Abstract:
BACKGROUND:Respiratory failure secondary to a variety of causes remains a significant cause of morbidity and mortality in the pediatric population. Newer therapies are appearing frequently in an attempt to decrease the number of deaths from this disease state. We briefly review the current literature on some of the newer modalities including: high-frequency ventilation, surfactant, liquid ventilation, and nitric oxide. We then present our experience from the past 11 years in the most invasive, yet successful, therapy for acute respiratory failure-extracorporeal membrane oxygenation (ECMO). METHODS:Retrospective review of all patients treated with ECMO from September 1983 to December 1994 was undertaken. Data were collected from bedside ECMO flow sheets and the standardized data entry forms submitted to the Extracorporeal Life Support Organization. All statistical analyses were performed using a standard statistical software program. RESULTS:During the study period, 194 neonates and 47 pediatric patients were treated with ECMO. The survival rate in the neonatal population is 82% and in the pediatric population it is 40%. The neonatal patients required an average of 153 hours of support while the pediatric patients required 220 hours (P = 0.008). CONCLUSIONS:While the newer treatment modalities discussed may have an important role in treating neonatal and pediatric respiratory failure in the near future, ECMO remains a cornerstone of the modern treatment modalities. Although somewhat invasive, ECMO is effective therapy with increasing survival rates each year.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Arensman RM,Statter MB,Bastawrous AL,Madonna MBdoi
10.1016/s0002-9610(96)00057-8subject
Has Abstractpub_date
1996-07-01 00:00:00pages
41-7issue
1eissn
0002-9610issn
1879-1883pii
S0002961096000578journal_volume
172pub_type
杂志文章abstract::There is still considerable controversy among surgeons regarding the most opportune moment for surgical intervention in the case of acute cholecystitis. For this reason, 471 patients cholecystectomized for acute cholecystitis from 1970 through 1982 were studied. During the first period, there were two types of surgica...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90334-9
更新日期:1984-11-01 00:00:00
abstract::An animal wound model was used to compare the effectiveness of topical and systemic antibiotics and to examine the validity of using a combined regimen of both routes of antibiotic delivery. Gross infection rates and wound bacterial concentrations were determined after contamination with Staphylococcus aureus or Esche...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)91103-p
更新日期:1991-04-01 00:00:00
abstract::Vertical banded gastroplasty creates a channel by two applications of the TA-90 stapler from an end-to-end anastomosis window above the crow's foot to the angle of His, against a 32 F. tube along the lesser curvature. The caudad end of the channel is restricted by a 5 cm collar. Thirty-one obese patients more than 45 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80125-9
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.11.008
更新日期:2016-03-01 00:00:00
abstract::Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocki...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90377-3
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND:We performed an evaluation of antimicrobial guidelines for patients with surgical sepsis. METHODS:The purpose of this study was to validate current empiric antibiotic recommendations in our sepsis protocol based on the suspected site of infection. The primary objective was to assess the appropriateness of e...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.09.001
更新日期:2010-12-01 00:00:00
abstract::Neither computed tomography (CT) nor ultrasonography reliably distinguishes neoplastic from non-neoplastic pancreatic cysts. More invasive tests such as angiography or biopsy fail to differentiate these lesions in up to a third of patients. Because appropriate treatment differs greatly for these two classes of lesions...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81258-9
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the utility of breast-imaging studies in identifying cancer and high-risk lesions among patients with spontaneous, single-duct, nipple discharge (SSND). METHODS:The medical records of 168 cases with SSND treated with duct excision between June 1998 and May 2004 wer...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.032
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. METHODS:A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.12.022
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Surgery is indicated for acute uncomplicated appendicitis but the optimal timing is controversial. Recent literature is conflicting on the effect of time to intervention. METHODS:We queried the American College of Surgeons National Surgical Quality Improvement Project dataset for patients undergoing laparos...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.10.013
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:We report here the results of combined coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) repair and the factors associated with higher mortality following this procedure. METHODS:The authors performed a retrospective chart review of 26 patients who underwent combined CABG and AAA re...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00164-0
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Leakage from esophageal anastomoses is higher than that for other gastrointestinal anastomoses. An intrathoracic anastomotic leak is a potentially catastrophic event. METHODS:Patients with and without thoracic anastomotic leakage were compared for predisposing factors. Leak-related mortality was analyzed. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00559-1
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Several reports have indicated the benefits of the acute care surgery (ACS) model in surgical outcomes. We tried to delineate the impact of the ACS model on surgical efficiency and quality. METHODS:Before the ACS model was implemented, abdominal surgical emergencies were evaluated by an on-call nontrauma ge...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.04.016
更新日期:2014-11-01 00:00:00
abstract::Despite intensive investigation, the pathogenesis of postinjury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly implicate that the gastrointestinal tract plays a pivotal role. Shock with resulting gut hypoperfusion appears to be one important inciting event. While early studies ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(99)00231-7
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Platelets are thought to participate in tumor metastasis. However, the relationship between platelet count and prognosis in pancreatic cancer remains unresolved. METHODS:A chart review of patients undergoing resection for pancreatic adenocarcinoma was undertaken. Demographic, perioperative, and outcome data...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.014
更新日期:2005-03-01 00:00:00
abstract::Experience with 22 cases of reconstruction of the cervical esophagus, hypopharynx and oral cavity using free jejunal transfer is presented. The method requires an experienced team with high technical competence, but the benefits related to rapid single-stage completion and low morbidity certainly justify its use. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90197-x
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND:Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.04.020
更新日期:2007-02-01 00:00:00
abstract::Twenty-one patients presented with pathologic interactions between the gastrointestinal tract and aortic grafts. Seventeen patients were managed by excision of the graft and axillobifemoral bypass. Six patients died. four deaths were due to disruption of the proximal aortic stump after initial therapy that appeared su...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90003-3
更新日期:1980-08-01 00:00:00
abstract::The determination of surgical risk is a major problem in general surgical practice and many studies have attempted to predict postoperative outcome. Clinical judgment is still a fundamental skill with which the experienced surgeon can estimate the risk of postoperative infectious morbidity. Predictive scores based on ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81207-3
更新日期:1993-02-01 00:00:00
abstract::The current study suggests the need for routine post-discharge surveillance to improve reliability on surgical site infection incidence rates. Surveillance only during hospitalization may not provide precise data on the incidence of surgical site infection, underestimating a true postoperative infection rate. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.05.016
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:The use of neoadjuvant chemotherapy (NAC) for pancreatic ductal adenocarcinoma (PDAC) has increased in recent years. Limited data exists on the impact of NAC on biliary microbiome. METHODS:Patients who underwent pancreaticoduodenectomy (PD) for PDAC between 2014 and 2017 were reviewed. Patients were stratif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.042
更新日期:2020-10-05 00:00:00
abstract::In the period from 1976 through 1986, 62 procedures were performed. Of these, 42 were posterior flap hemipelvectomies, 5 anterior flap hemipelvectomies, and 15 internal hemipelvectomies. The median duration of these procedures was 6.5 hours, and the median blood loss was 2,541 ml. Postoperatively, there were no wound ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90273-0
更新日期:1989-11-01 00:00:00
abstract::The American Board of Surgery was established in 1937 to certify surgeons who through training, experience, and examination meet the highest standards of surgical care. This lecture was given as the Edgar Poth lecture at the April 2015 meeting of the Southwestern Surgical Congress. Dr Poth was a surgical educator from...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1016/j.amjsurg.2015.05.038
更新日期:2015-12-01 00:00:00
abstract::Part II of this two-part article (See The American Journal of Surgery 1992; 164: 85-9) reviews the current definition of the role of immunosuppressive therapy in inflammatory bowel disease (IBD) and the use of antibiotics in IBD, as well as summarizes the uses of the new agents on the horizon for the treatment of IBD....
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80381-2
更新日期:1992-08-01 00:00:00
abstract::Six patients with intestinal obstruction secondary to benign adhesions so dense and vascular that the operating surgeon could not free them, were placed on a home total parenteral nutrition program. Four patients had enterocutaneous fistulas, and two had their bowels divided and stomas created to divert intestinal con...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90331-8
更新日期:1983-12-01 00:00:00
abstract::A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90419-1
更新日期:1983-09-01 00:00:00
abstract::Stapling instruments have been used for gastrointestinal anastomoses and reconstruction with increasing regularity. A technique for loop colostomy closure employing a stapling device is described. This approach provides a secure closure while avoiding major contaimination. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90398-2
更新日期:1979-08-01 00:00:00
abstract::Over 10 years, 8 infants required surgery for central diaphragmatic herniation. Contrast peritoneography and technetium-99m-sulfur colloid radionuclide scanning were the most definitive diagnostic aids. Associated anomalies included variations of the pentalogy of Cantrell. A midline gastroduodenal loop was found in tw...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90009-6
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.023
更新日期:2008-12-01 00:00:00
abstract::A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80267-8
更新日期:1988-01-01 00:00:00