Subcutaneous heparin does not increase postoperative complications in neurosurgical patients: An institutional experience

2012 ◽  
Vol 27 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Robert I. Hacker ◽  
Garry Ritter ◽  
Chris Nelson ◽  
Denis Knobel ◽  
Rajeev Gupta ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Subcutaneous Heparin ◽  
Neurosurgical Patients ◽  
Institutional Experience

Venous thromboembolism: deep venous thrombosis and pulmonary embolism in a neurosurgical population

2011 ◽  
Vol 114 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Ahmad Khaldi ◽  
Naseem Helo ◽  
Michael J. Schneck ◽  
Thomas C. Origitano
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Lower Extremity ◽  
Linear Correlation ◽  
Pharmacological Prophylaxis ◽  
Neurosurgical Procedure ◽  
Dvt Prophylaxis ◽  
Subcutaneous Heparin ◽  
Neurosurgical Patients ◽  
Duration Of Surgery

Object Venous thromboembolism (VTE), a combination of deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major cause of morbidity and death in neurosurgical patients. This study evaluates 1) the risk of developing lower-extremity DVT following a neurosurgical procedure; 2) the timing of initiation of pharmacological DVT prophylaxis upon the occurrence of VTE; and 3) the relationship between DVT and PE as related to VTE prophylaxis in neurosurgical patients. Methods The records of all neurosurgical patients between January 2006 and December 2008 (2638 total) were reviewed for clinical documentation of VTE. As part of a quality improvement initiative, a subgroup of 1638 patients was studied during the implementation of pharmacological prophylaxis. A high-risk group of 555 neurosurgical patients in the intensive care unit underwent surveillance venous lower-extremity duplex ultrasonography studies twice weekly. All patients throughout the review received mechanical DVT prophylaxis. Pharmacological DVT prophylaxis, consisting of 5000 U of subcutaneous heparin twice daily (initially started within 48 hours of a neurosurgical procedure and subsequently within 24 hours of a procedure) was implemented in combination with mechanical prophylaxis. The DVT and PE rates were calculated for each group. Results In the surveillance group (555 patients), 84% of the DVTs occurred within 1 week and 92% within 2 weeks of a neurosurgical procedure. There was a linear correlation between the duration of surgery and DVT development. The use of subcutaneous heparin reduced the rate of DVT from 16% to 9% when medication was given at either 24 or 48 hours postoperatively, without any increase in hemorrhagic complications. In the overall group (2638 patients), there were 94 patients who exhibited clinical signs of a possible PE and therefore underwent spiral CT; 22 of these patients (0.8%) had radiological confirmation of PE. There was no correlation between the use of pharmacological prophylaxis at either time point and the occurrence of PE, despite a 43% reduction in the lower-extremity DVT rate with pharmacological intervention. Conclusions The majority of DVTs occurred within the first week after a neurosurgical procedure. There was a linear correlation between the duration of surgery and DVT occurrence. Use of early subcutaneous heparin (at either 24 or 48 hours) was associated with a 43% reduction of developing a lower-extremity DVT, without an increase in surgical site hemorrhage. There was no association of pharmacological prophylaxis with overall PE occurrence.

scholarly journals Long-term Results after Total Thyroidectomy in Patients with Graves' Disease in Uzbekistan: Retrospective Study

2011 ◽  
Vol 3 (2) ◽  
pp. 79-82
Author(s):  
Said I Ismailov ◽  
Nusrat A Alimjanov ◽  
Bakhodir Kh Babakhanov ◽  
Murod M Rashitov ◽  
Alisher M Akbutaev
Keyword(s):  
Postoperative Complications ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Long Term Results ◽  
Graves Disease ◽  
Nerve Paralysis ◽  
Treatment Groups ◽  
Institutional Experience

ABSTRACT Subtotal thyroidectomy has been advocated as the standard treatment for Graves' disease (GD) because of the assumed lower risk of complications compared with total thyroidectomy, and also it provides the chance to avoid thyroxin therapy. The present study aims to examine our institutional experience with total thyroidectomy for GD. Patients were divided into two surgical treatment groups: Total thyroidectomy (TT) (n = 97) and total thyroidectomy with intraoperative thyroid autotransplantation (TTITA) (n = 74). TTITA performed in 74 patients. 0.5 to 2 gm of thyroid tissue was cut into small pieces and autotransplanted into the forearm muscle of the patient. Postoperative complications included eight cases of RLN palsy, two patients had nerve paralysis, two patients underwent tracheostomy, transient hypoparathyroidism in 25 patients, permanent hypoparathyroidism in two cases, wound hemorrhage in two patients. TPOAb levels were increased in 9% of patients with TT whereas in patients with TTITA TPOAb concentrations were elevated in 65% of patients at 3 months follow-up. TRAb in patients with TT were not detected while 20% patients undergone TTITA had high TRAb levels and 13.3% had terminal concentrations at 3 months follow-up. Serum TPOAb and TRAb were detected in none of the patients who underwent TT and TTITA at 1, 3 and 5 years follow-up. Removal of all thyroid tissue offers the best chance of preventing recurrent hyperthyroidism and we saw no increase in postoperative complications in the TT group. We feel that TT is safe and superior for achieving the goal of treatment of Graves' disease.

scholarly journals Postoperative Outcome in Non-Preterm Infants Under One Year Old in Non-Cardiac Surgery

2021 ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Postoperative Complications ◽  
Observational Study ◽  
Organ Failure ◽  
Preterm Infants ◽  
Secondary Analysis ◽  
Postoperative Outcome ◽  
Preterm Children ◽  
Surgery Patient ◽  
Neurosurgical Patients ◽  
One Year

Abstract Background and Objective : An observational study conducted earlier to determine predictors of postoperative outcome in non-cardiac surgical pediatric patients showed that factors which influenced postoperative evolution were multiple. These included American Society of Anesthesiologists (ASA) score, transfusion, age, emergency surgery, and surgery. The objective was to describe in details outcomes in non-preterm children under one year old included in the initial study. Methods : Secondary analysis of the initial retrospective observational study in 594 patients with a mean age of 90.86±71.80 months. The Ethics Committee approved the study under the registration number 2017-CK-5-R1. Results : There were 97 non-preterm children included with a mean age of 4.4±3.5 months. Mean weight was 5.1±2.7 kilograms. There were 48 abdominal surgical patients (49.5%), 48 neurosurgical patients (49.5%) and 1 orthopedic surgery patient (1%). 30 patients had intra-operative and or postoperative complications (organ failure or sepsis) (30.9%). The most common intra-operative complication was hemorrhagic shock (5.2%); the most affected system in the postoperative period was the respiratory system in terms of organ failure and pulmonary sepsis with an overall rate of 12.4%; the most common postoperative infection was septicemia (7.2%). The rate of postoperative renal failure was 1%. There were 5 in-hospital deaths (5.2%). Conclusion : In this cohort of 97 non-preterm infants under one year old, the rate of patients with intra-operative and or postoperative complications was 30.9%. It is time to reconsider integrating goal directed therapies in intra-operative patient management to improve postoperative outcome.

SUBCUTANEOUS HEPARIN AND HEMORRHAGE: AN EIGHT YEAR INSTITUTIONAL EXPERIENCE

2004 ◽  
Vol 32 (Supplement) ◽  
pp. A163
Author(s):  
John McNelis ◽  
Garry Ritter ◽  
Rafael Barrera ◽  
Corrado P Marini
Keyword(s):  
Subcutaneous Heparin ◽  
Institutional Experience

scholarly journals Challenges and Outcomes of COVID-19 Positive Neurosurgical Patients: An Institutional Experience With Emphasis on Modifications of Neurosurgical Practice

Cureus ◽  
2021 ◽  
Author(s):  
Binoy K Singh ◽  
Biswajit Dey ◽  
Deb K Boruah ◽  
Aishik Mukherjee ◽  
Sumit Kumar ◽  
...  
Keyword(s):  
Neurosurgical Patients ◽  
Institutional Experience

scholarly journals MDCT Evaluation of Post-Operative Cranium: Spectrum of Normal Findings & Complications

2020 ◽  
Vol 11 (4) ◽  
pp. 6008-6016
Author(s):  
Ibrahim M. Eladl ◽  
Rania M. Hassan ◽  
Mona M. Eladl ◽  
Asmaa A. Alshamy ◽  
Hanan A. Bahaaeldin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Postoperative Complications ◽  
Postoperative Infection ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Neurosurgical Patients ◽  
Line Imaging

Imaging plays an essential role in the evaluation of patients after cranial surgery. Postoperative infection and hemorrhage are common complications after cranial surgeries. Life-threatening complications (like tension and paradoxical herniation) must be identified rapidly at imaging to secure a favorable prognosis. This cross-sectional study included 250 patients who underwent neurosurgical operations and were imaged for the developed postoperative complications using Computed Tomography(CT), Magnetic Resonance Imaging(MRI) with and without contrast. We reviewed the common normal and abnormal findings in post-operative neurosurgical patients. The expected postoperative CT and MRI appearances of these procedures are discussed, followed by complications. These include hemorrhage, tension , wound/soft tissue infection, bone flap infection and abscesses. Complications specifically related to include herniation, external brain , paradoxical herniation, and syndrome. In our study165 male; 58 % and 85 female; 42 % were included; age range (6months-69 years), mean age 34.7 ± 2.9 years. 130 patients underwent , infection (23%) was the most dominant complication followed by cranial hemorrhage (19 %). So to conclude;radiologist must know how to recognize postoperative complications and differentiate them from expected normal findings because an early and accurate diagnosis is important for proper postoperative care. tomography is fast, cost effective, and easily accessible for first-line imaging. Magnetic resonance imaging has higher sensitivity for detecting postoperative infection and ischemia.

TRACHEOSTOMY IN CRITICALLY ILL NEUROSURGICAL PATIENTS

2001 ◽  
Vol 5 (1) ◽  
pp. A5-A5
Author(s):  
Keith Y.C. Goh ◽  
Wendy Teoh ◽  
Chumpon Chan
Keyword(s):  
Critically Ill ◽  
Neurosurgical Patients
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