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Abdullah A. Alghamdi M.Sc. M.D. Steve K. Singh M.D. Barbara C. S. Hamilton M.Mus. Mrinal Yadava M.B.B.S. Helen Holtby M.D. Glen S. Van Arsdell M.D. Osman O. Al‐Radi M.D. 《Journal of cardiac surgery》2010,25(5):586-595
Abstract Objective: To derive evidence‐based recommendations regarding early extubation strategy after congenital cardiac surgery. Outcomes: Incidence of total mortality, morbidity, reintubation, length, and costs of intensive care unit and hospital stay. Evidence: Medline, Embase, and the Cochrane‐controlled trial register on the Cochrane library were searched from the earliest achievable date of each database to present. No language restrictions were applied. Retrieved reprints were evaluated according to a priori inclusion criteria, and those included were critically appraised using established internal validity criteria. Benefits and Harms: Early extubation (in the operating room or ≤6 hours after surgery) was associated with a lower early mortality. There was a trend toward lower ICU and hospital length of stays, lower hospital costs, and less respiratory morbidity. There was no difference in the rate of reintubation in those extubated early versus late. Conclusion: Early extubation appears safe and is associated with reduction in length of ICU and hospital stay without adverse effects on mortality or morbidity. However, studies to date are poor, heterogeneous, and not suitable to determine a causal effect. Therefore, there is need for a well‐designed randomized clinical trial to demonstrate the potential significant benefits of early extubation . (J Card Surg 2010;25:586‐595) 相似文献
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Andrea Garatti Andrea Daprati Marzia Cottini Claudio F. Russo Margherita Dalla Tomba Giovanni Troise Antonio Salsano Francesco Santini Roberto Scrofani Francesca Nicolò Elisa Mikus Alberto Albertini Luca Di Marco Davide Pacini Marco Picichè Loris Salvador Guglielmo M. Actis Dato Paolo Centofanti Lorenzo Menicanti 《The Annals of thoracic surgery》2021,111(4):1242-1251
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Effective weight loss and reduction in comorbidities has been convincingly demonstrated with bariatric surgery. Concerns regarding increased perioperative complications and poor results have led to a reluctance to offer such surgery to older patients. We performed a systematic review and meta-analysis of the published evidence for those in the ≥55-year age group. An electronic search was conducted of MEDLINE, EMBASE, and the Cochrane Library databases from 1990 to December 2010. We included laparoscopic studies published in English where the results were broken down by surgical procedure, reporting a minimum 6-month follow-up for ≥10 patients aged ≥55. After an initial screen of 2,543 titles, 298 abstracts were reviewed. Eighteen studies were included in the analysis. Of these, 10 included patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) (663 patients), and 11 included patients undergoing laparoscopic adjustable gastric banding (LAGB) (543 patients). Meta-analyses of body mass index (BMI) reductions indicated sustained and clinically significant BMI reductions for both RYGB (mean percentage of excess weight loss at 1?year, 72.6?%) and LAGB (mean percentage of excess weight loss at 1?year, 39.1?%). The 30-day mortality was 0.30 and 0.18?% for LRYGB and LAGB, respectively. Meta-analysis of old versus young patients revealed better comorbidity and mortality outcomes for younger patients. Bariatric surgery for patients ≥55?years achieves weight loss and reduction in comorbidities and mortality comparable to the general bariatric surgery population. Based on the above findings, patients should not be denied bariatric surgery on the basis of age alone. 相似文献
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Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery,part 1: pathophysiological considerations 下载免费PDF全文
M. J. Scott G. Baldini K. C. H. Fearon A. Feldheiser L. S. Feldman T. J. Gan O. Ljungqvist D. N. Lobo T. A. Rockall T. Schricker F. Carli 《Acta anaesthesiologica Scandinavica》2015,59(10):1212-1231
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