly palliate symptoms of advanced cancer were identified prospectively. Patients were observed for >90 days or until death. Clinical outcomes were evaluated based on the type of primary malignancy. Results: There were 1,022 palliative procedures performed in 823 patients from July 2002 to June 2003. Palliative procedures were most commonly performed in patients with lung cancer (14%, 117/823) for neurologic symtpoms-39%, shortness of breath-29%, gastrointestinal obstruction-15%, and other symtpoms-17%. Symptom improvement or resolution within 30 days was less common in patients with lung cancer (66%, 77/117) than in those with other primary malignancies (82%, 579/706, p=0.02). As observed in other cancers, recurrence of the primary symptom occurred in 25% (p=0.46) while treatment of debilitating additional symptoms was required in 30% (p=0.39). Palliative procedures in patients with lung cancer were associated with similar 30-day postoperative morbidity (33% versus 34%, p=0.97) but increased mortality (22% versus 10%, p<0.001). Median overall survival from the time of the palliative procedure was significantly shorter in patients with lung cancer than all other primary malignancies (90 days versus 124 days, p<0.001). Conclusions: Careful patient selection for palliative procedures is required in patients with advanced lung cancer. These interventions are associated with shorter anticipated survival, higher perioperative mortality and less frequent symptom resolution compared to palliative procedures performed in patients with other primary malignancies. Symptom severity may necessitate, however, palliative procedures in patients with lung cancer. The compelling nature of shortness of breath often dictates intervention regardless of durability and illustrates the importance of symptom relief for a significant percentage of remaining life even when measured in days. No significant financial relationships to disclose.
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Marais, M. J., and C. S. De Vries. "An audit of percutaneous biliary stenting for the palliation of pancreatic cancer: Results, post-procedural survival period, and comparison of plastic and mental stents." South African Journal of Radiology 6, no. 2 (2002): 18–20. http://dx.doi.org/10.4102/sajr.v6i2.1441.
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The purpose of this retrospective study was to assess the patient survival period after palliative biliary stenting and to compare different kinds of stents used. During a 27-month period, 60 patients received palliative percutaneous biliary stents for obstructive jaundice due to carcinoma of the head of the pancreas. During the first procedure 17 patients received (metal) Wall stents (mean age 59.8 years, range 32 - 77 years), and 43 patients received (plastic) Carey Coons stents (mean age 62.3 years, range 31 - 87 years). In 12 patients the stent had to be replaced due to complications and 1 patient had a second replacement. All replacement stents were plastic except in 2 cases. Two out of 17 (11.7%) metal stents and 10 out of 43 (23.2%) plastic stents had to be replaced. The median post-procedural survival period was determined between the date of procedure and the date of death. There was a marked clinical improvement of jaundice in all patients with their follow-up within a few days. More plastic stents were replaced. The average post-procedural survival period for 41 patients was 85.6 days, which is on par with internationally accepted survival periods. The most cost-effective biliary stent must be used for palliation because of the very short survival rate of this disease. For patients with no surgical options this procedure yields excellent results in comparison with the high morbidity and mortality rates of palliative surgical bypass procedures.
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Ma, Kai, Lei Qi, Zhongdong Hua, et al. "Effectiveness of Bidirectional Glenn Shunt Placement for Palliation in Complex Congenitally Corrected Transposed Great Arteries." Texas Heart Institute Journal 47, no. 1 (2020): 15–22. http://dx.doi.org/10.14503/thij-17-6555.
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Surgery for complex congenitally corrected transposed great arteries is one of the greatest challenges in cardiovascular surgery. We report our experience with bidirectional Glenn shunt placement as a palliative procedure for complex congenitally corrected transposition. We retrospectively identified 50 consecutive patients who had been diagnosed with congenitally corrected transposition accompanied by left ventricular outflow tract obstruction and ventricular septal defect and who had then undergone palliative bidirectional Glenn shunt placement at our institution from January 2005 through December 2014. Patients were divided into 3 groups according to subsequent surgeries: Fontan completion (total cavopulmonary connection, 13 patients) (group 1), anatomic repair (hemi-Mustard and Rastelli procedures without Glenn takedown, 11 patients) (group 2), and prolonged palliation (no further surgery, 26 patients) (group 3). After shunt placement, no patient died or had ventricular dysfunction. Overall, mean oxygen saturation increased significantly from 79.5% ± 13.5% preoperatively to 94.1% ± 7.3% (P &lt;0.001). The median time from shunt placement to Fontan completion and anatomic repair, respectively, was 2.1 years (range, 1.6–5.2 yr) and 1.1 years (range, 0.6–2.4 yr). Only 2 late deaths occurred, both in group 1. In group 3, time from shunt placement to latest follow-up was 4.5 years (range, 2.3–8 yr). At latest follow-up, mean oxygen saturation was 91.6% ± 10.3%, and no patients had impaired ventricular function. Bidirectional Glenn shunt placement as an optional palliative procedure for complex congenitally corrected transposition has favorable outcomes. Later, patients can feasibly be treated by Fontan completion or anatomic repair. Use of a bidirectional Glenn shunt for open-ended palliation is also acceptable.
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Cheatham, Sharon L., and Grace M. Deyo. "Understanding the Hybrid Stage I Approach for Hypoplastic Left Heart Syndrome." Critical Care Nurse 36, no. 5 (2016): 48–55. http://dx.doi.org/10.4037/ccn2016894.
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Hybrid stage I palliation combines cardiothoracic surgery and interventional transcatheter procedures for treatment of hypoplastic left heart syndrome. The approach is an alternative to the Norwood procedure, the traditional first stage of surgical palliation. Hybrid stage I palliation involves placing bilateral branch pulmonary artery bands and a patent ductus arteriosus stent through a median sternotomy, performed without cardiopulmonary bypass. The purpose of the bands is to control blood flow to the lungs and protect the pulmonary bed while the stent sustains systemic cardiac output. A balloon atrial septostomy is performed to create an atrial septal defect for unobstructed blood flow from the left atrium to the right atrium. The second stage of palliative surgery is the comprehensive stage II, which incorporates removal of the stent and pulmonary artery bands, atrial septectomy, anastomosis of the diminutive ascending aorta to the main pulmonary artery, aortic arch augmentation, and bidirectional cavopulmonary anastomosis. The traditional Fontan procedure completes the series of palliation.
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MacLaughlan David, Shannon, Nicole Marjon, Diana English, Natasha Purington, Summer S. Han, and Don S. Dizon. "Palliative Total Pelvic Exenteration for Gynecologic Cancers: A Cross-sectional Study of Society of Gynecologic Oncology Members." International Journal of Gynecologic Cancer 28, no. 9 (2018): 1796–804. http://dx.doi.org/10.1097/igc.0000000000001371.
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ObjectiveThe aim of this study was to evaluate contemporary practices and opinions among gynecologic oncologists regarding the use of total pelvic exenteration (TPE) for palliative intent.MethodsThis cross-sectional study of the membership of the Society of Gynecologic Oncology utilized an electronic survey to assess the opinions and practice patterns of gynecologic oncologists regarding TPEs. The primary outcome was willingness to consider a TPE for palliative intent, and demographic and practice characteristics were collected for correlation. Qualitative data were also collected. Descriptive statistics are presented, and χ2 tests, Fisher exact tests, and logistic regression analyses were used.ResultsWe included 315 surveys for analysis, for a completed response rate of 23.5%. Approximately half (52.4%, n = 165) of respondents indicated willingness to consider palliative TPE. When controlled for all variables, gynecologic oncologists who were more than 10 years out of fellowship were less likely to perform a palliative exenteration (odds ratio, 0.55; 95% confidence interval, 0.30–0.98), whereas those who reported experience with minimally invasive exenteration were more likely to offer it for palliation (odds ratio, 2.20; 95% confidence interval, 1.07–4.73). Fifty-three respondents (16.8%) provided qualitative data. The themes that emerged as considerations for TPE as palliation were (1) symptoms and quality of life, (2) surgical and perioperative morbidity, (3) anticipated overall survival, (4) counseling and informed consent, (5) functional status and comorbidities, (6) likelihood of residual disease, and (7) alternative procedures available for palliation.ConclusionHalf of gynecologic oncologists seem to be willing to offer a palliative TPE, although more-experienced gynecologic oncologists are more likely to reserve the procedure for curative intent.
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Gobergs, Roberts, Elza Salputra, and Ingūna Lubaua. "Hypoplastic left heart syndrome: a review." Acta medica Lituanica 23, no. 2 (2016): 86–98. http://dx.doi.org/10.6001/actamedica.v23i2.3325.
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Background. Hypoplastic left heart syndrome (HLHS) is an etiologically multifactorial congenital heart disease affecting one in 5,000 newborns. Thirty years ago there were no treatment options for this pathology and the natural course of the disease led to death, usually within the first weeks of life. Recently surgical palliative techniques have been developed allowing for a five-year survival in more than half the cases. Materials and methods. We reviewed literature available on HLHS, specifically its anatomy, embryology and pathophysiology, and treatment. The Pubmed and ClinicalKey databases were searched using the key words hypoplastic left heart syndrome, foetal aortic valvuloplasty, foetal septoplasty, Norwood procedure, bidirectional Glenn procedure, Fontan procedure, hybrid procedure. The relevant literature was reviewed and included in the article. We reported a case from Children’s Clinical University Hospital, Riga, to illustrate treatment tactics in Latvia. Results. There are three possible directions for therapy in newborns with HLHS: orthotopic heart transplantation, staged surgical palliation and palliative non-surgical treatment or comfort care. Another treatment mode – foetal therapy – has arisen. Staged palliation and full Fontan circulation is a temporary solution, however, the only means for survival until heart transplantation. Fifty to 70% of patients who have gone through all three stages of palliation live to the age of five years. Conclusions. The superior mode of treatment is not yet clear and the management must be based on each individual case, the experience of each clinic, as well as the financial aspects and will of the patient’s parents.
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Webb, Hannah. "Holistic care following a palliative Hartmann's procedure." British Journal of Nursing 2, no. 2 (1993): 128–32. http://dx.doi.org/10.12968/bjon.1993.2.2.128.
Full textDissertations / Theses on the topic "Palliative procedure"
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Minata, Mauricio Kazuyoshi. "Próteses metálicas ou gastrojejunoanastomose no tratamento paliativo da obstrução gastroduodenal: revisão sistemática e metanálise." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-28092018-115210/.
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Introdução: obstrução gastroduodenal maligna é uma condição frequente em neoplasias gástricas e pancreáticas em estágio avançado. O tratamento paliativo visa a melhora dos sintomas e da qualidade de vida, sendo realizado pelas técnicas cirúrgicas ou endoscópicas. Embora a terapêutica cirúrgica seja consagrada, as complicações relacionadas ao procedimento e as condições clínicas desfavoráveis dos pacientes devem ser consideradas. Apesar dos avanços do tratamento endoscópico e da possibilidade de oferecer um tratamento menos invasivo, deve-se considerar as complicações e a taxa de reintervenção desta modalidade terapêutica. Novas tecnologias foram desenvolvidas para minimizar as complicações relacionadas ao uso de próteses e demandam uma análise pormenorizada. O objetivo desta revisão sistemática é comparar o tratamento endoscópico com próteses cobertas e não cobertas e o cirúrgico com gastrojejunoanastomose para obstrução gastroduodenal. Métodos: ensaios clínicos randomizados foram identificados nas bases de dados do MEDLINE, Embase, Cochrane, LILACS, SCOPUS e CINAHL. A comparação entre as próteses metálicas cobertas e não cobertas incluiu o sucesso técnico, sucesso clínico, complicações, obstrução, migração, sangramento, perfuração, fratura das próteses e reintervenção. Os desfechos usados na comparação da terapêutica cirúrgica com gastrojejunoanastomose e endoscópica com próteses foram o sucesso técnico, complicações e reintervenção. A avaliação da patência não pode ser incluída devido à falta de uniformidade dos dados extraídos. Resultados: oito artigos foram selecionados, três comparando gastrojejunostomia e próteses e cinco comparando próteses cobertas e não cobertas. A metanálise dos estudos sobre gastroenteroanastomose e próteses não demonstrou diferença significativa no sucesso técnico e número absoluto de complicações. O tratamento com próteses apresentou uma maior taxa de reintervenção que a terapêutica cirúrgica (DR = 0,26, IC 95% = 0,05 a 0,47, NNH = 4). A metanálise que comparou próteses metálicas cobertas e não cobertas não demonstrou diferença estatística significativa considerando o sucesso técnico, sucesso clínico, complicações, fratura das próteses, perfuração, sangramento e necessidade de reintervenção. Uma maior taxa de migração foi atribuída à terapêutica com próteses cobertas (DR = 0,09, IC 95% = 0,04 a 0,14, NNH = 11). Entretanto, o tratamento com próteses cobertas apresenta menor taxa de obstrução em relação às não cobertas (DR = -0,21, IC 95% = -0,27 a -0,15, NNT = 5). Uma análise de subgrupo de estudos com próteses metálicas que incluíram apenas pacientes com câncer gástrico demonstrou resultado semelhante à metanálise com todos os artigos. Conclusões: o tratamento endoscópico paliativo da obstrução gastroduodenal maligna com próteses cobertas apresenta maior taxa de migração e menor número de obstruções quando comparado com o uso de próteses não cobertas. A terapêutica cirúrgica com gastrojejunoanastomose associa-se a uma menor taxa de reintervenção em relação ao uso de próteses<br>Introduction: malignant gastric outlet obstruction is a frequent condition in advanced gastric and pancreatic neoplasms. Palliative treatment can be performed by endoscopic or surgical techniques. Palliation aims to relief symptoms and increase quality of life. Although surgical therapy is the established treatment, the complication rate of the procedure and the unfavorable clinical conditions must be considered. Despite the advances in the endoscopic treatment and the possibility to offer a minimally invasive therapy, complication rate and need of reintervention must be reminded. New technologies have been developed to minimize the complications related to the use of stents and require a detailed analysis. This systematic review aims to compare surgery and covered and uncovered stent treatments for gastric outlet obstruction. Methods: randomized clinical trials were identified in MEDLINE, Embase, Cochrane, LILACs, BVS, SCOPUS and CINAHL databases. Comparison of covered and uncovered stents included: technical success, clinical success, complications, obstruction, migration, bleeding, perforation, stent fracture and reintervention. The outcomes used to compare Gastrojejunostomy and stents were technical success, complications and reintervention. Patency rate could not be included because of lack of uniformity of the extracted data. Results: eight studies were selected, three comparing gastrojejunostomy and stents and five comparing covered and uncovered stents. The meta-analysis of surgical and endoscopic stent treatment showed no difference in the technical success and overall number of complications. Stents had higher reintervention rates than surgery (RD: 0.26, 95% CI [0.05, 0.47], NNH: 4). There is no significant difference in technical success, clinical success, complications, stent fractures, perforation, bleeding and the need for reintervention in the analyses of covered and uncovered stents. There is a higher migration rate in the covered stent therapy compared to uncovered self-expanding metallic stents in the palliation of malignant gastric outlet obstruction (RD: 0.09, 95% CI [0.04, 0.14], NNH: 11). Nevertheless, covered stents had lower obstruction rates (RD: -0.21, 95% CI [-0.27, - 0.15], NNT: 5). A subgroup analysis with studies that included only patients with gastric cancer showed similar results when compared with the analysis with all trials. Conclusions: in the palliation of malignant gastric outlet obstruction, covered stents had higher migration and lower obstruction rates when compared with uncovered stents. Gastrojejunostomy is associated with lower reintervention rates than stents
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Loureiro, Jarbas Faraco Maldonado. "Drenagem biliar na paliação dos tumores malignos da confluência biliopancreática: estudo comparativo das abordagens cirúrgica e endoscópica ecoguiada." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-13082014-105934/.
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Introdução: A maioria dos pacientes acometidos pela neoplasia que envolve a confluência biliopancreática é diagnosticada em fase avançada. A Colangiopancreatografia Retrógrada Endoscópica (CPRE) é o método de escolha para a drenagem da via biliar obstruída. Todavia, existe um índice de insucesso em torno de 10%. Nesses casos, técnicas alternativas serão aplicadas, como drenagem percutânea trans-hepática e drenagens cirúrgicas. Objetivo: Avaliar o sucesso técnico, clínico, qualidade de vida e sobrevida da drenagem biliar pela cirurgia convencional e técnica endoscópica ecoguiada em pacientes portadores de neoplasia maligna da confluência biliopancreática. Método: No período de abril de 2010 a setembro de 2013, foram estudados 32 pacientes portadores de neoplasia maligna da confluência biliopancreática. Todos os que foram incluídos nesse estudo apresentaram falha na drenagem biliar por CPRE. Três deles foram excluídos por insucesso técnico (falha na confecção da anastomose hepaticojejunal e da formação da fístula coledocoduodenal ecoguiada). O Grupo I foi formado por 15 pacientes submetidos à Hepaticojejunostomia (HJT) em \"Y\" de Roux e derivação gastrojejunal. O Grupo II foi formado por 14 pacientes submetidos à coledocoduodenostomia ecoguiada (CDT). O sucesso clínico foi avaliado pela queda da bilirrubina sérica total em mais de 50% nos sete primeiros dias após o procedimento. A qualidade de vida foi avaliada pelo questionário SF-36 e a sobrevida pela curva de Kaplan-Meier. Resultados: O sucesso técnico foi de 93,75% (15/16) no Grupo I e de 87,5% (14/16) no Grupo II (p = 0,598). O sucesso clínico ocorreu em 14 (93,33%) pacientes pertencentes ao Grupo I e em 10 (71,43%) do Grupo II. Não houve diferença estatisticamente significativa (p = 0,169). O comportamento médio dos escores de qualidade de vida foi estatisticamente igual entre as técnicas ao longo do seguimento (p > 0,05 Técnica * Momento). Houve alteração média estatisticamente significativa ao longo do seguimento nos escores de capacidade funcional, saúde física, dor, aspectos sociais, aspectos emocionais e saúde mental em ambas as técnicas (p < 0,05). O escore de saúde mental foi, em média, estatisticamente maior nos do Grupo II (CDT) em todos os momentos (p = 0,035). O tempo médio de sobrevida daqueles pertencentes ao Grupo I foi de 82,27 dias e os do Grupo II, de 82,36 dias. Sessenta por cento dos pertencentes ao Grupo I faleceram até 90 dias após o procedimento cirúrgico. Por outro lado, 42,9% dos submetidos à CDT faleceram no mesmo período. Não houve diferença estatisticamente significativa no tempo de sobrevida entre os Grupos (p = 0,389). Conclusão: Os dados relacionados aos sucessos técnico, clínico, qualidade de vida e sobrevida foram semelhantes em ambos os grupos, não se verificando diferença estatisticamente significativa<br>Introduction: Most patients with neoplasm in the biliopancreatic junction are diagnosed at an advanced stage. Endoscopic retrograde cholangiopancreatography (ERCP) is the method of choice for drainage of obstructed biliary tract. However, there is a failure rate of about 10%. In such cases, alternative techniques, such as, percutaneous transhepatic drainage and surgical drainage are applied. Aim: To evaluate the technical and clinical success, quality of life and patient survival of biliary drainage by conventional surgery and endosonography-guided technique in patients with malignant neoplasm of the biliopancreatic junction. Methodology: From April 2010 to September 2013, 32 patients with malignant neoplasm of the biliopancreatic junction were studied. All patients included in this study had failed biliary drainage by ERCP. Three patients were excluded due to technical failure (failure in the construction of hepatico-jejuno anastomosis and formation of endosonography-guided choledochoduodenal fistula). Group I comprised of 15 patients who underwent Roux-en-Y hepaticojejunostomy (HJT) and gastrojejunal bypass. Group II consisted of 14 patients who underwent endosonography-guided choledochoduodenostomy (CDT). Clinical success was assessed by the decrease of more than 50% in total serum bilirubin in the first seven days after the procedure. Quality of life was assessed by SF-36 questionnaire and survival by Kaplan-Meier curve. Results: Technical success rate was 93.75% (15/16) in group I and 87.5% (14/16) in group II (p = 0.598). Clinical success occurred in 14 (93.33%) patients in group I and 10 (71.43%) patients in group II. There was no significant statistically difference (p = 0.169). The average quality of life score were statistically equal between the techniques during follow-up (p > 0.05 * Technical Moment). There were statistically significant mean changes during follow-up of functional capacity score, physical health, pain, social functioning, emotional and mental health aspects in both techniques (p < 0.05). The mental health score was, on average, statistically higher in group II (CDT) at all times (p = 0.035). The median survival time of patients in group I was 82.27 days and Group II patients was 82.36 days. Sixty percent of patients in group I died within 90 days after the surgical procedure. On the other hand, 42.9% of the patients who underwent CDT died in the same period. There was no statistically significant difference in survival time between the groups (p = 0.389). Conclusion: Data relating to technical and clinical success, quality of life and survival were similar in both groups and there were no statistically significant differences
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Schocket, Kimberly Gardner. "Presurgical behavioral medicine evaluation for implantable devices for pain management : clinical effectiveness for predicting outcomes." 2005. http://edissertations.library.swmed.edu/pdf/SchocketK081105/SchocketKimberly.pdf.
Full textBooks on the topic "Palliative procedure"
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United States. Acute Pain Management Guideline Panel. Acute pain management: Operative or medical procedures and trauma. Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services, 1992.
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Farrar, John T. Understanding clinical trials in palliative care research. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0193.
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Advances in basic science, translational, and clinical research have led to rapid improvements in our understanding of many disease processes. The randomized clinical trial (RCT) has played an important role in validating the benefits and harms of therapies thought to be potentially useful based on scientific theory or clinical observation, and has become the ‘gold standard’ for the demonstration of efficacy. As in all clinical study designs, the RCT has strengths and weaknesses that must be understood to appropriately interpret the study results. While randomization of the intended study population is the primary strength of such trials, choice of the study population, control condition, outcome measures, analysis procedure, and procedures for blinding the study participants can all affect the results. Understanding the requirements of a valid RCT and what can potentially go wrong will improve the conduct of palliative care research and the usefulness of published information in the care of patients.
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Sabharwal, Tarun, Nicos I. Fotiadis, and Andy Adam. Interventional radiology in the palliation of cancer. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0126.
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Over the past four decades, a variety of invasive diagnostic and therapeutic procedures have been developed by radiologists. The term ‘interventional radiology’ most appropriately refers to therapeutic procedures performed under imaging guidance. Interventional radiological procedures have virtually replaced several more invasive and hazardous surgical alternatives. Other interventional techniques offer completely new therapeutic options. Some diagnostic radiological procedures are frequently followed by therapeutic manoeuvres. Interventional radiology can make a significant contribution to the palliation of patients with irresectable malignant tumours, as many of the procedures can relieve symptoms without the need for general anaesthesia, a prolonged stay in hospital, or the discomfort associated with recovery from a surgical operation. The vast majority of procedures are performed using local anaesthesia and mild sedation. The emphasis in this chapter is on the indications, contraindications, and likely outcomes, rather than on detailed technical descriptions.
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Scheunemann, Leslie P., and Robert M. Arnold. Communication with patients and families in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0011.
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Regular, consistent communication with families of intensive care unit (ICU) patients is important for family satisfaction, patient-centred decision-making, and reducing the emotional burden of the ICU stay on family members. In fact, the family meeting can appropriately be considered a core procedure of intensive care practice. Good communication requirements include the appropriate clinicians and family members, providing a quiet and undisturbed setting, and choosing appropriate goals for each meeting. Clinicians should strive to develop skills for listening, observing family dynamics, and responding to emotions. ICU administrators should consider building processes of care to promote regular, consistent communication and partnerships with interdisciplinary teams, such as ethics committees and palliative care that can supplement these skills.
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Acute pain management in adults: Operative procedures. Executive Office Center, Agency for Health Care Policy and Research, Public Health Service, Dept. of Health and Human Services, 1992.
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Wilkinson, Ian B., Tim Raine, Kate Wiles, Anna Goodhart, Catriona Hall, and Harriet O’Neill. References. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199689903.003.0020.
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This chapter presents key references on chest medicine, endocrinology, gastroenterology, renal medicine, haematology, infectious diseases, neurology, oncology and palliative care, rheumatology, surgery, clinical chemistry, radiology, practical procedures, and emergency medicine
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Watson, Max, Caroline Lucas, Andrew Hoy, and Jo Wells. The management of pain. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199234356.003.0012.
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This chapter covers physical pain in patients with cancer, assessment of pain, pain classification, principles of pain management, breakthrough pain, step 1 analgesics, step 2 analgesics, and step 3 analgesics. The chapter also covers opioid equivalence for transdermal patches, approximate equivalent doses for opioid analgesics for adults, neuropathic pain, anaesthetic procedures in palliative care, chemical neurolysis for cancer pain, and pain and difficulties in communication.
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Meyer, Mark J., and Norbert J. Weidner. Do-Not-Resuscitate Orders in the OR. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0006.
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A physician signs a do-not-resuscitate order (DNR) when aggressive resuscitation measures will not benefit the patient in the presence of a life-threatening illness. Many children living with a life-threatening illness derive benefit from invasive diagnostic and therapeutic procedures such as tracheostomies, peripherally inserted central lines, gastrostomy tubes, and tumor debulking procedures. These procedures are considered palliative rather than curative in that they improve or preserve quality of life but do not prevent progression of the underlying condition. In children, the presence of a DNR order may not be a harbinger that death is imminent and can be consistent with pursuing life-prolonging interventions aimed at improving quality of life. However, these orders confound pediatric anesthesiologists who, during the conduct of a routine anesthetic, can cause cardiovascular and respiratory compromise.
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Sharma, Manohar, Karen H. Simpson, Michael I. Bennett, and Sanjeeva Gupta, eds. Practical Management of Complex Cancer Pain. 2nd ed. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780198865667.001.0001.
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This new edition of the Practical Management of Complex Cancer Pain has been fully updated and expanded, with five new chapters on novel interventional techniques in cancer pain amelioration. The book provides advice on advanced pain management, emphasising the suitability and selection of patients for different invasive and complex procedures based on patient history. Case histories are included throughout the text to give the reader insight into the complexities of holistic management, with pain being only one component in the distress that cancer causes for both patients and families. The book also covers cancer pain management for patients in a community setting, and the collaboration between pain and palliative medicine. Concise, practical, and evidence-based, this guide is essential reading for all pain and palliative care specialists in the community, hospital, and hospice settings.
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Gottlieb, Erin A., and David F. Vener. Single-Ventricle Physiology. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0026.
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Pediatric and adult patients with single ventricle physiology may present for elective and emergent procedures, and it is critical for pediatric anesthesiologists to be familiar with the stages of palliation. In addition, basic knowledge of how to manage each stage perioperatively is required to avoid morbidity and mortality. This chapter describes the anatomy and physiology of and ventilation and oxygenation strategies for each stage of single ventricle palliation. It also discusses the risks associated with anesthetizing the single-ventricle patient with a modified Blalock-Taussig shunt, the rationale for performing elective noncardiac surgery during the Glenn stage of the single ventricle pathway, and the effects of positive pressure ventilation on the patient with Fontan physiology. A perioperative plan for caring for single-ventricle patients undergoing noncardiac procedures is also covered.
Book chapters on the topic "Palliative procedure"
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Qu, Kai, Qing Yao, and Chang Liu. "Palliative Surgical Therapy: Palliative Bypass Procedure." In Surgical Atlas of Pancreatic Cancer. Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-32-9864-4_20.
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Chandran, SriKrishna, and Phong Kieu. "Spinal Procedure Injectables." In Pain Management and Palliative Care. Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-2462-2_37.
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Racca, P., B. Mussa, R. Ferracini, D. Righi, L. Repetto, and R. Spadi. "Tecniche palliative e procedure di supporto in oncologia chirurgica." In Nuove tecnologie chirurgiche in oncologia. Springer Milan, 2011. http://dx.doi.org/10.1007/978-88-470-2385-7_13.
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Do, Thomas B., Mark A. Scheurer, and Andrew M. Atz. "Palliative Procedures." In Pediatric Critical Care Medicine. Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6359-6_24.
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Scheffczik, Jutta. "Palliative Procedures." In Paediatric Cardiac Anaesthesia. Springer Nature Switzerland, 2025. https://doi.org/10.1007/978-3-031-90330-4_41.
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Bompoint, Caroline, Alberto Castagna, Daphna Hutt, et al. "Transplant Preparation." In The European Blood and Marrow Transplantation Textbook for Nurses. Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-23394-4_4.
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AbstractHSCT is a complex procedure, which involves a long and complicated pathway for the patient and the intervention of many health professionals. Within this multidisciplinary team, the transplant coordinator, usually a nurse, is the ‘essential marrow’, the heart and the vital backbone of this procedure; they are an essential transplant ingredient facilitating a fluidity of the pathway and a good transmission of information. Written information about the procedure is beneficial for patients either prior to clinic visit or during clinic to allow the patients and relatives to reflect on conversations. Transplantation carries a significant risk of morbidity and mortality, and these should be considered regarding the ‘need’ to transplant, based upon risk of disease, versus risk of the transplant. Pre-transplant assessments must also be undertaken, and the results of these along with suitable donor medical clearance and cell availability are essential to ascertain that transplant is a valid option and can proceed safely. Dealing with fertility preservation upon diagnosis of cancer is often challenging; this issue is even more complex for paediatric patients. PDWP recommends that counselling about fertility preservation opportunities should be offered to each patient receiving HSCT.This chapter also focuses on vascular access for optimal treatment of haematology patients because stem cell treatment cannot be performed without it. Constant advances in haematology have raised challenging ethical dilemmas concerning end of life, palliative care, patient information, donor concerns and impartiality and issues related to the risk we run to our patients. Nurses provide a key role in patient education, providing pre- and post-transplant advocacy and counselling, plan hospitalisations and consultations. They also act as educators and role models to nursing students and share knowledge in accordance with local policies and JACIE guidelines.
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Dietz, Andreas. "The Surgical Approach to Elderly Patients with HNSCC." In Critical Issues in Head and Neck Oncology. Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63234-2_8.
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AbstractDespite the fact that elderly people are the main incidental and continuously growing patient group with head and neck cancer, prospective trials focusing on special issues regarding head and neck surgery in elderlies are missing. To avoid complications during and after surgery in that patient category, comprehensive evaluation of functional status, comorbidities, performance status, social support and mental condition is mandatory. Regarding functional parameters, cardiac and respiratory conditions play a major role for any primary surgical procedure. Nevertheless, other comorbidities, medication and patients view on self-determination have carefully to be taken into consideration. It has repeatedly been shown that fit elderly individuals may benefit from intensive therapies like reconstructive surgery with microvascular free tissue transfer, concurrent chemoradiotherapy in the locoregionally advanced disease setting, and even from the standard first- and second-line palliative systemic therapies. Since it is well known that tolerance of systemic nonsurgical treatments in elderly people is less and therefore death from noncancer-related causes in that population is higher, moderate surgical procedures can be even more effective regarding quality of life in situations facing higher comorbidities, or functional constraints with limited life expectancy compared to nonsurgical standard approaches. Older people usually are at increased risk of postoperative complications. In particular, organ failure progresses much faster in multiple organ failure. The preoperative clarification of comorbidity for the avoidance of surgical complications is therefore of major importance. Close coordination with anesthesia and rapid postoperative mobilization are essential for this. Decision-making and treatment based on specific assessment in an experienced multidisciplinary team is key.
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Crupi, G., R. Pignatelli, M. Carminati, P. Ferrazzi, P. Abruzzese, and L. Parenzan. "Palliative Procedures for Double-Inlet Ventricle." In Pediatric Cardiology. Springer New York, 1986. http://dx.doi.org/10.1007/978-1-4613-8598-1_139.
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Herfarth, Ch, and H. W. Schreiber. "Palliative Procedures for Unresectable Gastric Carcinoma." In Surgery of the Stomach. Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-88327-9_12.
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Su, Po-Yi Paul, Ann Cai Shah, and Sarah Gebauer. "Interventional Pain Procedures in Palliative Care." In Textbook of Palliative Medicine and Supportive Care, 3rd ed. CRC Press, 2021. http://dx.doi.org/10.1201/9780429275524-29.
Full textConference papers on the topic "Palliative procedure"
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Haggerty, Christopher M., Lakshmi P. Dasi, Jessica Kanter, and Ajit P. Yoganathan. "Effect of Flow Pulsatility on 2nd Stage Fontan Hemodynamics: An In Vitro Investigation." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-204573.
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The Fontan procedure [1] is the staged, palliative surgical approach used to treat patients suffering from single ventricle congenital heart defects. The second stage of this procedure involves the connection of the superior vena cava (SVC) to the pulmonary arteries (PAs) in either an end-to-side (known as the Bi-Directional Glenn (BDG)) or side-to-side (or Hemi-Fontan (HF)) fashion. Because of obvious disparities at the connection site, there are understandable differences in the fluid dynamics between the two geometries.
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DeGan, Jonathan, Jeffrey Kennington, Kameswararao Anupindi, et al. "Modeling of Patient-Specific Fontan Physiology From MRI Images for CFD Testing of a Cavopulmonary Assist Device." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53339.
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Single ventricle heart disease is a congenital condition characterized by the inoperability of one ventricle of an infant’s heart. Those suffering from this condition face a series of palliative surgeries called the Fontan procedure, which bypasses the non-functional ventricle by creating a total cavopulmonary connection, or TCPC. This TCPC forms from the anastomosis of the superior and inferior vena cavae (SVC, IVC) to the left and right pulmonary arteries (LPA, RPA), thus allowing systemic blood flow to bypass the heart and flow passively to the lungs. The Fontan procedure creates this junction with three surgeries separated by months or years.
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Dur, Onur, Ergin Kocyildirim, Curt G. Degroff, Peter Wearden, Victor Morell, and Kerem Pekkan. "Effect of Caval Waveform on Energy Dissipation of Failing Fontan Patients." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206540.
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Last stage of the palliative surgical reconstruction (i.e. Fontan procedure) for the infants with functional single-ventricle is total cavopulmonary connection (TCPC), where the superior vena cavae (SVC) and inferior vena cavae (IVC) are routed directly into the pulmonary arteries. Limited pumping energy available due to the absence of right-ventricle and altered venous characteristics require optimized hemodynamics inside the TCPC pathway, which can be achieved by minimizing the power losses.
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Dur, Onur, Ergin Kocyildirim, Curt G. Degroff, et al. "Pulsatile Efficiency and Pediatric Venous Assist Options in Failing Fontan Patients." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19644.
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Single ventricle (SV) anomalies are the fifth most common heart defect (2000 patients per year) and the leading cause of death from all structural birth defects. Total cavopulmonary connection (TCPC) is the last stage of the palliative surgical reconstruction i.e. Fontan procedure for the infants with SV. A large number of children continue to benefit from the Fontan operation. However, despite many refinements of the surgical procedure in the past 20 years, a relatively high proportion of patients demonstrate a gradual decline in functional capacity and premature death. Most of these failing Fontan patients require heart transplantation [1]. However, donor shortage and the high-risk nature of transplantation for these complex and often very ill patients demand alternative therapeutic options.
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Restrepo, Maria, Lucia Mirabella, Elaine Tang, et al. "Investigation of Vessel Growth and its Impact on Hemodynamics in Patients With Lateral Tunnel Total Cavopulmonary Connection." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80329.
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Single ventricle heart defects affect 2 per 1000 live births in the US and are lethal if left untreated. The Fontan procedure used to treat these defects consists of a series of palliative surgeries to create the total cavopulmonary connection (TCPC), which bypasses the right heart. In the last stage of this procedure, the inferior vena cava (IVC) is connected to the pulmonary arteries (PA) using one of the two approaches: the extra-cardiac (EC), where a synthetic graft is used as the conduit; and the lateral tunnel (LT) where part of the atrial wall is used along with a synthetic patch to create the conduit. The LT conduit is thought to grow in size in the long term because it is formed partially with biological tissue, as opposed to the EC conduit that retains its original size because it contains only synthetic material. The growth of the LT has not been yet quantified, especially in respect to the growth of other vessels forming the TCPC. Furthermore, the effect of this growth on the hemodynamics has not been elucidated. The objective of this study is to quantify the TCPC vessels growth in LT patients from serial magnetic resonance (MR) images, and to understand its effect on the connection hemodynamics using computational fluid dynamics (CFD).
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Ceballos, Andres, Eduardo Divo, Ricardo Argueta-Morales, Christopher Calderone, Alain Kassab, and William DeCampli. "A Multi-Scale CFD Analysis of the Hybrid Norwood Palliative Treatment for Hypoplastic Left Heart Syndrome: Effect of Reverse Blalock-Taussing Shunt Diameter." In ASME 2013 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/imece2013-66856.
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A multiscale model of the neonatal Hypoplastic Left Heart syndrome (HLHS) circulation following the Hybrid Norwood procedure was used to obtain systemic and pulmonary perfusion rates as well as detailed hemodynamics in the aortic arch region. The effects varying degrees of aortic arch stenosis, an obstruction to flow through the mid aortic arch, were studied. Implementation of a 3.0mm and 4.mm reverse-BT shunt (RBTS), a synthetic bypass from the main pulmonary to the innominate artery, and its effects on local and global hemodynamics were also studied.
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Marques, Grazielle de Oliveira, Gabriel Nogueira Noleto Vasconcelos, Gabriel Rodrigues Gomes da Fonseca, et al. "Malignant cerebral infarction (MCI): Review of the benefits of decompression craniectomy (DC)." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.261.
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Background: MCI is caused by occlusion of the middle cerebral artery (MCA) or internal carotid artery. Causing large ischemias, which edema can exert a mass effect, usually between the 2nd and 5th day, resulting in intracranial hypertension, herniation and even death. Objective: Review data related to the benefits of DC, elucidating the procedure, prognosis and indications of the method. Method: Review on MEDLINE and PubMed platforms. The descriptors: “craniectomy” AND “malignant infarction”. Were selected 9 articles dated between 2016 and 2021. Results: MCI has some clinical (Youngs, NIHSS>15, neurological deterioration) and radiological predictors (Impairment> 50% of the ACM territory, midline deviation> 5mm, MRI with DWI> 145 cm3). These patient’s clinical aim is to reduce intracranial pressure (ICP), however, as a consequence of the worse prognosis in clinical therapy, there’s a possibility of intervention by DC, which is a surgical technique that relieves ICP and prevents secondary injuries. It reduces the mortality rate and increases the patient’s survival up 3x compared to clinical management, but at the expense of low quality of life. Patients ≤60 years with loss of consciousness, must have an indication for DC within 48 hours after ictus. The indication should be better evaluated and a thorough discussion with family members. Conclusion: DC minimizes injuries and the risk of herniation. However, despite decreasing mortality, it can lead to complications and poor prognosis, although it isn’t uncommon the indication for the procedure and an approach to palliative care.
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Vukicevic, Marija, Timothy A. Conover, Jian Zhou, Tain-Yen Hsia, and Richard S. Figliola. "In Vitro Study of Pulmonary Vascular Resistance in Fontan Circulation With Respiration Effects." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80888.
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The Fontan operation is the final stage of palliative surgery for children born with single ventricle heart defects. The most common configuration is called total cavopulmonary connection (TCPC), wherein the inferior vena cava and superior vena cava are anastomosed directly to the pulmonary arteries; therefore the pulmonary circulation is driven by venous pressure only. The Fontan procedure, although successful in the early postoperative period, with time can decrease in efficiency or even fail within several years after the operation. The reasons of different clinical outcomes for some of the Fontan patients are not clear enough, even though it is commonly accepted that certain factors such as low pulmonary vascular resistance and proper shape and size of the TCPC construction are crucial for the succesful long term outcomes. Accordingly, one of the major problems is the increase in pulmonary vascular resistance due to altered hemodynamics after the surgery, causing venous hypertension and respiratory-dependent pulmonary regurgitation [1]. The main pulmonary arteries may also see increased resistance due to congenital malformations, surgical scarring, or deliberate surgical banding. Thus, the consequence of the increased pulmonary vascular resistance at both proximal and distal locations with respect to the TCPC junction, and its effect on the systemic pressures and flow rates, is the main objective of this study.
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Khiabani, Reza H., Maria Restrepo, Elaine Tang, Diane De Zélicourt, Mark Fogel, and Ajit P. Yoganathan. "Effect of Flow Pulsatility on Modeling the Total Cavopulmonary Hemodynamics: A Numerical Investigation." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80751.
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Single Ventricle Heart Defects (SVHD) are present in 2 per 1000 live births in the US. SVHD are characterized by cyanotic mixing between the de-oxygenated blood from the systemic circulation return and the oxygenated blood from the pulmonary arteries. Palliative surgical repairs (Fontan procedure) are performed to bypass the right ventricle in these patients. In current practice, the surgical interventions commonly result in the total cavopulmonary connection (TCPC). In this configuration the systemic venous returns (inferior vena cava, IVC, and superior vena cava, SVC) are directly routed to the right and left pulmonary arteries (RPA and LPA), bypassing the right heart. The resulting anatomy has complex and unsteady hemodynamics characterized by flow mixing and flow separation. Pulsation of the inlet venous flow during a cardiac cycle results in complex and unsteady flow patterns in the TCPC. Although various degrees of pulsatility have been observed in vivo, non-pulsatile (time-averaged) flow boundary conditions have traditionally been assumed in modeling TCPC hemodynamics, and only recently have pulsatile conditions been incorporated without completely characterizing their effect or importance. In this study, 3D numerical simulations were performed to predict TCPC hemodynamics with both pulsatile and non-pulsatile boundary conditions and to investigate the accuracy of applying non-pulsatile boundary conditions. Flow structures, energy dissipation rate and pressure drop were compared under rest and estimated exercise conditions. The results show that TCPC hemodynamics can be strongly influenced by the presence of pulsatile flow. However, there exists a minimum pulsatility threshold, identified by defining a weighted pulsatility index (wPI), above which the influence is significant.
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Menon, Prahlad G., Nikola Teslovich, Chia-Yuan Chen, Fotis Sotiropoulos, Akif Undar, and Kerem Pekkan. "Device Specific Aortic Outflow Cannula Jets Studied Using 2D PIV and High-Performance 3D CFD Simulation." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80454.
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In the US, approximately 1 in 100 children are born with a clinically significant congenital heart defect (CHD). The palliative repair of these defects requires complex biventricular and univentricular surgical operations in newborns often smaller than 2 kg. However, recovery after neonatal intervention remains suboptimal 1. A major component of these surgeries is the cardiopulmonary by-pass (CPB) procedure which if prolonged can potentially lead to neurological complications and developmental defects in a young patient. During CPB, tiny aortic cannulae (2–3 mm inner diameter), with micro-scale blood-wetting features transport relatively large blood volumes (0.3 to 1.0 L/min) resulting in high blood flow velocities. Our recent 3D computational fluid dynamics (CFD) simulations of jet flows in device specific cannulae 2 have indicated that the turbulent jet wake at high physiological neonatal extracorporeal life support (ECLS) circuit blood flow rates can potentially have damaging hemolytic effects, when evaluated in a cuboidal flow domain, as well as in in-silico aortic insertion configurations. Such severe flow conditions can result in platelet activation, vascular injuries and blood damage. Despite these risks, cannulation methods have received little attention compared to the effort expended to assure the safety and efficacy of the mechanical circulatory support blood pumps. Qui et al 3 report that cannula problems are the second most frequently reported mechanical complication in ECLS therapy for respiratory cases and the third most frequent complication in cardiac cases. The purpose of this study is to quantitatively evaluate the jet wake region of two popular 8FR pediatric cannulae, DLP Medtronic 77008 and RMI FEM II – 008 – AT (inner diameter ∼1850 microns), using stereo particle image velocimetry (PIV) to validate numerically computed flow fields.
Reports on the topic "Palliative procedure"
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Ma, Bingqing, Tianxing Ren, Chengjun Cai, Biao Chen, and Jinxiang Zhang. Palliative procedures for advanced obstructive colorectal cancer: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2024. http://dx.doi.org/10.37766/inplasy2024.7.0114.
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