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Barthelsson, Cajsa. "Laparoscopic cholecystectomy : patients' experiences and self-reported symptoms the first week after sugery /." Stockholm, 2007. http://diss.kib.ki.se/2007/20071220bart/.
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Imamura, Kyoko. "The impact of comorbidity on the outcome of total hip replacement in Japan and the United Kingdom." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1995. http://researchonline.lshtm.ac.uk/682270/.
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The impact of comorbidity on patient outcomes following an intervention has been largely ignored. No studies have been reported in the UK or Japan. The aim of this thesis was to assess the impact of comorbidity on the outcome of a common major surgical operation - total hip replacement. Comorbidity was measured using the Index of Co-Existent Disease developed in the USA, which reliability was assessed. Two retrospective cohorts, one in Japan and one in the UK were studied. Data were collected from patients' case notes extraction and by postal questionnaire to patients one year after surgery. After THR, patient's health status was improved in both countries and satisfaction for care was high. Significant differences in in-hospital complications were observed between Japan and the UK in terms of complication rate. type and severity, and their association with independent variables. Comorbidity was significantly associated with serious complications and with change in health status in the UK and with minor complications in Japan. A logistic regression model using the ICED and independent confounding factors suggested a significant relationship between comorbidity and complications. However, the model did not fit the data well. A multiple regression model for change in health status showed that much of the variance was explained by the preoperative health status but not by comorbidity. The low number of serious complications in Japan and the high complication rate in patients in the lowest comorbidity severity level in the UK made the predictive power weak. Finally, through the experience of this study, some recommendations for clinical practice and further research are discussed.
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Pettersson, Max. "REBUS BMI and renal surgery, perioperative outcomes and postoperative complications." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-55310.
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Shaw, P. J. "Neurological and neurophysiological complications of coronary artery bypass graft surgery." Thesis, University of Newcastle Upon Tyne, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380746.
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Kelava, Marta. "HOSPITALIZATION PRIOR TO CARDIAC SURGERY AND RISK FOR POSTOPERATIVE INFECTIOUS COMPLICATIONS." Case Western Reserve University School of Graduate Studies / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1390513551.
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Lapidus, Lasse. "Thromboembolism following orthopaedic surgery : outcome and diagnostic procedures after prophylaxis in lower limb injuries /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-111-1/.
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Blåder, Karin, and Karl Sunneskär. "Påverkar val av anestesimedel den dagkirurgiska patientens postoperativa återhämtning? : En jämförelse mellan Propofol och Sevofluran." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-26285.
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Intravenös anestesi med Propofol eller inhalationsanestesi med gasen Sevofluran är de två vanligaste anestesiformerna i Sverige. Syftet med studien vara att undersöka om patienters postoperativa återhämtning skiljer sig åt beroende på om de sövts med Propofol eller Sevofluran. Datainsamlingen till studien genomfördes med systematisk litteraturöversikt baserad på integrativ metod. Både kvalitativa och kvantitativa studier samlades in, men enbart kvantitativa artiklar inkluderades. Resultatet visade att det under den postoperativa återhämtningen var vanligt förekommande med två postoperativa komplikationer, smärta samt illamående och kräkningar. Resultatet visar inga statistiskt signifikanta skillnader när det gällde dessa beroende på val av anestesimedel. Men vidare studier behövs inom ämnet, framför allt om kön eller ålder kan vara ytterligare påverkande faktorer.Intravenous anesthesia with Propofol or inhalation anesthesia with the gas Sevoflurane are the two most common forms of anesthesia in Sweden. The purpose of the study was to investigate whether patient's postoperative recovery differs depending on whether they have been anesthetized with Propofol or Sevoflurane. The data collection for the study was carried out with a systematic literature review based on integrative research Both qualitative and quantitative studies were collected, but only quantitative articles were included. The results showed that during postoperative recovery it was common with two postoperative complications, pain, nausea, and vomiting. The results show no statistically significant differences in these depending on the choice of anesthetic agents. However, further studies are needed in the subject, especially if gender or age can be additional influencers.
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Waage, Anne. "On gallstone disease : complications and surgical treatment /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-550-X/.
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Kugelberg, Maria. "Prevention of complications in pediatric cataract surgery /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-111-3/.
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Stenberg, Erik. "Preventing complications in bariatric surgery." Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-50649.
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Obesity is a major public health problem. Bariatric surgery is currently the only available treatment that offers sufficient weight-loss and metabolic benefits over time. Although bariatric surgery is considered safe now, serious complications still occur. The aim of this thesis was to identify factors associated with an increased risk for postoperative complication after laparoscopic gastric bypass surgery. Study I included patients operated with laparoscopic gastric bypass surgery in Sweden from May 2007 until September 2012. The risk for serious complication was low (3.4%). Suffering an intraoperative adverse event or conversion of the operation to open surgery were the strongest risk factors for postoperative complication. The annual operative volume and experience of the procedure at the institution were also important risk factors. Patient-specific risk factors appeared to be less important although age was associated with an increased risk. In Study II, a raised glycated haemoglobin A1c (HbA1c) was evaluated as a risk factor for serious postoperative complications in non-diabetics. A higher incidence of serious postoperative complications was seen with elevated HbA1c values, even at levels classified as ‘‘pre-diabetic’’. Study III was a multicentre, randomised clinical trial (RCT). 2507 patients planned for laparoscopic gastric bypass surgery were randomised to either mesenteric defects closure or non-closure. Closure of the mesenteric defects reduced the rate of reoperation for small bowel obstruction from 10.2% to 5.5% at 3 years after surgery. A small increase in the rate of serious postoperative complication within the first 30 days was seen with mesenteric defects closure. This relatively small increase in risk was however outweighed by the marked reduction of later reoperations for small bowel obstruction. Study IV was a comparison between study III and an observational study on the same population under the same period of time. Although the observational study reached the same conlusion as the RCT, the efficacy of mesenteric defects closure was less pronounced. Observational studies may thus be an alternative to RCTs under situations when RCTs are not feasible. The efficacy may however be underestimated.
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Andalib, Amin. "The influence of postoperative complications on long-term survival of lung cancer patients." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=107586.
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Background: Surgery is essential to any curative plan for lung cancer, but is associated with a high complication rate, which in turn increases short-term mortality. However, the impact of postoperative morbidity on long-term oncologic outcomes is not understood well. Objectives: We sought to determine the impact of complications on long-term survival after a curative surgery for lung cancer, independent of the effect on early postoperative mortality. Methods: We studied a population-based cohort of patients with lung cancer who underwent curative-intent surgery in the province of Quebec, Canada from 2000-2005. Kaplan-Meier survival analysis was used to compare unadjusted overall survival (OS) beyond postoperative day 90 for patients with and without complications. Cox regression was used to determine the prognostic impact of 30-day postoperative complications on the OS after adjusting for confounders.Results: The overall 30-day postoperative complication rate was 58.2% among 4,033 eligible patients. A major infectious complication (pneumonia, empyema or mediastinitis) occurred in 378 patients. The 5-year OS was lower for those with any postoperative complication (62.8%) than those without (73.8%; P < 0.001). Those with major infectious complications had the lowest OS (56.3%; P < 0.001). Postoperative complication was an independent prognostic factor after adjusting for several patient and treatment factors (HR=1.37, 95% CI:1.21–1.54). Adjusted HR for major infectious complications was 1.67 (95% CI:1.39–2.01). Conclusions: Postoperative complications, particularly of a major infectious type, are strong negative predictors of long-term survival in lung cancer patients. The findings emphasize the importance of achieving lung resections with minimal morbidity as this translates into a beneficial impact on long-term outcomes independent of the effect on early mortality. The strong association between major infectious complications and survival may also open the door to investigational therapies targeting bacterial antigens in the perioperative period in patients undergoing lung cancer surgery.Mise en Contexte: La chirurgie est essentielle à tout plan curatif pour le cancer du poumon, mais est associé à un taux élevé de complications, ce qui accroît à son tour mortalité à court terme. Toutefois, l'impact de la morbidité postopératoire sur les résultats oncologiques à long terme n'est pas bien compris. Objectifs: Nous avons cherché à déterminer l'impact des complications sur le long terme la survie après une chirurgie à visée curative pour un cancer du poumon, indépendamment de l'effet sur la mortalité postopératoire précoce. Méthodes: Nous avons étudié une cohorte basée sur la population des patients atteints de cancer du poumon qui a subi une chirurgie visée curative dans la province de Québec, au Canada de 2000 à 2005. Analyse de survie de Kaplan-Meier a été utilisée pour comparer de survie globale (OS) au-delà 90e jour postopératoire pour les patients avec et sans complications. La régression de Cox a été utilisé pour déterminer l'impact pronostique des complications postopératoires (jusqu'à 30 jours) sur l'OS, après ajustement pour les facteurs confondants. Résultats: Le taux de complications postopératoires dans les premiers 30 jours était de 58,2% chez les 4033 patients éligibles. Une complication majeure infectieuse (pneumonie, empyème ou médiastinite) sont survenus chez 378 patients. L'OS de 5-ans était plus faible pour ceux avec aucune complication post-opératoire (62,8%) que ceux sans (73,8%; p <0,001). Ceux avec une complication majeure infectieuse étaient les plus faibles de l'OS (56,3%, p <0,001). Complication postopératoire était un facteur pronostique indépendant après ajustement pour plusieurs des facteurs concernant des patients et de traitement. (HR = 1,37, IC 95%:1.21-1.54). HR ajusté pour la complication majeure infectieuse était de 1,67 (IC 95%:1.39-2.01). Conclusions: Les complications postopératoires, en particulier d'un type majeure infectieuse, sont forts prédicteurs négatifs de survie à long terme chez les patients du cancer du poumon. Les résultats soulignent l'importance de réaliser des résections pulmonaires avec une morbidité minime, car cela se traduit par un impact bénéfique sur le long terme des résultats indépendants de l'effet sur la mortalité précoce. La forte association entre les complications majeures infectieuses et de la survie peut aussi ouvrir la porte à des thérapies expérimental ciblant les antigènes bactériens dans la période périopératoire chez les patients subissant une chirurgie du cancer du poumon.
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Fujita, Shiro. "Postoperative complications after induction chemoradiotherapy in patients with non-small-cell lung cancer." Kyoto University, 2008. http://hdl.handle.net/2433/135810.
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Ander, Fredrik. "Perioperative complications in obese patients : A thesis on risk reducing strategies." Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-59411.
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Aspiration of gastric content and delayed or failed intubation are the leading causes of anesthesia-related mortality and morbidity. In the recovery period, airway obstruction with subsequent hypoxia is a relatively common cause of morbidity, and is highly associated to the amount of opioids administered, especially in obese patients. The overall aim of this thesis was to study these risk factors for airway complications and postoperative hypoxia in obese patients, and to evaluate possible strategies for their prevention. In Study I, intubation times and incidence of failed intubation in obese patients were compared between direct laryngoscopy and videolaryngoscopy with the Stortz® C-MAC™. In Studies II and III, the effect of esmolol vs. remifentanil on the esophageal junction, and the possible analgesic properties of low-dose esmolol vs. placebo were evaluated using high-resolution manometry and the cold pressor test, respectively. Finally, in Study IV, the possible opioid-sparing effect of esmolol after laparoscopic gastric bypass surgery was evaluated. The use of videlaryngoscopy did not shorten intubation times, however appeared to reduce the incidence of failed intubation. Our results also show that esmolol has a favorable profile, compared to remifentanil, with regard to the protection against passive regurgitation and aspiration of gastric content. No analgesic effect of low-dose esmolol was however demonstrated. The intraoperative administration of esmolol instead of remifentanil also did not reduce the requirement of morphine for treatment of post-operative pain. The use of Stortz® C-MAC™ may be recommended for intubation of obese patients. Further studies are however required to clarify the possible role of esmolol in anesthesia.
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Moore, Samuel William. "The study of the etiology of post-surgical obstruction in patients with Hirschsprung's disease." Thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/26152.
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Zeitz, Kathryn. "Post-operative observations, ritualised or vital in the detection of post-operative complications." Title page, contents and abstract only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phz483.pdf.
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Copy of author's previously published work inserted. Includes bibliographical references (leaves 273-283). Aims to identify if the current practice of post-operative vital sign collection detects complications in the first 24 hours after the patient has returned to the general ward setting using a combination of methods within a triangulated approach to data collection.
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Fränneby, Ulf. "Patient-orientated aspects of the postoperative course after hernia surgery /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-810-X/.
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Qvarford, Moa, and Siw Østby. "Kejsarsnitt : Komplikationer, riskfaktorer och kvinnors upplevelser - en litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-334760.
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Bakgrund: Kejsarsnitt, en kirurgisk metod då barnet blir förlöst via ett snitt i bukväggen, medför risker vare sig det är elektivt eller akut. Sjuksköterskans roll i omvårdnaden av patienten postoperativt blir central för att främja egenvård och stärka patientens delaktighet. Syfte: Att undersöka vilka komplikationer som uppstår, hur många som drabbas av dessa samt att kartlägga eventuella riskfaktorer för komplikationer hos kvinnorna som genomgått kejsarsnitt. Studien syftar också till att undersöka vilken upplevelse dessa kvinnor har angående proceduren pre-, intra - och postoperativt. Metod: Litteraturstudie av vetenskapliga artiklar med både kvalitativ och kvantitativ design. Sökningen skedde på databaserna Statens Beredning för medicinsk och social Utvärdering (SBU), Cochrane, Cinahl, PsychINFO och Pubmed. Sammanlagt 15 artiklar inkluderades efter kvalitetsgranskning. Resultat: Risken för att få en postoperativ komplikation, exempelvis sårinfektion, var liten. Förekomsten var cirka 10 %, men detta varierade kraftigt mellan artiklarna. Risken var dock större vid högt BMI, tobaksanvändning, högre ålder och hypertoni. Smärta var den mest frekvent förekommande komplikationen. För kvinnorna var det viktigt att vara välinformerade och att känna sig inkluderade under proceduren. Slutsats: Kvinnornas upplevelse av kejsarsnitten var främst förknippad med tiden innan kejsarsnittet. Rädslan för smärtan preoperativt var problematisk för kvinnorna som genomgick kejsarsnitt. Majoriteten av de postoperativa komplikationerna var smärta och sårinfektioner. Att ge patienten trygghet och strategier för coping inför kejsarsnittet var det som efterfrågas för att stärka patientens delaktighet och autonomi.Background: Caesarean section, a surgical procedure whereas the child is delivered by an incision through the abdominal wall. The procedure entails some risks whether it is done electively or by emergency. The nurse’s part in the care of the patient becomes essential in the postoperative stage to support in the self-care and to make the patient participate in his/her own treatment. Purpose: The purpose was to look into which complications may occur, and to identify possible risk factors causing complications in the women undergoing a caesarian section. The purpose of this study was also to find out what kind of perception these women have of the procedure before, during and after the caesarean surgery. Method: A literature review of scientific studies and articles of both quantitative and qualitative design. The search was preformed on the databases: SBU, Cochrane, Cinahl, PsychINFO and Pubmed, after assessing the quailty, 15 articles were selected for inclusion. Results: The risk of having a postoperative infection was small, circa 10 % occurence, although varying a lot between articles. The risk was increased with high BMI, age, tobacco use and hypertension. Physical pain was the most experienced postoperative complication. Women felt that it was very important to be well-informed and for them to feel included in the caesarean procedure. Conclusion: Women’s experiences of a caesarean section were mostly influenced by the time before surgery. The fear of pain before surgery was problematic for women undergoing caesarean section. The majority of complications were postoperaitve pain and wound infections. Giving the patient strategies for coping and security was important to strengthen her participation and autonomy.
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Rouvelas, Ioannis. "Esophageal cancer surgery - factors influencing survival /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-004-6/.
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Ситнік, Олександр Леонідович, Александр Леонидович Сытник, Oleksandr Leonidovych Sytnik, Світлана Павлівна Коробова, Светлана Павловна Коробова, and Svitlana Pavlivna Korobova. "Післяопераційні ускладнення у хворих на перфоративну гастродуоденальну виразку." Thesis, Вид-во СумДУ, 2005. http://essuir.sumdu.edu.ua/handle/123456789/7346.
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Chuong, Koon Shin Brian Lit Shing. "Unattended Portable Monitors in the Preoperative Screening of Obstructive Sleep Apnoea and Their Role in Predicting Postoperative Cardio-Respiratory Complications." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29475.
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Preoperative screening for obstructive sleep apnoea (OSA) is recommended to identify patients at risk of perioperative complications. In addition to screening questionnaires, portable monitors (PM), capable of recording oximetry and nasal airflow signals, are increasingly used to screen for OSA. With their simpler setup than a laboratory study, together with automated scoring, type 3 PM home sleep study (HSS) may be performed without a sleep technician (unattended).
We investigated if an unattended type 3 PM HSS could stratify preoperative anaesthetic clinic (PAC) patients for risk of postoperative complications. Secondary aims were analysis of HSS recording failure rate, factors influencing successful HSS recording, and accuracy of automated scoring for HSS.
Forty-eight patients recruited from a PAC were provided with instructions to self-apply the type 3 PM HSS. Recorded HSS data were manually and automatically scored for Apnoea-Hypopnoea Index (AHI) and Oxygen Desaturation Index (ODI). Continuous oximetry was recorded on the first 3 postoperative nights. Incidence of cardiac and respiratory complications was recorded.
Recording failure rate for unattended type 3 PM HSS was high at 31%, although success rate was improved with use of pictorial instructions. Greater accuracy was noted in the automated scoring of ODI than in the automated scoring of AHI for type 3 PM HSS. Moderate-severe OSA, defined by preoperative AHI>=15 events/hr, was not associated with a higher rate of complications, but ODI>=15 events/hr predicted more postoperative adverse events, including prolonged episodes of undetected nocturnal hypoxaemia.
Our results indicate that unattended type 3 PM HSS may not be well suited for preoperative screening of PAC patients. Rather, oximetry screening alone may be better at identifying PAC patients at risk of postoperative complications.
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Alabbas, Haytham. "Can recent health service use predict postoperative complications in seniors undergoing colon cancer surgery?" Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=123188.
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Introduction: Colon cancer surgery is associated with high morbidity, particularly in seniors. There is currently a lack of tools for accurately assessing vulnerable patients at risk of postoperative adverse events. The aim of this study was to identify predictors of severe postoperative complications in seniors undergoing colon cancer surgery based on recent health service use data. Methods: A historical prospective cohort of colon cancer patients aged ≥ 65 years was assembled from hospitalization data provided by Quebec's provincial healthcare insurance provider (2000–2006). For each patient, health administrative claims were used to document domains of the Comprehensive Geriatric Assessment tool. 30-day postoperative severe complications were assessed using the Clavien-Dindo classification (grades III-V). A multivariate Cox model was used to evaluate associations between complications and patient characteristics. Results: 3,789 patients were included (median age: 76; female 54.3%). 24.2% of cases were emergency procedures. Postoperative complications were observed in 29% of the cohort. Grade III, IV, or V complication were experienced in 17.3%, 12.6%, and 5% of the cohort, respectively (median time to first complication: 6 days). The incidence of postoperative emergency room visits and readmissions were 17.8% and 11.3%, respectively. Multivariate analysis indicated that the following variables were significantly associated with complications: male gender (HR = 1.28, CI = 1.13-1.45), age ≥ 85 years (HR = 1.25, CI = 1.03-1.52), ≥ 10 active medications prescribed in the 6 months preceding surgery (HR = 1.24, CI = 1.03-1.49), recent care for renal insufficiency or cardiovascular disease (HR = 1.43, CI = 1.02-1.99; HR = 1.25, CI = 1.10 – 1.43), and emergency procedures (HR = 1.39, CI = 1.22-1.59). Conclusion: A large number of newly prescribed medications, recent care for renal insufficiency or cardiovascular disease, and emergency procedures were associated with severe postoperative complications. This study demonstrates the potential of developing assessment tools using recent health service use to identify vulnerable seniors at risk of postoperative complications.Introduction: La chirurgie pour un cancer du colon est associée à un taux élevé de morbidité, particulièrement chez les personnes âgées. Il y a présentement un manque d'outils d'évaluation pour les patients vulnérables à risque de complications postopératoires. Le but de cette étude était d'identifier des prédicteurs de complications postopératoires graves chez les personnes âgées subissant une chirurgie pour cancer du colon, basé sur des données provenant de statistiques récentes sur l'utilisation des services de santé.Méthodes: Une cohorte prospective historique de patients atteints de cancer du colon âgés de 65 ans ou plus a été assemblée à partir de données d'hospitalisation provenant du fournisseur d'assurance de soins de santé de la province du Québec (2000-2006). Les réclamations administratives pour soins de santé de chaque patient ont été utilisées pour documenter les sections de l'Outil d'évaluation gérontologique (Comprensive Geriatric Assessment). Les complications postopératoires graves à 30 jours ont été évaluées à l'aide de la classification Clavien-Dindo (échelons III-V). Les associations entre complications et les caractéristiques des patients ont été évalués à l'aide d'un modèle Cox.Résultats: 3,789 patients ont été inclus (âge médian : 76; 54,3% féminin). 24,2% des cas étaient des chirurgies d'urgence. Des complications postopératoires ont été décelées dans 29% de la cohorte. Des complications d'échelon III, IV ou V ont été décelées dans 17.3%, 12.6% et 5% de la cohorte, respectivement (délai médian avant la première complication : 6 jours). Le taux d'incidence de visites postopératoires en salle d'urgence et de réadmission était de 17.8% et 11.3%, respectivement. Certaines variables furent associées de manière significative aux complications grâce à une analyse multivariée : sexe masculin (RR = 1.28, ICI = 1.13-1.45), âge ≥ 85 ans (RR = 1.25, IC = 1.03-1.52), plus de 10 médicaments actifs prescrits dans les 6 mois précédent la chirurgie (RR = 1.24, IC = 1.03-1.49), soins récents pour insuffisance rénale ou maladie cardiovasculaire (RR = 1.43, IC = 1.02-1.99; RR = 1.25, IC = 1.10 – 1.43), et chirurgie d'urgence (RR = 1.39, IC = 1.22-1.59).Conclusions: Une quantité importante de medicaments nouvellement prescrits, des soins récents pour insuffisance rénale ou maladies cardiovascuaires, et des chirurgies d'urgence ont tous été associés avec des complications postopératoires graves. Cette étude démontre la pertinence du développement d'outils d'évaluation basées sur des données provenant de statistiques d'utilisation des services de santé, dans le but d'identifier des populations âgées vulnérables à risque de complications postopératoires.
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Someda, Hitoshi. "Vascular complications in living related liver transplantation detected with intraoperative and postoperative Doppler US." Kyoto University, 1997. http://hdl.handle.net/2433/202237.
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Kaw, Roop, Priyanka Bhateja, y. Mar Hugo Paz, Adrian V. Hernández, Anuradha Ramaswamy, Loutfi S. Aboussouan, and Abhishek Deshpande. "Postoperative Complications in Patients with Unrecognized Obesity Hypoventilation Syndrome Undergoing Elective Non-cardiac Surgery." American College of Chest Physicians, 2015. http://hdl.handle.net/10757/558500.
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BACKGROUND: Among patients with obstructive sleep apnea (OSA) a higher number of medical morbidities are known to be associated with those that have obesity hypoventilation syndrome (OHS) compared to OSA alone. OHS can therefore pose a higher risk of postoperative complications after elective non-cardiac surgery (NCS) and is often unrecognized at the time of surgery. The objective of this study was to retrospectively identify patients with OHS and compare their postoperative outcomes with those who have OSA alone. METHODS: Patients meeting criteria for OHS were identified within a large cohort of patients with OSA who underwent elective NCS at a major tertiary care center. We identified postoperative outcomes associated with OSA and OHS as well as the clinical determinants of OHS (BMI, AHI). Multivariable logistic or linear regression models were used for dichotomous or continuous outcomes, respectively. RESULTS: Patients with hypercapnia from definite or possible OHS, and overlap syndrome are more likely to develop postoperative respiratory failure [OR: 10.9 (95% CI 3.7-32.3), p<0.0001], postoperative heart failure (p<0.0001), prolonged intubation [OR: 5.4 (95% CI 1.9-15.7), p=0.002), postoperative ICU transfer (OR: 3.8 (95% CI 1.7-8.6), p=0.002]; longer ICU (beta coefficient: 0.86; SE: 0.32, p=0.009) and hospital length of stay (beta coefficient: 2.94; SE: 0.87, p=0.0008) when compared to patients with OSA. Among the clinical determinants of OHS, neither BMI nor AHI showed associations with any postoperative outcomes in univariable or multivariable regression. CONCLUSIONS: Better emphasis is needed on preoperative recognition of hypercapnia among patients with OSA or overlap syndrome undergoing elective NCSRevisión por pares
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Snell, Jennifer Miranda. "Pediatric Emergence Delirium in the Postoperative Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3921.
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Emergence delirium (ED), also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors following general anesthesia. The incidence of ED is 3 to 8 times higher in children 5 years of age or less. There is no standard of nursing practice for managing ED symptoms in the pediatric surgical population. The purpose of this quality improvement project was to address a gap in knowledge needed to inform clinical decision-making when managing ED in the postoperative setting. Using an educational presentation for post anesthesia care unit (PACU) nurses, this project introduced the use of non-pharmacological interventions to mitigate symptoms of ED in the pediatric population as inspired by The Green Star Initiative, an Army program at Fort Carson. The project aim was to describe the effectiveness of ED-specific interventions from the nursing perspective. Using tenets of the Iowa model, this quality improvement project included a needs assessment survey, PowerPoint presentation, parent education leaflet, ED cheat sheet, and a post-intervention survey. Applying the context, input, process, product model for evaluation, this project increased knowledge of ED-specific interventions used by nurses that demonstrates a change in clinical decision-making. PACU nurses rated the interventions 43% effective on pediatric patients. This project addressed the gap in practice by providing structured education on ED, inspiring the use of ED-specific interventions, and promoting readiness to care for the pediatric surgical population. Outcomes add to the nursing literature by introducing ED-specific interventions to manage pediatric ED in facilities nationwide. A social implication of this project is to improve the care of pediatric surgical patients.
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Cálamo-Guzmán, Bernardo, and Vinatea-Serrano Luis De. "Letter to the editor in response to: The role of preoperative C-reactive protein and procalcitonin as predictors of post-pancreaticoduodenectomy infective complications: A prospective observational study." Springer International Publishing, 2018. http://hdl.handle.net/10757/622872.
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Bothin, Claes. "Experimental studies on the role of the gastrointestinal microflora in postsurgical adhesion formation /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-233-7.
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Figueiredo, Wellington Ribeiro. "AvaliaÃÃo da anastomose colo-cÃlica com e sem preparo intestinal. Estudo experimental em cÃes." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=9135.
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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgicoEsse estudo avaliou as anastomoses colo-cÃlicas sem preparo intestinal comparando com anastomoses realizadas com preparo intestinal prÃvio. Foram utilizados 42 animais (Canis familiares) fÃmeas, pesando entre 8,4 a 16,9 Kg, clinicamente sadios, oriundos do Canil da Prefeitura Municipal de Teresina, PiauÃ. Foram distribuÃdos em 2 grupos de 21 animais: grupo I (controle) â animais submetidos ao preparo intestinal com soluÃÃo glicerinada a 12% via retal 24hs antes do procedimento e grupo II (estudo) â animais submetidos ao procedimento sem preparo intestinal prÃvio. Todos os animais de ambos os grupos foram submetidos à laparotomia com secÃÃo do cÃlon descendente e anastomose primÃria com fio de polipropileno e acompanhados no trans e pÃs-operatÃrio por um mÃdico veterinÃrio, sendo a dieta instituÃda quando ocorreu a primeira evacuaÃÃo. Esses animais foram submetidos à eutanÃsia no 21 dia de pÃs-operatÃrio apÃs anestesia venosa com cloridrato de cetamina e aplicaÃÃo de cloreto de potÃssio a 20% endovenosa; realizou-se nova laparotomia e avaliaÃÃo da anastomose colo-cÃlica. Avaliou-se a evoluÃÃo clÃnica, o grau de aderÃncias intestinais e a pressÃo de ruptura da anastomose. Utilizou-se o teste T para amostras nÃo pareadas para dados paramÃtricos e Mann-Whitney test para dados nÃo paramÃtricos. Ocorreu um (4,5%) Ãbito em cada grupo sendo o do grupo I (controle) no 7 dia pÃs-operatÃrio devido à deiscÃncia da anastomose colo-cÃlica e outro no 10 dia de pÃs-operatÃrio no grupo II(estudo) devido à infecÃÃo de sÃtio cirÃrgico incisional profunda com deiscÃncia total da parede abdominal. NÃo foi observado diferenÃa estatisticamente significante no grau de aderÃncias intestinais entre os grupos. Durante a realizaÃÃo do teste de pressÃo de ruptura ocorreu ruptura da anastomose de um animal em cada grupo e nÃo houve diferenÃa estatisticamente significante entre os grupos (p>0,05). A anastomose colo-cÃlica sem preparo intestinal apresentou a mesma seguranÃa e eficÃcia da anastomose realizada com preparo prÃvio.
Esse estudo avaliou as anastomoses colo-cÃlicas sem preparo intestinal comparando com anastomoses realizadas com preparo intestinal prÃvio. Foram utilizados 42 animais (Canis familiares) fÃmeas, pesando entre 8,4 a 16,9 Kg, clinicamente sadios, oriundos do Canil da Prefeitura Municipal de Teresina, PiauÃ. Foram distribuÃdos em 2 grupos de 21 animais: grupo I (controle) â animais submetidos ao preparo intestinal com soluÃÃo glicerinada a 12% via retal 24hs antes do procedimento e grupo II (estudo) â animais submetidos ao procedimento sem preparo intestinal prÃvio. Todos os animais de ambos os grupos foram submetidos à laparotomia com secÃÃo do cÃlon descendente e anastomose primÃria com fio de polipropileno e acompanhados no trans e pÃs-operatÃrio por um mÃdico veterinÃrio, sendo a dieta instituÃda quando ocorreu a primeira evacuaÃÃo. Esses animais foram submetidos à eutanÃsia no 21 dia de pÃs-operatÃrio apÃs anestesia venosa com cloridrato de cetamina e aplicaÃÃo de cloreto de potÃssio a 20% endovenosa; realizou-se nova laparotomia e avaliaÃÃo da anastomose colo-cÃlica. Avaliou-se a evoluÃÃo clÃnica, o grau de aderÃncias intestinais e a pressÃo de ruptura da anastomose. Utilizou-se o teste T para amostras nÃo pareadas para dados paramÃtricos e Mann-Whitney test para dados nÃo paramÃtricos. Ocorreu um (4,5%) Ãbito em cada grupo sendo o do grupo I (controle) no 7 dia pÃs-operatÃrio devido à deiscÃncia da anastomose colo-cÃlica e outro no 10 dia de pÃs-operatÃrio no grupo II(estudo) devido à infecÃÃo de sÃtio cirÃrgico incisional profunda com deiscÃncia total da parede abdominal. NÃo foi observado diferenÃa estatisticamente significante no grau de aderÃncias intestinais entre os grupos. Durante a realizaÃÃo do teste de pressÃo de ruptura ocorreu ruptura da anastomose de um animal em cada grupo e nÃo houve diferenÃa estatisticamente significante entre os grupos (p>0,05). A anastomose colo-cÃlica sem preparo intestinal apresentou a mesma seguranÃa e eficÃcia da anastomose realizada com preparo prÃvio.
The objective of this study was to evaluate the efficacy of colo-colonic anastomosis in dogs with and without preoperative bowel preparation. The experiment included 42 healthy female mongrel dogs (Canis familiaris) weighing 8.4-16.9 Kg, supplied by the municipal dog pound of Teresina, PiauÃ. The animals were distributed at random in two groups of 21 animals each: Group I (control) = submitted to bowel preparation with rectal administration of 12% glycerin solution one day before the procedure, and Group II (study) = without previous bowel preparation. All animals were submitted to laparotomy with sectioning of the descending colon and primary anastomosis using polypropylene thread under the peri and postoperative supervision of a veterinary physician. The animals were allowed access ad libitum to water and standard feed following the first evacuation. On the 21st postoperative day (POD 21), the dogs were euthanized with ketamine i.v. followed by 20% potassium chloride i.v., and a second laparotomy was performed through the same incision in order to evaluate the anstomosis. In addition, the abdominal cavity was evaluated for adhesions and the burst pressure of the anastomosis was tested. The unpaired samples were compared with Studentʼs t test for parametric data and with the Mann-Whitney test for non-parametric data. One animal in each group (4.5%) died. The death in Group I (control) occurred on POD 7 due to anastomotic dehiscence. The death in Group II (study) occurred on POD 10 due to deep incisional infection at the surgical site and complete dehiscence of the abdominal wall. The groups did not differ significantly with regard to adhesion grade or anastomotic burst pressure (one specimen burst in each group) (p>0.05). In conclusion, the level of safety and efficacy was the same for colo-colonic anastomosis with and without previous bowel preparation.
The objective of this study was to evaluate the efficacy of colo-colonic anastomosis in dogs with and without preoperative bowel preparation. The experiment included 42 healthy female mongrel dogs (Canis familiaris) weighing 8.4-16.9 Kg, supplied by the municipal dog pound of Teresina, PiauÃ. The animals were distributed at random in two groups of 21 animals each: Group I (control) = submitted to bowel preparation with rectal administration of 12% glycerin solution one day before the procedure, and Group II (study) = without previous bowel preparation. All animals were submitted to laparotomy with sectioning of the descending colon and primary anastomosis using polypropylene thread under the peri and postoperative supervision of a veterinary physician. The animals were allowed access ad libitum to water and standard feed following the first evacuation. On the 21st postoperative day (POD 21), the dogs were euthanized with ketamine i.v. followed by 20% potassium chloride i.v., and a second laparotomy was performed through the same incision in order to evaluate the anstomosis. In addition, the abdominal cavity was evaluated for adhesions and the burst pressure of the anastomosis was tested. The unpaired samples were compared with Studentʼs t test for parametric data and with the Mann-Whitney test for non-parametric data. One animal in each group (4.5%) died. The death in Group I (control) occurred on POD 7 due to anastomotic dehiscence. The death in Group II (study) occurred on POD 10 due to deep incisional infection at the surgical site and complete dehiscence of the abdominal wall. The groups did not differ significantly with regard to adhesion grade or anastomotic burst pressure (one specimen burst in each group) (p>0.05). In conclusion, the level of safety and efficacy was the same for colo-colonic anastomosis with and without previous bowel preparation.
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Сміян, Світлана Анатоліївна, Светлана Анатольевна Смиян, and Svitlana Anatoliivna Smiian. "Профілактика запальних післяабортних ускладнень з використанням антигомотоксичних препаратів." Thesis, Видавництво СумДУ, 2004. http://essuir.sumdu.edu.ua/handle/123456789/9013.
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Шевченко, Володимир Порфирович, Владимир Порфирьевич Шевченко, Volodymyr Porfyrovych Shevchenko, Тетяна Володимирівна Шевченко, Татьяна Владимировна Шевченко, and Tetiana Volodymyrivna Shevchenko. "Хірургічне лікування гігантської післяопераційної вентральної грижі з використанням алотрансплантанта." Thesis, Видавництво СумДУ, 2004. http://essuir.sumdu.edu.ua/handle/123456789/9403.
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Parkman, Sharon E. "The infant undergoing cardiac surgery : can we predict length of stay and presence of complications from age, weight, diagnoses, and type of of surgery? /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7215.
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Tran, Diem. "Clinical Prediction Rule for the Development of New Onset Postoperative Atrial Fibrillation After Cardiac Surgery." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/24400.
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This project set out to derive a prediction rule based on preoperative clinical variables to identify patients with high risk of developing atrial fibrillation following cardiac surgery. Methods: Prospectively collected data from a perioperative database was corroborated with chart review to identify eligible patients who had non-emergent surgery in 2010. Details on 28 preoperative variables were collected and significant predictors (p<0.2) were inserted into multivariable logistic regression and recursive partitioning. Results: 305 (30.5%) of 999 patients developed new onset postoperative atrial fibrillation. Eleven variables were significantly associated with atrial fibrillation, however, both final models included only three: left atrial dilatation, mitral valve disease and age. Bootstrapping with 5000 samples confirmed that both final models provide consistent predictions. Coefficients from the logistic regression model were converted into a simple seven point predictive score. Conclusions: This simple risk score can identify patients at higher risk of developing atrial fibrillation after cardiac surgery.
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Woodruff, Vicky D. "Physiologic Capacity as a Predictor of Postoperative Complications and Associated Costs in Three Types of Oncological Surgeries." ScholarWorks, 2011. http://scholarworks.waldenu.edu/hodgkinson/18.
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An estimated 12 million individuals undergoing non-cardiac surgery in the United States each year will experience postoperative complications. The costs of complications are manifested in the growing healthcare economic burden and patients' reduced quality of life, future economic productivity, and shortened long-term survival. This research is grounded in a conceptual framework derived from literature in physiologic capacity and stress. The purpose of the study was to test the hypothesis that physiologic capacity is a predictor of postoperative complications and associated costs in three types of oncological surgery (esophagectomy, hepatectomy, and radical cystectomy). Data analysis strategies included forward step-wise binary logistic regression. Results showed a peak oxygen uptake (PVO 2 ) of >20 mL/min/kg, plus a heart rate time (HRTIME) of(for the heart rate to fall at or below 100 bmp after stop test) as the multivariate predictive model (67% sensitivity and 92% specificity) for complications in the hepatectomy group. Conversely, an anaerobic threshold (AT) of >10 mL/min/kg was found to be the univariate predictive model (33% sensitivity and 91% specificity) for the radical cystectomy group. No predictor was found for the esophagectomy group. Each predictive model also predicted between 89%-100% of actual length of stay and hospital costs. Lastly, trends in complications showed esophagectomy with 60 events over 60 days, radical cystectomy with 21 events over 12 days, and hepatectomy with 36 events over 7 days. Implications for positive social change included a paradigm shift from subjective to objective phenotypic physiologic risk assessment affecting standards of care, policies, procedures, and decision-making changes in the healthcare industries and surgeon practice, resulting in better patient outcomes, fewer surgical complications, and increased quality of life.
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Winnerkvist, Anders. "Management of thoracoabdominal aortic aneurysms and dissections : with emphasis on spinal cord protection in aneurysm repair and non-surgical treatment of type-B dissection /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-768-5/.
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Wejde, Gisela. "Posterior capsule opacification and postoperative endophthalmitis following cataract surgery : predictive and protective factors /." Stockholm : Karolinska institutet, 2005. http://diss.kib.ki.se/2005/91-7140-291-8/.
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Matthiessen, Peter. "Rectal cancer surgery : Defunctioning stoma, anastomotic leakage and postoperative monitoring." Doctoral thesis, Linköping : Univ, 2006. http://www.bibl.liu.se/liupubl/disp/disp2006/med940s.pdf.
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Mogensen, Karin. "Hustruers oplevelse af det postoperative forløb efter ægtefællens prostataoperation." Thesis, Nordic School of Public Health NHV, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3255.
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Indlæggelsestiden i forbindelse med kirurgi er blevet kortere. Der er meget lidt viden om, hvordan den umiddelbare postoperative periode forløber. Formålet med undersøgelsen har været at vurdere om korte hospitalsforløb hos patienter, der er opereret for forstørret prostata, bevirker at de pårørende overtager en del af plejen, at undersøge om der kommer en øget belastning på andre dele af sundhedsvæsenet, samt at få en viden om hvordan patienterne har det i de første uger efter operationen. Der er foretaget kvalitative interviews med ti hustruer. Til analyse af interviewene er brugt den fænomenologiske metode, beskrevet af Giorgi og Karlsson. På baggrund af disse interviews er der udarbejdet et spørgeskema, som er udsendt til alle hustruer, hvis ægtefælle i perioden november 2004 til maj 2005 er blevet prostataopereret. Resultaterne fra spørgeskemaundersøgelsen blev sat ind i en access database. Resultatet viser at den første postoperative periode er præget af mange vandladningsgener så som inkontinens, hyppige vandladninger, blødning og urinstop. Gener som også belaster hustruerne. Hustruerne følte sig usikre på om efterforløbet var normalt, og de manglede viden om, hvor de kunne henvende sig med problemer.The length of stay at hospital after surgery has shortened. Little is known about the immediate post-surgery period. The aim of this study is to assess whether spouses have to take active care of their husbands and to assess if the burden of other part of the health service increases as a result of early discharge after prostatic surgery. Furthermore, the study intends to increase the knowledge about how patients experience the first postoperative weeks. Initially qualitative interviews were conducted with ten spouses. The Phenomological method described by Giorgi and Karlsson was used for analysing the interviews. Based on the experience of this, a questionnaire was prepared and sent to all spouses of patients who had undergone prostatic surgery between November 2004 and May 2005. The results of the questionnaires were put into an access database. The principal finding is that many patients during the first postoperative period experience various urinary problems such as incontinence, frequency, haematuria, and urinary retention. Problems which negatively impacted on the spouses. Furthermore, the spouses were uncertain whether it was common to experience these problems, and they did not know whom to contact when in need of support
ISBN 91-7997-152-0
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Finjan, Sarmed. "Septoplasty for nasal obstruction in Region Örebro county - a retroperspecitve study evaluating postoperative complications and quality of life." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-52591.
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Pettersson, Albert. "Giant retinal tears vs primary rhegmatogenousretinal detachments : A study with the purpose of comparing postoperative results and complications." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-86240.
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Introduction Giant retinal tears (GRT) are rare and difficult to treat. Today, there are seven centers inSweden where this complicated form of rhegmatogenous retinal detachment (RRD) can betreated. Despite the technical and surgical advances in the last decades, the ideal treatment isstill unknown. In the end, the choice is made by an individual surgeon, without much researchto back it up.In contrast, a mild form of RRD is considered easier to handle. Previous studies describe asingle surgery success rate of over 90% for this form of RRD. This is higher compared togiant retinal tears, where the rate is 70-90%. Purpose The purpose of this study was to compare the postoperative results and complications of giantretinal tears with a mild type of rhegmatogenous retinal detachment. Method This is a retrospective cohort study of 18 patients with GRT treated at USÖ between 2013-2017. The GRT sample was matched with the same number of patients with a mild form ofRRD treated at USÖ between 2011-2019. The period before, under and after surgery wereinvestigated to compare results and complications. Results Several factors with statistical significance were found: the single surgery success rate ishigher in GRT; the number of reoperations is less when an outlier has been removed; thefrequency of glaucoma and residual silicone oil are higher in GRT; the rate of preoperativeepiretinal membranes is higher in RRD, and the portion of preoperative proliferativevitreoretinopathy (PVR) is higher in GRT. Conclusion Somewhat surprisingly, the results present a higher single surgery success rate in GRT thanthe mild form of RRD. Compared to literature the rate for RRD is relatively low, but the ratefor GRT is among the best compared to other studies. However, this may be due to the smallsample size and potential bias in the matching. Before surgery GRT presents with worsepreoperative visual acuity and higher rate of complications. These differences seem to shrinkafter surgery. The exception being glaucoma, which is more common in GRT
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Svärd, Elin, and Anna-Karin Vilhelmsson. "Intensivvårdssjuksköterskans omvårdnadsåtgärder för att förebygga luftvägskomplikationer hos den postoperativa patienten." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-26655.
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Bakgrund: Postoperativa luftvägskomplikationer är vanligt förekommande och ökar risken för både morbiditet och mortalitet samt ökar kostnaderna för samhället. Olika omvårdnadsåtgärder finns för att förebygga postoperativa luftvägskomplikationer. Syfte: Syftet med studien var att beskriva hur intensivvårdssjuksköterskor definierar begreppet postoperativa luftvägskomplikationer, samt deras omvårdnadsåtgärder för att förebygga dessa komplikationer hos den postoperativa patienten Metod: Studien genomfördes med en beskrivande design med kvalitativ ansats. Tio intensivvårdssjuksköterskor intervjuades med hjälp av semistrukturerade intervjuer. Resultat: Det framkom fem huvudkategorier i resultatet: Definition av begreppet postoperativa luftvägskomplikationer, Att välja omvårdnadsåtgärder, Att ge förebyggande omvårdnad, Att bedöma patientens individuella behov och Att se hinder till att ge omvårdnadsåtgärder. Intensivvårdssjuksköterskorna beskrev att det inte finns några rutiner eller riktlinjer att följa gällande förebyggandet av postoperativa luftvägskomplikationer. De beskrev också att patientens individuella behov ligger till grund för valet av omvårdnadsåtgärder för att förebygga postoperativa luftvägs-komplikationer. Intensivvårdssjuksköterskorna beskrev även olika råd om egenvård som de ger patienterna med syfte att förebygga postoperativa luftvägskomplikationer, bland annat att uppmana dem till att hosta och djupandas och att instruera dem att blåsa i PEEP-ventil*. Slutsats: Studiens resultat belyser avsaknaden av rutiner och känslan av att de postoperativa patienterna är en åsidosatt patientgrupp inom intensivvården samt att intensivvårdssjuksköterskorna saknar tiden till att kunna vårda denna patientgrupp optimalt. Rutiner bör upprättas för att intensivvårdssjuksköterskorna ska veta vilka omvårdnadsåtgärder som behöver sättas in för att förebygga postoperativa luftvägskomplikationer. Nyckelord: Intensivvårdssjuksköterska, omvårdnadsåtgärder, postoperativa luftvägskomplikationer, prevention. *PEEP- PEEP betyder Positive End Expiratory Pressure (positivt slutexpiratoriskt tryck). PEEP-ventil = Ventil som patienten andas ut emot, som gör att respirationscykeln startar och slutar med ett positivt tryck i luftvägarna (Gulbrandsen & Stubberud, 2009).Background: Postoperative respiratory complications are common and can be associated with an increase of mortality, morbidity and costs for society. There are different kinds of nursing actions to prevent postoperative pulmonary complications. Aim: The aim of this study was to describe how intensive care nurses define postoperative respiratory complications, and what kind of nursing actions they perform to prevent these complications among the postoperative patients. Method: The study was performed through a descriptive design with qualitative approach. Semistructured interviews with ten intensive care nurses were conducted. Result: Five categories appeared in the result: Definition of the concept postoperative respiratory complications, To choose nursing actions, To perform preventive care, To assess the patient´s individual needs and To see obstacles to perform nursing actions. The intensive care nurses described that there are no routines to follow in preventing respiratory complications for the postoperative patient. The intensive care nurses also described that they see to the patientens´ individual needs to prevent postoperative respiratory complications and that they give them different self-care advices in order to prevent postoperative respiratory complications, for instance tell the patient to cough, take deep breaths and instruct them how to use a PEEP-tube*. Conclusion: The result of this study showed that there is a lack of routines and that the these patients are breachede within the intensive care and also that the intensive care nurses experience a lack of time to givet hese patientes optimal care. Routines should be established so that intensive care nurses know what kind of nursing action to choose in order to prevent postoperative pulmonary complications. Key words: Intensive care nurse, nursing actions, postoperative respiratory complications, prevention. *PEEP- PEEP means Positive End Expiratory Pressure. PEEP-tube = Ventilator/tube in which the patient exhales against to make the cycle of respiration start and end onto a positive pressure in the respiratory system (Gulbrandsen & Stubberud, 2009).
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Lassen, Rampe Amanda, and Caroline Hallgren. "Kvinnors upplevelser kring komplikationer efter planerat kejsarsnitt : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-44187.
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Bakgrund: Kejsarsnitt är ett ingrepp som blir allt vanligare världen över vilket resulterar till att fler kvinnor drabbas av komplikationer. I takt med att kejsarsnitt blivit säkrare har vårdtiden för kvinnorna blivit kortare, vilket gör att det uppstår en osäkerhet och rädsla kring komplikationer efter utskrivning för dessa kvinnor. Syfte: Syftet var att belysa kvinnors upplevelse kring komplikationer vid panerat kejsarsnitt efter utskrivning. Metod: Studien är en litteraturstudie med induktiv ansats där sju kvalitativa resultatartiklar ligger till grund för resultatet. Resultat: Utefter syftet identifierades fyra teman: att leva med långvarig smärta orsakad av genomgånget planerat kejsarsnitt, upplevelse av information, upplevelse av postnatal infektion samt skam och ångest kring planerat kejsarsnitt. Kvinnor upplever sin egen kunskap otillräcklig för att identifiera komplikationer samt vart kvinnan skall vända sig när komplikationer uppstår. Informationen som kvinnan får postoperativt kring infektion och smärtans utveckling vid planerat kejsarsnitt efter utskrivning, ansåg kvinnan bristfällig med avsaknad av personcentrerat förhållningssätt. Kvinnor upplever även en stigmatisering kring planerat kejsarsnitt från hälso- och sjukvårdspersonal samt samhället. Konklusion: Hälso- och sjukvården behöver få en större förståelse för kvinnans upplevelse kring komplikationer vid planerat kejsarsnitt efter utskrivning samt förbättra vården med ett personcentrerat förhållningssätt i form av stöd och information.Background: Cesarean section is a procedure that is becoming more common around the world, which means that more women are suffering from complications. As the operation has become safer, the care time for the women has become shorter, which indicates that there is an uncertainty about complications after discharge. Aim: The aim was to illustrate women's experience of complications during elective cesarean section after discharge. Method: The study is a literature study with an inductive approach where seven qualitative articles formed the result. Result: According to the purpose, four themes were identified: living with long-term pain caused by elective cesarean section, experience of information, experience of postnatal infection and shame and anxiety around a planned cesarean section. Women experience insufficient knowledge to identify complications and where the woman should turn once it occurs. Postoperative information is not designed to be easily absorbed, as well as a stigma surrounding the woman's elective cesarean section in meetings with health and medical profession and society. Conclusion: The health care needs to gain a greater understanding of the woman's experience of complications after elective caesarean section at discharge and improve care with a person-centered approach in the form of support and information.
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Pourmand, Pedram. "Komplikationen bei Entfernungen von Weisheitszähnen im Oberkiefer : eine retrospektive Studie von 1562 Fällen /." [S.l.] : [s.n.], 2009. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000297940.
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Ritsema, David, Jennifer Watson, Amanda Stiteler, and Mike Nguyen. "Sequential compression devices in postoperative urologic patients: an observational trial and survey study on the influence of patient and hospital factors on compliance." BioMed Central, 2013. http://hdl.handle.net/10150/610106.
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BACKGROUND:Sequential compression devices (SCDs) are commonly used for thromboprophylaxis in postoperative patients but compliance is often poor. We investigated causes for noncompliance, examining both hospital and patient related factors.METHODS:100 patients undergoing inpatient urologic surgery were enrolled. All patient had SCD sleeves placed preoperatively. Postoperative observations determined SCD compliance and reasons for non-compliance. Patient demographics, length of stay, inpatient unit type, and surgery type were recorded. At discharge, a patient survey gauged knowledge and attitudes regarding SCDs and bother with SCDs. Statistical analysis was performed to correlate SCD compliance with patient demographicspatient knowledge and attitudes regarding SCDs
and patient self-reported bother with SCDs.RESULTS:Observed overall compliance was 78.6%. The most commonly observed reasons for non-compliance were SCD machines not being initially available on the ward (71% of non-compliant observations on post-operative day 1) and SCD use not being restarted promptly after return to bed (50% of non-compliant observations for entire hospital stay). Mean self-reported bother scores related to SCDs were low, ranging from 1-3 out of 10 for all 12 categories of bother assessed. Patient demographics, knowledge, attitudes and bother with SCD devices were not significantly associated with non-compliance.CONCLUSIONS:Patient self-reported bother with SCD devices was low. Hospital factors, including SCD machine availability and timely restarting of devices by nursing staff when a patient returns to bed, played a greater role in SCD non-compliance than patient factors. Identifying and addressing hospital related causes for poor SCD compliance may improve postoperative urologic patient safety.
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Rodrigues, Cristiane Delgado Alves 1978. "Disfunção transitória da troca gasosa no pós-operatório de cirurgia cardíaca e procedimentos cardíacos = Transitory dysfunction in gas exchange in the postoperative period of cardiac surgery and cardiac procedures." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312568.
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Orientadores: Desanka Dragosavac, Luciana Castilho de FigueiredoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: OBJETIVO: Estudo de coorte retrospectivo realizado com o objetivo de verificar a presença de Disfunção Transitória da Troca Gasosa (DTTG) no pós-operatório de cirurgia cardíaca e determinar se esse transtorno está relacionado a eventos cardiorrespiratórios. MÉTODOS: Foram incluídos 942 pacientes consecutivos submetidos à cirurgia cardíaca e procedimentos cardíacos, encaminhados para a UTI, entre junho de 2007 e novembro de 2011. RESULTADOS: A Síndrome do Desconforto Respiratório Agudo (SDRA) foi observada em 15 pacientes (2%), apresentaram Disfunção Transitória da Troca Gasosa (DTTG) leve 199 (27.75%) pacientes, DTTG moderada em 402 (56.1%) pacientes e DTTG grave em 39 (5.4%) pacientes. A presença de hipertensão arterial e choque cardiogênico foram associadas ao surgimento de DTTG moderada no período pós-operatório (p=0.02 e p=0.019, respectivamente) e foram considerados fatores de risco para esta disfunção (p=0.0023 e p=0.0017, respectivamente). A presença de diabetes mellitus também foi considerada um fator de risco para DTTG (p=0.03). Houve correlação entre a presença de pneumonia e a presença de DTTG moderada em 8.9% dos casos (p = 0.001). A presença de DTTG grave foi associada a pacientes que necessitaram de terapia de substituição renal (p=0.0005), hemoterapia (p=0.0001), nutrição enteral (p=0.0012), ou arritmia cardíaca (0.0451). CONCLUSÕES: A presença de hipertensão pré-operatória e choque cardiogênico foram associados com a ocorrência de DTTG pós-operatória. Os fatores de risco pré-operatórios foram hipertensão, choque cardiogênico e diabetes. No pós-operatório, a pneumonia, pneumonia associada à ventilação (PAV), terapia de substituição renal, hemoterapia e arritmia cardíaca foram associados com o aparecimento de certo grau de DTTG, que foi fator de risco para reintubação, pneumonia, PAV e terapia de substituição renal no pós-operatório de cirurgia cardíaca e procedimentos cardíacos
Abstract: OBJECTIVE: A retrospective cohort study was preformed aiming to verify the presence of transient dysfunction of gas exchange (TDGE) in the postoperative period of cardiac surgery and determine if this disorder is linked to cardiorespiratory events. METHODS: We included 942 consecutive patients undergoing cardiac surgery and cardiac procedures who were referred to the ICU between June 2007 and November 2011. RESULTS: Fifteen patients had acute respiratory distress syndrome (2%), 199 (27.75%) had mild TDGE, 402 (56.1%) had moderate TDGE, and 39 (5.4%) had severe TDGE. Hypertension and cardiogenic shock were associated with the emergence of moderate TDGE postoperatively (p = 0.02 and p = 0.019, respectively) and were risk factors for this dysfunction (p = 0.0023 and p = 0.0017, respectively). Diabetes mellitus was also a risk factor for TDGE (p = 0.03). Pneumonia was present in 8.9% of cases and correlated with the presence of moderate TDGE (p = 0.001). Severe TDGE was associated with patients who had had renal replacement therapy (p = 0.0005), hemotherapy (p = 0.0001), enteral nutrition (p = 0.0012), or cardiac arrhythmia (0.0451). CONCLUSIONS: Preoperative hypertension and cardiogenic shock were associated with the occurrence of postoperative TDGE. The preoperative risk factors included hypertension, cardiogenic shock, and diabetes. Postoperatively, pneumonia, VAP, renal replacement therapy, hemotherapy, and cardiac arrhythmia were associated with the appearance of some degree of TDGE, which was a risk factor for reintubation, pneumonia, VAP, and renal replacement therapy in the postoperative period of cardiac surgery and cardiac procedures
Doutorado
Fisiopatologia Cirúrgica
Doutora em Ciências
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Сухоставець, Н. П., and Т. В. Ясинецька. "Використання препарату Нео-пенотран з метою профілактики післяопераційних ускладнень у гінекологічних хворих старших вікових груп." Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27122.
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Kinjo, Yousuke. "Effectiveness of combined thoracoscopic-laparoscopic esophagectomy: comparison of postoperative complications and midterm oncological outcomes in patients with esophageal cancer." Kyoto University, 2013. http://hdl.handle.net/2433/174803.
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Ekdahl, Manne, and Åsa Nordling. "Perioperativa åtgärder för att lindra och förebygga postoperativ halsont och heshet hos patienter som genomgått generell anestesi." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-389344.
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Bakgrund: Halsont och heshet är några av de vanligaste postoperativa komplikationerna hos patienter som erhållit endotrakealtub eller larynxmask under generell anestesi. Syfte: Att kartlägga anestesisjuksköterskans perioperativa åtgärder för att förebygga och lindra patientens postoperativa halsont och heshet. Metod: En litteraturöversikt med deskriptiv design. Resultat sammanställdes utifrån 18 granskade artiklar av kvantitativ ansats, eftersökta i databaserna PudMed och Cinahl. Resultat: Litteraturöversikten visade flertalet åtgärder som kunde minska både incidens och svårighetsgrad av postoperativ halsont och heshet. En mindre endotrakealtub, användning av kontinuerlig tryckregulator, administrering av glukokortikoider och användning av larynxmask gav minskad incidens av halsont och heshet. Även videolaryngoskop, minskad kraft vid extraktion av ledare och vissa naturläkemedel visade sig minska incidensen. Åtgärderna visade på goda effekter i nära anslutning till operationen och inom första postoperativa dygnet, emellertid gav få artiklar resultat med bibehållen effekt över tid. Slutsats: Studien gav goda indikationer för åtgärder som kunde minska patienters förekomst av halsont och heshet och därigenom deras lidande. Resultatet visade på stor spridning vilket gjorde det svårt bedöma vilka åtgärder som var lämpliga att applicera i kliniken. Att minska storleken på endotrakealtuben och använda larynxmask när operationen tillåter var åtgärder som ansågs användbara. Även användning av glukokortikoider/antiinflammatoriska läkemedel samt att i större utsträckning utnyttja videolaryngoskopstekniken ansågs som adekvata åtgärder för att minska patientens lidande orsakat av postoperativ halsont och heshet.Background: Sore throat and hoarseness are some of the most common postoperative complications in patients receiving endotracheal tube or laryngeal mask during general anesthesia. Aim: To investigate the anesthetic nurse's perioperative measures to prevent and alleviate the patient's suffering from postoperative sore throat and hoarseness. Method: A literature review with descriptive design. Results were compiled based on 18 articles of quantitative approaches, requested in the databases PudMed and Cinahl. Result: The literature review showed several measures that could reduce both incidence and severity of postoperative sore throat and hoarseness. A minor endotracheal tube, the use of continuous cuff pressure regulator, administration of glucocorticoids and use of laryngeal mask reduced the incidence of sore throat and hoarseness. Also, video laryngoscopes, reduced force when extracting stylet removal and some herbal medications seemed to give good results in reducing the incidence. The measures showed good effects close to surgery and within the first postoperative day, however, few studies gave results with retained effect over time. Conclusions: The study provided good indications for measures that could reduce patients' incidence of sore throat and hoarseness and thereby their suffering. The results showed a large spread, which made it difficult to assess which measures were suitable for application in the clinic. Reducing the size of the endotracheal tube and using the laryngeal mask when the operation allows was implications that considered useful. Also, the use of glucocorticoids / anti-inflammatory drugs and to a greater extent utilizing the video laryngoscope technique was considered adequate measures to reduce the suffering of patients caused by postoperative sore throat and hoarseness.
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Larsson, Eva-Lena. "Pre- and postoperative evaluation of function and activity in patients with paralytic scoliosis." Doctoral thesis, Linköping : Univ, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5236.
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Jidéus, Lena. "Atrial fibrillation after coronary artery bypass surgery : a study of causes and risk factors /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-5151-9/.
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Vladimir, Dolinaj. "Procena efikasnosti laringealne maske u odnosu na endotrahealni tubus u zbrinjavanju disajnog puta u dečjoj otorinolaringološkoj hirurgiji." Phd thesis, Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, 2017. https://www.cris.uns.ac.rs/record.jsf?recordId=104700&source=NDLTD&language=en.
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Uvod: Adenoidektomija sa tonzilektomijom je najčešće indikovana hirurška intervencija u dečjem uzrastu. Intervencija se izvodi u opštoj anesteziji. Endotrahealni tubus predstavlja „zlatni standard“ za obezbeđenje disajnog puta u dečjoj otorinolaringološkoj hirurgiji. Upotreba endotrahealnog tubusa nosi rizike od nastanka komplikacija koje se mogu javiti pri uvodu u opštu anesteziju, u toku hirurške intervencije i nakon ekstubacije deteta. Učestalost komplikacija se može smanjiti upotrebom supraglotičnih sredstava. Fleksibilna laringealna maska spada u prvu generaciju supraglotičnih sredstava, koja omogućava zadovoljavajuću oksigenaciju i ventilaciju bolesnika u ORL hirurgiji. Cilj istraživanja: Utvrditi: efikasnost fleksibilne laringealne maske u zaštiti disajnog puta od aspiracije krvi i sekreta gornjih disajnih puteva u odnosu na endotrahealni tubus u toku adenotonzilektomije; da li primena fleksibilne laringealne maske u zbrinjavanju disajnog puta u toku adenotonzilektomije utiče na učestalost postekstubacionih komplikacija u odnosu na zbrinjavanje disajnog puta endotrahealnim tubusom; da li zbrinjavanje disajnog puta fleksibilnom laringealnom maskom u toku adenotonzilektomije ima uticaj na intenzitet postoperativnog bola u odnosu na zbrinjavanje disajnog puta endotrahealnim tubusom; da li zbrinjavanje disajnog puta fleksibilnom laringealnom maskom u toku adenotonzilektomije ima uticaj na pojavu postoperativne mučnine i povraćanja u odnosu na zbrinjavanje disajnog puta endotrahealnim tubusom. Metodologija: Prospektivnom, randomizovanom, studijom bilo je obuhvaćeno 160 dečaka i devojčica uzrasta od 3 do 8 godina planiranih za elektivnu hiruršku intervenciju adenotonzilektomiju u opštoj anesteziji. Bolesnici su bili podeljeni u dve grupe: 80 bolesnika kod kojih je disajni put bio obezbeđen endotrahealnim tubusum (ET grupa) i 80 bolesnika kod kojih je disajni put bio obezbeđen laringealnom maskom (LMA grupa). Na kraju hirurške intervencije, u obe grupe bolesnika, izvršena je provera prisustva krvi na larinksu i u traheji pomoću fiberoptičkog bronhoskopa. Postekstubacione respiratorne komplikacije vezane za upotrebu fleksibilne laringealne maske odnosno endotrahealnog tubusa (kašalj, opstrukcija disajnog puta i laringospazam) bile su praćene neposredno nakon ekstubacije bolesnika. Procena postoperativnog bola bila je vršena pomoću Face, Legs, Activity, Cry, Consolability Scale 2 i 4 sata nakon hirurške intervencije kao i prvog postoperativnog dana u 7 sati ujutro. Postojanje postoperativne mučnine i povraćanja bilo je utvrđivano heteroanamnestički, anketom roditelja, dan nakon hirurške intervencije u 7 sati ujutro. Statistička analiza izvršena je pomoću statističkog paketa Statistical Package for Social Sciences – SPSS 21. Podaci su predstavljeni tabelarno i grafički, a statistička značajnost je određivana na nivou p<0.05. Rezultati: Ni kod jednog deteta iz ET odnosno LMA grupe bolesnika nakon hirurške intervencije fiberoptičkim bronhoskopom nije uočeno prisustvo krvi, sekreta niti regurgitiranog želudačnog sadržaja na larinksu odnosno u traheji. Bolesnici iz ET grupe su imali statistički značajno više komplikacija u odnosu na bolesnike iz LMA grupe (χ2=4.254; p=0.039; p < 0.05). Ne postoji statistički značajna razlika u distribuciji bolesnika sa i bez respiratornih komplikacija izmeĊu ET i LMA grupe (χ2=3.413; p=0.065; p > 0.05). U proceni postoperativnog bola FLACC skalom 2 sata nakon hirurške intervencije postoji statistički značajna razlika u intenzitetu postoperativnog bola kod bolesnika iz ET u odnosu na bolesnike iz LMA grupe (χ2=31.316; p=0.000; p<0.05). Četiri sata nakon hirurške intervencije, statistički je značajno više bolesnika sa umerenim bolom u ET grupi u odnosu na LMA grupu (χ2=40.705; p=0.000; p<0.05). Na dan otpusta, statistički je značajno više bolesnika sa blagim diskomforom u ET grupi bolesnika u odnosu na LMA grupu (χ2=8,012; p=0,005; p < 0.05). U LMA grupi bolesnika jedan ili 1.49% bolesnika je imao postoperativnu mučninu i povraćanje, dok je u ET grupi troje ili 3.56% bolesnika imalo postoperativnu mučninu i povraćanje. Zaključak: Fleksibilna laringealna maska pruža podjednaku zaštitu distalnih delova disajnog puta od krvi i sekreta tokom adenotonzilektomije kao i endotrahealni tubus. Učestalost postoperativnih komplikacija i intenzitet postoperativnog bola su manji kada se za obezbeđenje disajnog puta u toku adenotonzilektomije koristi fleksibilna laringealna maska. Primenom fleksibilne laringealne maske smanjuje se učestalost postoperativne mučnine i povraćanja u toku adenotonzilektomije.Introduction: Adenoidectomy with tonsillectomy is the most indicated surgery in childhood. The intervention is performed under general anesthesia. Endotracheal tube represents the „gold standard“ for airway management in paediatric ENT surgery. The use of endotracheal tube carries the risk of complications that may occur during the induction of general anesthesia, during the surgery and after extubation of the child. The frequency of complications may be reduced by the use of supraglottic airway devices. Flexible laryngeal mask is first generation of supraglottic airway devices, which allows sufficient oxygenation and ventilation of patients in ENT surgery. Aims: To determine the effectiveness of the flexible laryngeal mask which protectes the airway from aspiration of blood and secretions of the upper airways compared to the airway management with endotracheal tube during adenotonsillectomy; to determine does the usage of the flexible laryngeal mask in airway management during adenotonsillectomy affects the frequency of post extubation complications compared to the airway management with endotracheal tube, as wll as does the usage of the flexible laryngeal mask in airway management during adenotonsillectomy has an impact on the intensity of postoperative pain compared to the airway management with endotracheal tube, and does the usage of the flexible laryngeal mask in airway management during adenotonsillectomy has an impact on the incidence of postoperative nausea and vomiting compared to the airway management with endotracheal tube. Methodology: One hundred and sixty boys and girls aged from 3 to 8 years scheduled for elective surgical intervention adenotnosillectomy in general anaesthesia were included in this prospective, randomized study. Patients were divided into two groups: 80 patients in whom the airway was managed with a cuffed endotracheal tube (ET group) and 80 patients in whom airway was managed with a laryngeal mask (LMA group). At the end of surgical procedure, in both groups of patients, fiberoptic bronchoscopy was performed to verify the presence of blood in the larynx and trachea. Immediate respiratory complications associated with the use of flexible laryngeal mask or endotracheal tube (cough, airway obstruction and laryngospasm) were monitored following extubation of patients. Postoperative pain assessment was performed using Face, Legs, Activity, Cry, Consolability Scale 2 and 4 hours following surgery as well as the first postoperative day at 7 o'clock a.m. The presence of postoperative nausea and vomiting was confirmed heteroanamnestically by polling the parents the day after surgery at 7 o'clock a.m. The statistical analysis was performed using Statistical Package for Social Sciences - SPSS version 21. The data were presented in tables and graphs, statystical significance was set at p value of less than 0.05. Results: Following surgery there were no any patient in ET or LMA group in which the presence of blood, secretion or regurgitated stomach contents on larynx or in the trachea could be observed by using the fiberoptic bronchoscope. Patients in the ET group had statistically more significant complications compared to patients in the LMA group (χ2 = 4.254; p = 0.039; p <0.05). There is no statistically significant difference in the distribution of patients with and without respiratory complications between ET and LMA groups (χ2 = 3.413; p = 0.065; p> 0.05). In the assessment of postoperative pain using FLACC scale 2 hours following surgical intervention, there is a statistically significant difference in the intensity of postoperative pain in ET patients compared to patients in the LMA group (χ2 = 31.316, p = 0.000, p <0.05). Four hours following surgical intervention, a statistically significant number of patients had mild pain in the ET group compared to the LMA group (χ2 = 40.705; p = 0.000; p <0.05). On the day of release, statistically significant numbers of patients with mild discomfort in the ET group were compared to the LMA group (χ2 = 8,012; p = 0,005; p <0.05). In the LMA group, one or 1.49% of the patients had postoperative nausea and vomiting, while in the ET group, three or 3.56% of the patients had postoperative nausea and vomiting. Conclusion: Flexible laryngeal mask provides equal protection of the distal parts of airway from the blood and secretions during adenotonsillectomy as the endotracheal tube. The frequency of postoperative complications and the intensity of postoperative pain are smaller when a flexible laryngeal mask is used for airway management during adenotonsillectomy. The usage of the flexible laryngeal mask reduces the frequency of postoperative nausea and vomiting during adenotonsillectomy.
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Westerdahl, Elisabeth. "Effects of Deep Breathing Exercises after Coronary Artery Bypass Surgery." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4520.
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