Abstract：
:Clinical parameters alone have repeatedly been proven unreliable in assessing cardiopulmonary status, especially in hemodynamically unstable patients. To learn if we had a diagnostic problem in our hospital, we compared physician assessment of cardiac index (CI) and thoracic fluid content (TFC) to values obtained using impedance cardiography (ICG). We selected the newest available ICG monitor, the BioZ, which employs this noninvasive technology. For CI measurements we have shown it to be equivalent to thermodilution and to be more reproducible (variability: 6.3% vs. 24.7%). Physician assessment of CI and TFC (high, normal, or low) was compared to the BioZ monitor's results in 186 patients, considered to be hemodynamically unstable, from the emergency room, the intensive care units, and the floors. Normal values were defined for CI (2.5-4.2 L/min m(2)) and for TFC (males: 30-50 kohm(-1) and females: 21-37 kohm(-1)). The concordance between physician assessment and the BioZ was 51% for CI with Kappa of 0.14 and 58% for TFC with Kappa of 0.19. Attendings did slightly better than the surgical residents with CI (52% vs. 48%) but slightly worse with TFC (57% vs. 61%). The potentially serious conditions of low CI and high TFC were misdiagnosed 42% and 46% of the time, respectively, by all physicians. Analysis of the data revealed that physician use of clinically available objective hemodynamic data, such as heart rate, blood pressure, and pulse pressure index, would not have been helpful. Furthermore, assistance from the pulmonary artery catheter (PAC) is often not available in our hospital, which has experienced a 90% decrease in its utilization over the past six years. Considering the increasing acuity of our aging patient population, accurate assessment of cardiopulmonary status is needed. The use of ICG could be a valuable addition to the physician's armamentarium.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Van De Water JM,Dalton ML,Parish DC,Vogel RL,Beatty JC,Adeniyi SOdoi
10.1007/s00268-004-2073-zkeywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
S95-8eissn
0364-2313issn
1432-2323journal_volume
29 Suppl 1pub_type
临床试验,杂志文章abstract：:Technetium 99m ((99m)Tc)-methoxyisobutylisonitrile (MIBI) scintigraphy has been reported to be a useful method for visualizing the parathyroid glands for the diagnosis of hyperparathyroidism. Some drug metabolism transporters, such as p-glycoprotein (P-GP) or multidrug resistance-associated protein (MRP), are believed...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0177-2
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:Anastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resectio...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4423-7
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:There is increasing interest in provision of essential surgical care as part of public health policy in low- and middle-income countries (LMIC). Relatively simple interventions have been shown to prevent death and disability. We reviewed the published literature to examine the cost-effectiveness of simple su...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2243-y
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:We aimed to systematically review the literature on the educational impact of Advanced Trauma Life Support (ATLS) courses and their effects on death rates of multiple trauma patients. METHODS:All Medline, Pubmed, and the Cochrane Library English articles on the educational impact of ATLS courses and their e...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-013-2294-0
更新日期：2014-02-01 00:00:00
abstract：BACKGROUND:Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. METHODS:Prospective data on 11...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2716-7
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Primary hyperaldosteronism (PHA) is a cause of secondary arterial hypertension potentially curable by laparoscopic unilateral adrenalectomy. We describe the follow-up of these patients according to their medical or surgical treatment. METHODS:We report a retrospective single-center study of 91 patients with...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2461-y
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Small intestinal neuroendocrine neoplasms (SI-NEN) are rare, and only about 40% of patients are diagnosed without distant metastases. Aim of the study was to identify prognostic factors in patients with potentially curative resected locoregional SI-NEN. METHODS:Patients with curative resected locoregional S...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05884-6
更新日期：2021-01-08 00:00:00
abstract：BACKGROUND:Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and f...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05034-7
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Vibrio vulnificus infection can progress rapidly in skin or soft tissue, and it is potentially life-threatening. The purpose of the present study was to explore the predictors of mortality in patients with V. vulnificus infections of skin or soft tissue. METHODS:The medical records of 119 consecutive patien...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0455-y
更新日期：2010-07-01 00:00:00
abstract：INTRODUCTION:Unilateral adrenal hyperplasia (UAH) is a rare, surgically correctable cause of primary hyperaldosteronism (PH). We report 2 cases and review the literature for cases of PH secondary to UAH successfully treated via surgery. METHODS:Two cases of UAH treated at our institution were retrospectively reviewed....
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-0594-8
更新日期：2007-01-01 00:00:00
abstract：:Pectus excavatum (PE) is one of the most common anomalies of childhood. It occurs in approximately 1 in every 400 births, with males afflicted 5 times more often than females. PE is usually recognized in infancy, becomes much more severe during adolescent growth years, and remains constant throughout adult life. Sympt...
journal_title：World journal of surgery
pub_type： 社论,评审
doi：10.1007/s00268-003-7025-5
更新日期：2003-05-01 00:00:00
abstract：:The surgical management of pancreatic islet cell carcinomas poses a complicated set of questions resulting from their rare occurrence and the difficulty in establishing a diagnosis in early cases or, conversely, the problems inherent in dealing with metastatic disease. However, because their biologic behavior is rathe...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01655109
更新日期：1993-07-01 00:00:00
abstract：:The hypervascular nature of carcinoid tumors and their metastases allows a more aggressive role by the radiologist in diagnosis and interventional management. Double-contrast gastrointestinal studies still best define the primary neoplasms. Appendiceal tumors, the most frequent site of carcinoids, frequently escape ra...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900023
更新日期：1996-02-01 00:00:00
abstract：BACKGROUND:Pancreatic cancer has higher concentrations of angiotensin II compared with other cancers. This study sought to assess the effect of angiotensin II receptor blockers (ARBs) on survival of patients undergoing resection using a large, nationally representative dataset. METHODS:Patients undergoing pancreatic c...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4021-8
更新日期：2017-09-01 00:00:00
abstract：BACKGROUND:Intestinal epithelial cell apoptosis has been reported in sepsis as a mechanism of organ failure. The aim of this study was to clarify the role of apoptosis-regulating proteins (bcl-2, bax, cytochrome-c, and caspase-8) in septic rats by studying their expression in gastric and intestinal epithelial cells. M...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0742-1
更新日期：2007-04-01 00:00:00
abstract：:Congenital diaphragmatic hernia (CDH) is one of the most common causes of neonatal morbidity and mortality. The clinical spectrum of CDH ranges from minimally affected infants who do well with modern neonatal care to severely affected infants who die despite all interventions. Two decades of research have led to advan...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-002-6739-0
更新日期：2003-01-01 00:00:00
abstract：PURPOSE:Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant complications. METHODS:The outcome of patients who underwe...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9504-1
更新日期：2008-06-01 00:00:00
abstract：INTRODUCTION:Preventing secondary insult to the brain is imperative following traumatic brain injury (TBI). Although TBI does not preclude nonoperative management (NOM) of splenic injuries, development of hypotension in this setting may be detrimental and could therefore lead trauma surgeons to a lower threshold for op...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4494-0
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:The commonest surgical treatment used for peptic ulcer perforation is omental patching. If, however, the perforation leaks, it rarely heals by itself due to persistence of duodenal fistula (DF). We present our experience with a T-tube placed into the DF for better outcome of the patients. METHODS:All patien...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2196-1
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:The pancreatic fistula rate following distal pancreatectomy ranges widely, from 13.3 to 64.0 %. The optimal closure method of the pancreatic remnant remains controversial, especially regarding whether to use a stapler. METHODS:All patients who underwent distal pancreatectomy in five Japanese hospitals from ...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-012-1595-z
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:Awake tracheostomy (AT) is aimed at securing the airway of patients with upper airway obstruction when other means are not feasible or have failed. Reports on AT in the literature are scarce. The goal of this study was to review our experience with the indications, complications and outcome of AT. METHODS:A...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4578-x
更新日期：2018-09-01 00:00:00
abstract：:A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted, especially during the last decade. This change in regimen was first seen in the handling of splenic trauma, initiated by pediatric surgeons. Later, the concept of conservative management was also introduced among a...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658672
更新日期：1990-07-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900418
更新日期：1998-05-01 00:00:00
abstract：BACKGROUND:The role of neutrophil-to-lymphocyte ratio (NLR) and preoperative prediction model in gastric cancer is controversial, while postoperative prognostic models are available. This study investigated NLR as a preoperative prognostic indicator in gastric cancer. METHODS:We reviewed patients with primary gastric ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4510-4
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Laparoscopic rectal resection (LRR) for cancer is a challenging procedure, with conversion to open surgery being reported in up to 30% of cases. Since only a few studies with short follow-up have compared converted LRR and open RR (ORR), it is unclear if conversion to open surgery should be prevented by pref...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4614-x
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Intra-abdominal adhesions constitute between 49% and 74% of the causes of small bowel obstruction. Traditionally, laparotomy and open adhesiolysis have been the treatment for patients who have failed conservative measures or when clinical and physiologic derangements suggest toxemia and/or ischemia. With the...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-7778-0
更新日期：2006-04-01 00:00:00
abstract：:The role of the tumor suppressor gene p53 and proto-oncogenes mdm-2, waf-1,and bcl-2 in sporadic colorectal carcinoma (CRC) has been well investigated. However, little is known about the role of these genes in the development of ulcerative colitis-associated colorectal carcinoma (CAC). Colectomy specimens from patient...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0237-7
更新日期：2002-03-01 00:00:00
abstract：BACKGROUND:Midgut malrotation most commonly presents in young children. This diagnosis is not often entertained in the adolescent or adult with abdominal complaints. We reviewed our experience with this subset of malrotation patients. METHODS:A retrospective review of medical records from adolescent or adult patients ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9490-3
更新日期：2008-07-01 00:00:00
abstract：:The first laparoscopic Nissen fundoplication was performed 20 years ago. Surgical management of gastroesophageal reflux disease (GERD) should be offered only to appropriately studied and selected patients, with the ultimate aim of improving the well-being of the individual, the "quality of life." The choice of fundopl...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-011-1050-6
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:Hepatic trisectionectomy is a challenge for surgeons. We describe a technique by combination of the Glisson pedicle method and anterior approach to perform hepatic trisectionectomy. METHODS:In this technique, the Glisson pedicles are isolated above the hilar plate without hilar dissection. After dividing th...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2579-y
更新日期：2014-09-01 00:00:00
