scholarly journals Randomized Study Comparing Pre-Operative Glycemic Profile in Pediatric Cardiac Surgical Patients Administered Oral Carbohydrate Solution Preoperatively versus Those Kept Fasting

2018 ◽  
Vol 08 (06) ◽  
pp. 298-306
Author(s):  
Uma Balasubramaniam ◽  
Usha Kiran ◽  
Suruchi Hasija ◽  
V. Devagourou
Keyword(s):  
Randomized Study ◽  
Surgical Patients ◽  
Glycemic Profile ◽  
Carbohydrate Solution

Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: a randomized study

1989 ◽  
Vol 70 (4) ◽  
pp. 530-535 ◽  
Author(s):  
Ludwig M. Auer ◽  
Wolfgang Deinsberger ◽  
Kurt Niederkorn ◽  
Günther Gell ◽  
Reinhold Kleinert ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Medical Treatment ◽  
Functional Recovery ◽  
Randomized Study ◽  
Treated Group ◽  
Surgical Patients ◽  
Lower Mortality ◽  
Intracerebral Hematoma ◽  
Content Type ◽  
Fine Print

✓ A controlled randomized study of endoscopic evacuation versus medical treatment was performed in 100 patients with spontaneous supratentorial intracerebral (subcortical, putaminal, and thalamic) hematomas. Patients with aneurysms, arteriovenous malformations, brain tumors, or head injuries were excluded. Criteria for inclusion were as follows: patients' age between 30 and 80 years; a hematoma volume of more than 10 cu cm; the presence of neurological or consciousness impairment; the appropriateness of surgery from a medical and anesthesiological point of view; and the initiation of treatment within 48 hours after hemorrhage. The criteria of randomization were the location, size, and side of the hematoma as well as the patient's age, state of consciousness, and history of hypertension. Evaluation of outcome was performed 6 months after hemorrhage. Surgical patients with subcortical hematomas showed a significantly lower mortality rate (30%) than their medically treated counterparts (70%, p < 0.05). Moreover, 40% of these patients had a good outcome with no or only a minimal deficit versus 25% in the medically treated group; the difference was statistically significant for operated patients with no postoperative deficit (p < 0.01). Surgical patients with hematomas smaller than 50 cu cm made a significantly better functional recovery than did patients of the medically treated group, but had a comparable mortality rate. By contrast, patients with larger hematomas showed significantly lower mortality rates after operation but had no better functional recovery than the medically treated group. This effect from surgery was limited to patients in a preoperatively alert or somnolent state; stuporous or comatose patients had no better outcome after surgery. The outcome of surgical patients with putaminal or thalamic hemorrhage was no better than for those with medical treatment; however, there was a trend toward better quality of survival and chance of survival in the operated group.

Preoperative parenteral nutrition in malnourished surgical patients: a prospective randomized study

1990 ◽  
Vol 9 ◽  
pp. 55
Author(s):  
G.B. Doglietto ◽  
M. Bossola ◽  
F. Pacelli ◽  
F. Negro ◽  
R. Bellantone ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Randomized Study ◽  
Surgical Patients ◽  
Prospective Randomized Study

Nutritional Approach in Malnourished Surgical Patients: A Prospective Randomized Study

2002 ◽  
Vol 17 (5) ◽  
pp. 325-326
Author(s):  
M Braga ◽  
L Gianotti ◽  
L Nespoli ◽  
G Radaelli ◽  
V Di Carlo
Keyword(s):  
Randomized Study ◽  
Surgical Patients ◽  
Prospective Randomized Study

scholarly journals Comparison of propofol-based versus volatile-based anaesthesia and postoperative sedation in cardiac surgical patients: a prospective, randomized, study

2018 ◽  
Vol 50 (3) ◽  
pp. 200-209
Author(s):  
Marcin Wąsowicz ◽  
Angela Jerath ◽  
Warren Luksun ◽  
Vivek Sharma ◽  
Nicholas Mitsakakis ◽  
...  
Keyword(s):  
Randomized Study ◽  
Surgical Patients ◽  
Prospective Randomized Study

Transfusion with Washed vs. Unwashed Packed Red Cells in Coronary Artery Bypass Graft (CABG) Surgery: Major Outcome Differences

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2887-2887 ◽  
Author(s):  
Wenche Jy ◽  
Orlando Gomez-Marin ◽  
Tomas A Salerno ◽  
Anthony Panos ◽  
Donald Williams ◽  
...  
Keyword(s):  
Adverse Events ◽  
Artery Bypass ◽  
Randomized Study ◽  
Bypass Graft ◽  
Surgical Patients ◽  
Prospective Randomized Study ◽  
Artery Bypass Graft ◽  
Serious Adverse Events ◽  
Small Patient Population ◽  
Small Patient

Abstract BACKGROUND: Blood transfusion (Tx) carries greater risks of adverse events (AEs) than previously appreciated. These adverse effects include higher incidence of post-surgical infections, longer hospital stay, higher mortality, more frequent serious adverse events (SAE’s), and generally poorer surgical outcomes. Accordingly, ameliorating these adverse effects constitutes an urgent challenge to medical science. Factors responsible for Tx-related adverse events (AE’s) are not well understood. Many potentially toxic substances are released during blood storage, and many of them have been implicated or postulated as culprits. Washing of packed RBC remove these products and may ameliorate transfusion-related AE’s. Benefits of washed RBC are well established for pediatric surgical patients, chiefly by preventing hyperkalemia, but use of washed RBC in adult surgical patients has not heretofore been systematically investigated. We here report results of a prospective randomized study directly comparing surgical outcomes, in terms of mortality and AE’s, between groups of adult CABG patients transfused with either washed or unwashed (conventional) RBC. METHODS: A prospective randomized study of 148 patients undergoing coronary artery bypass graft (CABG) was conducted. Fifty-eight patients were randomized to receive unwashed (conventional) RBC (UW group) and 41 to washed RBC (W group). The remaining 49 did not require Tx. The main in-hospital outcomes recorded included mortality, serious adverse events (SAE’s), non-serious adverse events (AE’s), and SOFA scores pre- and post-surgery. A telephone interview was conducted at day 30 post-discharge, and mortality at one-year was also assessed. The statistical techniques used for the comparison of the UW and W RBC groups included: independent sample t-tests for variables with normal or approximately normal distribution; Mann-Whitney tests for variables with skewed distributions and for ordinal variables; chi-squared tests or Fisher’s exact tests for discrete variables; and logistic regression model for assessing different factors as predictors of the occurrence of each kind of event. RESULTS: Between the 2 groups, demographic, clinical, and comorbidity data were similar and there was no statistically significant difference in number of serious AE’s (SAE’s). However, 4 of 6 patients died from SAE’s in the UW group but all 7of 7 with SAE in the W group survived. The in-hospital mortality was greater in the UW group (4 vs. 0, p = 0.149) but 1-year post-op mortality was significantly higher in UW group (7 vs. 0, p=0.036). Frequency of less serious AE’s was higher in UW group in every category. Negative binomial regression analyses showed that, after adjusting for comorbidities, UW-group are likely to experience 64% more AEs (p= 0.027). The 30-day follow-up showed similar trends of higher AE’s in UW-group, but only CNS-related AE’s were significant (30 vs. 5, p<0.01). CONCLUSIONS / DISCUSSION: These data suggest major benefits to patient outcomes by use of washed RBC in CABG. Most important is significant reduction of mortality. Less serious AE’s were also lower in the W group in nearly every category, but only CNS-related AE’s were statistically significant in this comparatively small patient population. To our knowledge, this is the first prospective randomized study in adults to assess possible benefits of washing RBC prior to cardiac surgery. At present, washed RBCs are seldom used in adults but the present study clearly demonstrates major advantages. It may be possible to reduce costs of washing by using on-site cell call-salvage equipment but this needs to be evaluated. This study was undertaken with the hypothesis that cell-derived microparticles (MP) are major culprits in Tx-associated AE’s. Further study is needed to determine if that hypothesis is correct. Other evidence has led us to conjecture that MP are largely responsible for post-surgical adverse outcomes; the present study is consistent with that conjecture but does not prove it. A major shortcoming of this study is the comparatively small patient population. A much larger study, including other types of surgery, is certainly warranted by these findings, and should be designed to include more quantitative evaluation of post-surgical cognitive impairment. Disclosures No relevant conflicts of interest to declare.

Structured Versus Long-Chain Triglycerides: A Safety, Tolerance, and Efficacy Randomized Study in Colorectal Surgical Patients

1999 ◽  
Vol 23 (3) ◽  
pp. 123-127 ◽  
Author(s):  
Rocco Bellantone ◽  
Maurizio Bossola ◽  
Concetta Carriero ◽  
Marina Malerba ◽  
Paolo Nucera ◽  
...  
Keyword(s):  
Randomized Study ◽  
Surgical Patients ◽  
Long Chain Triglycerides ◽  
Long Chain

scholarly journals A prospective randomized study to see the effects of combined administration of dexmedetomidine plus propofol versus propofol alone in cardiac surgical patients.

2021 ◽  
Vol 28 (04) ◽  
pp. 447-454
Author(s):  
Sajid Farooq ◽  
Muhammad Farhan Ali Rizvi ◽  
Sana Urooj Hashmi ◽  
Mirza Ahmad Raza Baig ◽  
Hafiz Syed Muhammad Irfan Yousaf ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Randomized Study ◽  
Systolic Arterial Pressure ◽  
Cardiac Surgical Procedures ◽  
Surgical Patients ◽  
P Value ◽  
Intraoperative Awareness ◽  
Combined Administration ◽  
Group 2 ◽  
Group 1

Objective: To compare the hemodynamics changes, intraoperative awareness and postoperative delirium after combined administration of dexmedetomidine plus propofol versus propofol alone in cardiac surgical patients. Study Design: Randomized Clinical Trial. Setting: Cardiac Center, Bahawal Victoria Hospital, Bahawalpur. Period: 1st December 2018 to January 2020. Material & Methods: Sixty-two (62) patients who underwent different cardiac surgical procedures were included in the study. Patients were randomly divided in group 1 {Dexmedetomidine (DEX) +Propofol} and group 2 {propofol alone}. Induction in group 1 was done by loading dose of DEX (0.7 microgram/kg) while induction in group 2 was done by Lignocaine 1.5 mg/kg. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) were recorded at different time intervals. Intraoperative awareness and post-operative delirium was also assessed. Results: All hemodynamic parameters (HR, SAP, DAP, MAP) were statistically significant lower in group 1 in comparison to group 2 at different intervals indicating a more stable hemodynamic profile in group 1. End tidal CO2, pH, and peak airway pressures were not statistically significant between both groups. Intra-operative awareness was diagnosed in 1 (3.2%) patients in group 1 and in 5 (16.1%) patients in group 2 (p-value 0.08). Delirium was diagnosed in 3 (9.6%) patients in group 1 and in only 1 (3.2%) patients in group 2 (p-value 0.30). Conclusion: Combined administration of DEX and propofol produces more stable hemodynamics, less intraoperative awareness but more incidence of delirium as compared to propofol alone in cardiac surgical patients.

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