Aim:

The aim was to quantify the degree and duration of perioperative metabolic disturbance and

to determine the relationship between the metabolic changes and the duration of surgery and total volume of blood and colloid given during surgery.

Background:

These patients have the potential for massive KU-55933 mw blood loss and significant metabolic acidosis. Routine perioperative monitoring includes the serial measurement of base deficit (BD) as a marker of metabolic disturbance.

Methods/Materials:

All patients undergoing elective major craniofacial surgery were prospectively studied over a 10-month period. BD from arterial blood gas analysis was measured at standardized intervals during the perioperative period. The duration of surgery and total volume of blood and colloid given intraoperatively were used as covariates in a multiple regression analysis.

Results:

Maximum recorded BD ranged from Fer-1 nmr -3 to -20 (median -9). Median time taken to return to normal was 9.25 h (range 0-18 h). Median duration of significant BD was 3.8 h (range 0-20 h).

Conclusions:

Children undergoing major craniofacial surgery develop a varying degree of perioperative metabolic acidosis persisting for several hours. The maximum BD appears to be related to the amount of intraoperative blood loss and replacement rather than duration of surgery. As it is difficult to predict the extent and duration of metabolic acidosis for an

individual patient, this study confirmed our current practice that all patients should be admitted to a neurosurgical high-dependency unit postoperatively for overnight monitoring.”
“Objective. This systematic safety review reports multicenter safety results of symptomatic lumbar spinal stenosis (LSS) patients treated with percutaneous lumbar decompression. Design. All percutaneous lumbar decompression institutional review

boardapproved study patients, as well as a retrospective safety survey, were included in this review. Methods. All study centers followed the same widely accepted and standardized procedure for percutaneous decompression and utilized the same criteria when observing and reporting device- or procedure-related selleck chemicals adverse events. Outcome Measures. In addition to safety data, Oswestry Disability Index scores were used to document baseline functional disability, and visual analog scale values defined the intensity of baseline back and leg pain. Treatment outcomes of patients who reached 1-year follow-up were also included. Results. Of the 373 patients included in this safety review, there were no reports of major device- or procedure-related adverse events, and there were no mortalities. Major complications were defined as any device- or procedure-related event that required intervention, including events such as incidental durotomy, epidural hematoma, infection, or bleeding that required transfusion.