Healthcare professionals



J Clin Pharmacol. 2010 May 25. [Epub ahead of print]

Safety of Plasma Volume Expanders.

Farrugia A.

Plasma Protein Therapeutics Association.

Abstract

Hypovolemia from a range of etiologies can lead to severe morbidity and mortality unless blood volume and tissue perfusion are restored. The treatment of hypovolemia has included the improvement and restoration of blood volume loss by the intravenous infusion of plasma expanding therapeutic agents. These have included crystalloid and/or colloid solutions, and a brisk controversy as to which modality is better has engaged therapeutics for the past 30 years. In addition, those favoring either modality have debated which crystalloid, and which colloid, is better. This area was given a dramatic turn a decade ago when a Cochrane meta-analysis concluded that albumin, a historically important plasma expander, resulted in increased mortality when administered to critically ill patients. Although subsequently modified by other studies, the Cochrane meta-analysis has served to generate an ongoing interest in the safety of plasma expanders. This review will assess the safety of these therapies from the viewpoint of the heterogeneous range of clinical indications for which they are used.
 

Dig Surg. 2010 Jun 22;27(3):224-231. [Epub ahead of print]

A Simple Novel Model to Predict Hospital Mortality, Surgical Site Infection, and Pneumonia in Elderly Patients Undergoing Operation.

Huang TS, Hu FC, Fan CW, Lee CH, Jwo SC, Chen HY.

Divisions of General Surgery, Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University, Keelung Branch, Keelung, Taiwan, ROC.

Abstract

Background/Aims: Predicting models of operative morbidity and mortality in the geriatric population are important in the prevention of adverse surgical outcomes. Methods: A retrospective review of medical records was performed for patients over 80 years of age who underwent gastrointestinal surgery from 1998 to 2008. Results: 215 patients were identified with a mean age of 83.7 years. Overall morbidity and mortality rates were 48.8 and 14.4%, respectively. Multivariate logistic regression analysis revealed that serum albumin levels [odds ratio (OR) = 0.367, p = 0.0267], postoperative pneumonia (OR = 3.471, p = 0.0101), hollow organ perforation or anastomosis combined with leakage (OR = 7.600, p = 0.0126), and preoperative systemic inflammatory response syndrome (OR = 3.186, p = 0.0323) were significant predictors of hospital mortality. Moreover, albumin (OR = 0.270, p = 0.0002) and physical disability (OR = 3.802, p = 0.0009) were significant predictors of postoperative pneumonia, and albumin (OR = 0.491, p = 0.0212) and enterotomy (OR = 3.335, p = 0.0208) were significant predictors of surgical site infections. Conclusion: This study provides novel predicting models to identify the elderly surgical patients at high risk, who should receive more intensive preventive and perioperative care. Copyright © 2010 S. Karger AG, Basel.
 
More Articles...
<< Start < Prev 1 2 3 4 5 6 7 8 9 10 Next > End >>

Page 1 of 42