Management of Intra-operative Crises, An Issue of Thoracic Surgery Clinics

Name: Management of Intra-operative Crises, An Issue of Thoracic Surgery Clinics
Brand: Elsevier
Price: 59.99 EUR
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Shanda H. Blackmon(Autor*in)

Elsevier (Verlag)

1. Auflage

Erschienen am 12. November 2015

100 Seiten

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978-0-323-39359-1 (ISBN)

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Front Cover
Management of Intraoperative Crises
Copyright
Contributors
Contents
Thoracic Surgery Clinics
Preface
Erratum
Pulmonary Artery Bleeding During Video-Assisted Thoracoscopic Surgery
Key points
Introduction
Incidence of pulmonary artery bleeding during video-assisted thoracoscopic surgery lobectomies
Mechanisms of pulmonary artery injury
During Dissection of an Adjacent Hilar Structure
During Pulmonary Artery Dissection
Planning
Intraoperative techniques to control injury
Summary
References
Intraoperative Tracheal Injury
Key points
Introduction
Prevention
Diagnosis
Methods of injury
Esophagectomy
Tracheostomy
Intubation
Other
Repair
Conservative Management
Summary
References
Massive Airway Hemorrhage
Key points
Introduction
Cause
Management strategy
Stabilization
Securing the airway
Bleeding control
Bleeding Control by Flexible/Rigid Bronchoscopy
Interventional Radiology Approaches
Surgery
Summary
References
Great Vessel Injury in Thoracic Surgery
Key points
Intraoperative bleeding in general thoracic surgery
Preoperative Imaging and Vascular Anatomic Variation
Minimally Invasive Thoracic Surgery and Intraoperative Bleeding
Device Malfunction
Procedure-specific bleeding
Lung Resection
Overview
Less common clinical scenarios
Surgical technique
Consequences
Extrapleural Pneumonectomy for Mesothelioma
Decortication
Mediastinal Procedures
Thymectomy
Mediastinoscopy
Mediastinoscopy and the complex mediastinum
Surgical technique and specific injuries
Superior vena cava injury
Innominate artery injury
Azygous vein injury
Aortic injury
Esophageal surgery
Specific injuries
Aortic injury
Supraceliac aortic vascular control
Celiac trunk and branches
Spleen
Summary
References
Endotracheal Tube Management and Obstructed Airway
Key points
Introduction
Monitoring
Lung isolation
Double-Lumen Endotracheal Tube
Bronchial Blocker
Adjunct Ventilation Modalities
Summary
Obstructed airway
Introduction
Presentation
Cause
Anesthesia
Management
Dilation
Recanalization
Airway stents
Tissue destruction
Postoperative Management
Summary
References
Operative and Perioperative Pulmonary Emboli
Key points
Introduction
Risk factors
Pathophysiology
Intraoperative detection
Initial stabilization and monitoring
Venous thromboembolism in thoracic surgery patients
Prevention
Treatment
Heparin-induced thrombocytopenia
Therapeutic options for the treatment of acute pulmonary embolism
Anticoagulation
Systemic Thrombolysis
Catheter Embolectomy or Catheter-Directed Thrombolysis
Pulmonary Embolectomy
Pulmonary embolectomy
Indications for surgical embolectomy
Surgical technique
Postoperative anticoagulation
Pulmonary embolism in pregnancy
Other embolic syndromes
Summary
References
Further readings
Acute Intraoperative Pulmonary Aspiration
Key points
Introduction
Pulmonary aspiration: definition, consequences, and risk factors
Definition and Consequences
Risk Factors
Risk factors: medications
Risk factors: predisposing conditions
Risk factors: provider expertise
Prevention
Preoperative Risk Assessment
Preoperative Fasting
Preemptive Nasogastric Tube Placement
Histamine Blockers, Proton Pump Inhibitors, and Prokinetics
Rapid-Sequence Induction
Patient Positioning During Induction
Management of acute intraoperative aspiration
Summary
Acknowledgments
References
Coagulopathy and Anticoagulation During Thoracic Surgery
Key points
Introduction
Classification of anticoagulation agents
Major Classification
Classification of Novel Oral Anticoagulants
Classification of antiplatelet agents
Assessment of risk
Risk of Thromboembolism
Risk Stratification
Risk Scores
Timing
Risk of Bleeding
Classification of bleeding
Risk scores
Risk of Bleeding Versus Venous Thromboembolism
General principles of perioperative antithrombotic management
Perioperative management of anticoagulation therapy
Discontinuation and Bridging of Anticoagulation Agents
Definition
Postoperative Resumption of Anticoagulation Therapy
Perioperative management of antiplatelet therapy
Discontinuation of Antiplatelet Therapy for Coronary Stents
Bridging for Antiplatelet Therapy
Resumption of Antiplatelet Therapy
Vena caval filters
Hereditary hypercoagulable conditions
Urgent reversal of anticoagulation
Summary
References
Cardiopulmonary Bypass and Extracorporeal Life Support for Emergent Intraoperative Thoracic Situations
Key points
Introduction
Predictors of operative mortality and avoidable factors
Use of cardiopulmonary bypass in thoracic surgery
Emergent Use of Cardiopulmonary Bypass in Thoracic Surgery
Outcomes of Cardiopulmonary Bypass with Resection of Thoracic Malignancies
Use of venoarterial extracorporeal membrane oxygenation in thoracic surgical procedures
Use of venovenous extracorporeal membrane oxygenation in thoracic surgical procedures
Lung transplantation: cardiopulmonary bypass or extracorporeal membrane oxygenation?
Summary
References
Management of Complications After Pneumonectomy
Key points
Patient selection
Mortality
Morbidity
Technical complications
Postoperative Hemorrhage
Patch Complications
Cardiovascular complications
Arrhythmias
Myocardial Infarction
Cardiac Arrest
Pulmonary Artery Hypertension
Mechanical Cardiac Complications
Constrictive inflammatory epicarditis
Cardiac herniation
Acute mediastinal shift
Tamponade
Respiratory complications
Pneumonia
Acute Respiratory Distress Syndrome
Postpneumonectomy Syndrome
Empyema
Bronchopleural Fistula
Hematologic complications
Summary
References
Video-Assisted Thoracic Surgery After Median Sternotomy for Cardiac Surgery
Key points
Introduction: nature of the problem
Surgical technique
Preoperative Planning
Preparation and Patient Positioning
Monitoring
Surgical Approach
Surgical Procedure
Incision placement
Camera and visualization considerations
Safe dissection of adhesions by internal mammary artery
Division of adhesions to mediastinum
Management of injury to internal mammary artery graft
Immediate postoperative care
Rehabilitation and recovery
Summary
References
Postlobectomy Early Complications
Key points
Introduction
Air leak
Prevention strategies
Bronchial Stump Buttressing with a Muscle Flap
Pleural Tent
Suture Closure of Identified Leaks
Buttressed Staple Line
Fissureless Operation
Sealants
Expedited Liberation from Mechanical Ventilation
Treatment strategies
Nonoperative Management
Operative Management
Pneumonia/Mucous Plugging
Prevention strategies
Chest Physiotherapy
Aggressive Strategies
Pain Control
Smoking Cessation
Treatment strategies
Antibiotic Treatment
Aggressive Chest Physiotherapy
Ventilatory Support
Atrial fibrillation
Prevention strategies
Treatment strategies
Right middle lobe torsion
Prevention strategies
Treatment strategies
Hemorrhage
Chylothorax
Nerve injury
Phrenic Nerve
Recurrent Laryngeal Nerve
Summary
References
Index

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