scholarly journals Recruitment Maneuver in Elderly Patients with Different Peripheral Chemoreflex Sensitivity during Major Abdominal Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Nikita Trembach ◽  
Igor Zabolotskikh
Keyword(s):  
Abdominal Surgery ◽  
Elderly Patients ◽  
Recruitment Maneuver ◽  
Biomechanical Properties ◽  
Major Abdominal Surgery ◽  
Breath Holding ◽  
Initial Value ◽  
Chemoreflex Sensitivity ◽  
Peripheral Chemoreflex ◽  
Respiratory Biomechanics

The goal of the study was to evaluate the effect of a recruitment maneuver on respiratory biomechanics, oxygenation, and hemodynamics in patients suffering from chronic heart failure with different peripheral chemoreflex sensitivity. The study was conducted in 115 elderly patients which underwent major abdominal surgery under general/epidural surgery. Peripheral chemoreflex sensitivity (PCS) was evaluated with breath-holding duration (BHD) during breath-holding test. All patients were divided into two groups: group H had a high PCS (BHD = 38 seconds or less,n=49); Group M had a middle PCS (BHD more than 38 seconds,n=66). Recruitment maneuver improved oxygenation and respiratory biomechanics in all cases. However, cardiac output decreased by an average of 18%–31% in group H compared to 18%–28% in group M. SVR either remained unchanged or decreased by up to 14% of the initial value in group H, while, in group M, it had a tendency to increase, which was 24% of the initial value. So, recruitment maneuver is an effective method to improve oxygenation and biomechanical properties of the respiratory system but in patients with increased peripheral chemoreflex sensitivity it associates with the risk of hemodynamic disturbances.

scholarly journals THE INFLUENCE OF PERIPHERAL CHEMOREFLEX SENSITIVITY ON THE CRITICAL INCIDENTS RATE DURING COMBINED ANESTHESIA

2018 ◽  
Vol 25 (3) ◽  
pp. 113-118
Author(s):  
N. V. TREMBACH
Keyword(s):  
Abdominal Surgery ◽  
Critical Incidents ◽  
High Sensitivity ◽  
Major Abdominal Surgery ◽  
Physical Status ◽  
Factors Associated ◽  
Chemoreflex Sensitivity ◽  
Combined Anesthesia ◽  
Peripheral Chemoreflex ◽  
The Impact

Aim. The goal of the study was to assess the impact of peripheral chemoreflex sensitivity on the rate of critical incidents in extensive abdominal operations.Materials and methods. The study included 176 patients who underwent major abdominal surgery under combined anesthesia. On the eve of surgery, sensitivity of peripheral chemoreflex was determined in all subjects. Sex, age, initial physical status, cardiovascular risk were also registered. During anesthesia hemodynamic, respiratory and metabolic critical incidents were registered.Results. In total, 158 critical incidents were observed. They were significantly more common in patients with high sensitivity to peripheral chemoreflex (72% vs. 48%, p<0.05). The structure of critical incidents was dominated by hemodynamic, primarily hypotension, and its frequency was 2 times higher among patients with high sensitivity of peripheral chemoreflex.The logistic regression showed that factors associated with the risk of critical incidents are high sensitivity of peripheral chemoreflex, increased age, and initially high grade of ASA scale.Conclusion. Hemodynamic incidents are the most common in major abdominal surgery; risk factors for their development are high sensitivity of peripheral chemoreflex, increased age and deterioration of the initial physical status.

An evaluation of the quality of care for elderly patients undergoing major abdominal surgery

2007 ◽  
Vol 205 (3) ◽  
pp. S40 ◽  
Author(s):  
Marcia L. McGory ◽  
Paul Shekelle ◽  
Arlene Fink ◽  
Michael Leonardi ◽  
Janak Parikh ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Major Abdominal Surgery

scholarly journals A multicomponent prehabilitation pathway to reduce the incidence of delirium in elderly patients in need of major abdominal surgery: study protocol for a before-and-after study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ties L. Janssen ◽  
Christina A. Mosk ◽  
Chantal C. H. A. van Hoof-de Lepper ◽  
Daphne Wielders ◽  
Tom C. J. Seerden ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Elderly Patients ◽  
Study Protocol ◽  
Major Abdominal Surgery ◽  
Before And After ◽  
Before And After Study

scholarly journals Multimodal prehabilitation to reduce the incidence of delirium and other adverse events in elderly patients undergoing elective major abdominal surgery: An uncontrolled before-and-after study

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0218152 ◽  
Author(s):  
T. L. Janssen ◽  
E. W. Steyerberg ◽  
J. C. M. Langenberg ◽  
C. C. H. A. van Hoof- de Lepper ◽  
D. Wielders ◽  
...  
Keyword(s):  
Adverse Events ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Major Abdominal Surgery ◽  
Before And After ◽  
Before And After Study

scholarly journals The Efficacy of Multimodal Prehabilitation in Elderly Patients Undergoing Elective Major Abdominal Surgery: A Systematic Review Protocol

2021 ◽  
Author(s):  
Yu Xiang Tan ◽  
Miny Samuel ◽  
Ning Qi Pang
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
The Elderly ◽  
Major Abdominal Surgery ◽  
Walking Distance ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Introduction Multimodal prehabilitation has been touted as a potential strategy to better prepare our elderly and frail patients for major surgery. While randomized controlled trials and systematic reviews have been done to investigate the effect of prehabilitation on various surgical cohorts, most of these studies have focused on single modality prehabilitation and without an emphasis on the elderly. This systematic review aims to assess the effect of a multimodal prehabilitation program on elderly patients undergoing major abdominal surgery. MethodsThis protocol has been written according to the PRISMA-P statement and is registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number 250281). MEDLINE, EMBASE, CENTRAL, CINAHL and PsychINFO databases will be searched. Only randomized controlled trials with an average study population age ≥65 that has undergone major abdominal operation with at least two components (physical, nutritional, psychological) of prehabilitation will be included. Clinical outcomes that will be collected include post-operative morbidity and mortality, length of stay, 30-day readmission and peri-operative 6-minute walking distance. The risk of bias in included studies will be assessed. Data will be pooled where possible. DiscussionThis systematic review will evaluate and establish the effectiveness of multimodal prehabilitation for the elderly, who represents the group of patients most likely to benefit from prehabilitation. This review with its focus on the elderly will provide us with fresh insight into the utility of prehabilitation that will better inform policy makers in its implementation.PROSPERO Registration: On 20/04/2021, ID 250281

Disability after major abdominal surgery: determinants of recovery of walking ability in elderly patients

2018 ◽  
Vol 54 (5) ◽  
Author(s):  
Lucia Petrucci ◽  
Serena Monteleone ◽  
Susanna Ricotti ◽  
Erica Giromini ◽  
Mariangela Gullace ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Elderly Patients ◽  
Major Abdominal Surgery ◽  
Walking Ability
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