Driving Pressure and Postoperative Pulmonary Complications in Thoracic Surgery
One-Lung VentilationPostoperative Complications4 morePulmonary complications are the most common complication in thoracic surgery and the leading cause of mortality.Therefore, lung protection is utmost important, and protective ventilation is strongly recommended in thoracic surgery. Protective ventilation is a prevailing ventilatory strategy in these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure. However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, and positive end-expiratory pressure are not related to patient outcomes, or only related when they influenced the driving pressure. Recently, the investigators reported the first prospective study about the driving pressure-guided ventilation in thoracic surgery. PEEP was titrated to bring the lowest driving pressure in each patient and applied throughout the one lung ventilation. The application of individualized PEEP reduced the incidence of pulmonary complications.However, that study was small size single center study with 312 patients. Thus, investigators try to perform large scale multicenter study. Through this study investigators evaluate that driving pressure-guided ventilation can reduce the incidence of postoperative pulmonary complications compared with conventional protective ventilation in thoracic surgery.
Clinical Trial : Complications of in the Bag IOL Versus Optic Capture of IOL in Pediatric Cataract...
Posterior Capsule OpacificationPostoperative ComplicationsThis prospective, randomized, clinical trial looks to compare children undergoing congenital cataract surgery with intraocular lens (IOL) implantation in terms of visual axis obscuration as well as postoperative complications such as glaucoma, inflammation and IOL centration when IOL fixation is performed using two different techniques : 1) conventional in the bag IOL implantation with anterior vitrectomy, and, 2) posterior optic capture of the IOL through the posterior capsulorhexis without any vitrectomy. 61 eyes of 61 children randomized to receiving IOL implantation using one of the two techniques will be followed up until 12 months postoperatively.
Preoperative Biliary Drainage for the Lower Malignant Obstructive Jaundice
Postoperative ComplicationsPatients with the lower malignant obstructive jaundice planned to do the pancreaticoduodenectomy, receiving preoperative biliary drainage or early surgery (without preoperative biliary drainage), both groups has the similar surgical morbidity, no statistics significance.
Should Prosthetic Repair of Incisional Abdominal Hernias be Drain or Not?
Postoperative ComplicationsHerniaThe purpose of this study is to determine whether drainage after prosthetic repair of incisional abdominal hernias increases or decreases complications such as infection, seromas and hematomas.
Trendelenburg's Slide Prevention Study
Misadventure During Surgical OperationPostoperative ComplicationsThe purpose of this study is to compare two cushioning materials (a gel mattress and an egg-crate foam mattress) placed beneath patients undergoing gynecologic surgery to prevent patients from sliding toward the head of the bed during head-down positioning. Our hypothesis is that the two materials will be equally good at preventing slide on the table and that slide will be less than 5 cm (<2 inches) on average.
2% Chlorhexidine Gluconate Skin Cloths to Prevent SSI in Spine Surgery Patients
Surgical Site InfectionsPost Operative ComplicationSurgical site infection (SSI) following spinal surgery is a frequent complication and results in higher morbidity, mortality and healthcare costs. SSI following adult spinal surgery is a frequent complication that has been reported to occur in 0.7-12.0% of patients and result in higher postoperative morbidity, mortality and health care costs. Vanderbilt University Medical Center SSI rate is 7%. Treatment for SSI can be challenging often requiring revision surgery, long-term antibiotics, and prolonged hospitalization. The accurate identification of risk factors is thus important in the development of strategies to prevent these potentially devastating infections. This study proposes a randomized, controlled trial of neuro-spine patients of 2% chlorhexidine gluconate skin preparation cloths for the prevention of post op surgical site infections in spine patients. Use of CHG cloths the night before and morning of surgery (neckline to toes) will affect (decrease rates) of SSI compared to patients who receive routine standard of care (soap and water pre-op, day of surgery and daily post-operative).
Individualized Perioperative Open Lung Ventilatory Strategy
Moderated-high Risk of Postoperative Pulmonary ComplicationAbdominal Surgery Expected More Than Two HoursThe purpose of this study is to determine whether individualized ventilatory management combining the use of low tidal volumes, alveolar recruitment maneuvers, individually titrated positive end-expiratory pressure and postoperative individualized ventilatory support will decrease postoperative complications, unplanned ICU readmissions, ICU and hospital length of stay and mortality compared to a standardized Lung Protective Ventilation (LPV) for all patients at risk.
A Study of Residual Curarization Incidence in China
Perioperative/Postoperative ComplicationsPORC (Postoperative Residual Curarization)The purpose of this study is to determine the incidence of residual curarization in PACU and relevant risk factors.
HemORL: Monocentric, Prospective, Comparative Study on the Use of a Haemostatic Vacuum Device During...
TonsillectomyHemorrhage1 moreThe long-term objective of this study is to prove: the equivalence of the number of post-operation hemorrhages, and maybe a decrease of the number of secondary hemorrhages the decrease of pain and quicker re-feeding an easier haemostasis the simplification of the tonsillectomy surgical kit the decrease of dissection time
Postoperative Inflammation and Recovery After Tracheostomy
Tracheostomy ComplicationInflammation1 moreThe main purpose of this study is to examine if there are differences in postoperative inflammation following percutaneous dilatation tracheostomy versus surgical tracheostomy in intensive care unit patients.