BOOK
Management of Intra-operative Crises, An Issue of Thoracic Surgery Clinics, E-Book
(2015)
Additional Information
Book Details
Abstract
Management of Intra-operative Crises is reviewed extensively in this important Thoracic Surgery Clinics of North America issue. Articles include: Massive Airway Hemorrhage; Great Vessel Injury; Endotracheal Tube Management and Obstructed Airway; Perioperative or Operative Pulmonary Embolus; Acute Intraoperative Aspiration; Patent Mammary Disruption During Thoracic Surgery; Immediate Post-lobectomy Crisis Management; Cardiopulmonary Bypass, Rapid Pacing, and ECMO for Emergent Intraoperative Thoracic Situations; Unexplained Intraoperative Hypotension; Coagulopathy & Anticoagulation during Thoracic Surgery; Perioperative Pneumonectomy Management; Pulmonary Artery Bleeding during VATS; Tracheal Repair and Airway Management; and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Management of\rIntraoperative Crises | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| Contents | v | ||
| Thoracic Surgery Clinics | viii | ||
| Preface | ix | ||
| Erratum | x | ||
| Pulmonary Artery Bleeding During Video-Assisted Thoracoscopic Surgery | 239 | ||
| Key points | 239 | ||
| Introduction | 239 | ||
| Incidence of pulmonary artery bleeding during video-assisted thoracoscopic surgery lobectomies | 240 | ||
| Mechanisms of pulmonary artery injury | 241 | ||
| During Dissection of an Adjacent Hilar Structure | 241 | ||
| During Pulmonary Artery Dissection | 242 | ||
| Planning | 243 | ||
| Intraoperative techniques to control injury | 244 | ||
| Summary | 245 | ||
| References | 246 | ||
| Intraoperative Tracheal Injury | 249 | ||
| Key points | 249 | ||
| Introduction | 249 | ||
| Prevention | 249 | ||
| Diagnosis | 250 | ||
| Methods of injury | 250 | ||
| Esophagectomy | 250 | ||
| Tracheostomy | 251 | ||
| Intubation | 251 | ||
| Other | 252 | ||
| Repair | 252 | ||
| Conservative Management | 252 | ||
| Summary | 253 | ||
| References | 253 | ||
| Massive Airway Hemorrhage | 255 | ||
| Key points | 255 | ||
| Introduction | 255 | ||
| Cause | 255 | ||
| Management strategy | 256 | ||
| Stabilization | 256 | ||
| Securing the airway | 257 | ||
| Bleeding control | 258 | ||
| Bleeding Control by Flexible/Rigid Bronchoscopy | 258 | ||
| Interventional Radiology Approaches | 259 | ||
| Surgery | 259 | ||
| Summary | 259 | ||
| References | 259 | ||
| Great Vessel Injury in Thoracic Surgery | 261 | ||
| Key points | 261 | ||
| Intraoperative bleeding in general thoracic surgery | 261 | ||
| Preoperative Imaging and Vascular Anatomic Variation | 261 | ||
| Minimally Invasive Thoracic Surgery and Intraoperative Bleeding | 263 | ||
| Device Malfunction | 264 | ||
| Procedure-specific bleeding | 265 | ||
| Lung Resection | 265 | ||
| Overview | 265 | ||
| Less common clinical scenarios | 265 | ||
| Surgical technique | 266 | ||
| Consequences | 268 | ||
| Extrapleural Pneumonectomy for Mesothelioma | 268 | ||
| Decortication | 268 | ||
| Mediastinal Procedures | 268 | ||
| Thymectomy | 268 | ||
| Mediastinoscopy | 269 | ||
| Mediastinoscopy and the complex mediastinum | 269 | ||
| Surgical technique and specific injuries | 269 | ||
| Superior vena cava injury | 269 | ||
| Innominate artery injury | 270 | ||
| Azygous vein injury | 271 | ||
| Aortic injury | 271 | ||
| Esophageal surgery | 271 | ||
| Specific injuries | 272 | ||
| Aortic injury | 272 | ||
| Supraceliac aortic vascular control | 273 | ||
| Celiac trunk and branches | 273 | ||
| Spleen | 273 | ||
| Summary | 273 | ||
| References | 273 | ||
| Endotracheal Tube Management and Obstructed Airway | 279 | ||
| Key points | 279 | ||
| Introduction | 279 | ||
| Monitoring | 280 | ||
| Lung isolation | 280 | ||
| Double-Lumen Endotracheal Tube | 280 | ||
| Bronchial Blocker | 282 | ||
| Adjunct Ventilation Modalities | 282 | ||
| Summary | 283 | ||
| Obstructed airway | 283 | ||
| Introduction | 283 | ||
| Presentation | 283 | ||
| Cause | 283 | ||
| Anesthesia | 283 | ||
| Management | 284 | ||
| Dilation | 284 | ||
| Recanalization | 285 | ||
| Airway stents | 285 | ||
| Tissue destruction | 286 | ||
| Postoperative Management | 286 | ||
| Summary | 286 | ||
| References | 286 | ||
| Operative and Perioperative Pulmonary Emboli | 289 | ||
| Key points | 289 | ||
| Introduction | 289 | ||
| Risk factors | 291 | ||
| Pathophysiology | 291 | ||
| Intraoperative detection | 291 | ||
| Initial stabilization and monitoring | 292 | ||
| Venous thromboembolism in thoracic surgery patients | 293 | ||
| Prevention | 293 | ||
| Treatment | 293 | ||
| Heparin-induced thrombocytopenia | 294 | ||
| Therapeutic options for the treatment of acute pulmonary embolism | 294 | ||
| Anticoagulation | 294 | ||
| Systemic Thrombolysis | 294 | ||
| Catheter Embolectomy or Catheter-Directed Thrombolysis | 295 | ||
| Acute Intraoperative Pulmonary Aspiration | 301 | ||
| Key points | 301 | ||
| Introduction | 301 | ||
| Pulmonary aspiration: definition, consequences, and risk factors | 301 | ||
| Definition and Consequences | 301 | ||
| Risk Factors | 302 | ||
| Risk factors: medications | 302 | ||
| Risk factors: predisposing conditions | 302 | ||
| Risk factors: provider expertise | 302 | ||
| Prevention | 303 | ||
| Preoperative Risk Assessment | 303 | ||
| Preoperative Fasting | 303 | ||
| Preemptive Nasogastric Tube Placement | 303 | ||
| Histamine Blockers, Proton Pump Inhibitors, and Prokinetics | 304 | ||
| Rapid-Sequence Induction | 304 | ||
| Patient Positioning During Induction | 304 | ||
| Management of acute intraoperative aspiration | 305 | ||
| Summary | 306 | ||
| Acknowledgments | 306 | ||
| References | 306 | ||
| Coagulopathy and Anticoagulation During Thoracic Surgery | 309 | ||
| Key points | 309 | ||
| Introduction | 309 | ||
| Classification of anticoagulation agents | 310 | ||
| Major Classification | 310 | ||
| Classification of Novel Oral Anticoagulants | 310 | ||
| Classification of antiplatelet agents | 312 | ||
| Assessment of risk | 312 | ||
| Risk of Thromboembolism | 312 | ||
| Risk Stratification | 312 | ||
| Risk Scores | 312 | ||
| Timing | 314 | ||
| Risk of Bleeding | 314 | ||
| Classification of bleeding | 314 | ||
| Risk scores | 315 | ||
| Risk of Bleeding Versus Venous Thromboembolism | 315 | ||
| General principles of perioperative antithrombotic management | 315 | ||
| Perioperative management of anticoagulation therapy | 315 | ||
| Discontinuation and Bridging of Anticoagulation Agents | 315 | ||
| Definition | 316 | ||
| Postoperative Resumption of Anticoagulation Therapy | 317 | ||
| Perioperative management of antiplatelet therapy | 318 | ||
| Discontinuation of Antiplatelet Therapy for Coronary Stents | 318 | ||
| Bridging for Antiplatelet Therapy | 319 | ||
| Resumption of Antiplatelet Therapy | 319 | ||
| Vena caval filters | 319 | ||
| Hereditary hypercoagulable conditions | 319 | ||
| Urgent reversal of anticoagulation | 319 | ||
| Summary | 320 | ||
| References | 320 | ||
| Cardiopulmonary Bypass and Extracorporeal Life Support for Emergent Intraoperative Thoracic Situations | 325 | ||
| Key points | 325 | ||
| Introduction | 325 | ||
| Predictors of operative mortality and avoidable factors | 325 | ||
| Use of cardiopulmonary bypass in thoracic surgery | 327 | ||
| Emergent Use of Cardiopulmonary Bypass in Thoracic Surgery | 327 | ||
| Outcomes of Cardiopulmonary Bypass with Resection of Thoracic Malignancies | 328 | ||
| Use of venoarterial extracorporeal membrane oxygenation in thoracic surgical procedures | 331 | ||
| Use of venovenous extracorporeal membrane oxygenation in thoracic surgical procedures | 332 | ||
| Lung transplantation: cardiopulmonary bypass or extracorporeal membrane oxygenation? | 332 | ||
| Summary | 333 | ||
| References | 333 | ||
| Management of Complications After Pneumonectomy | 335 | ||
| Key points | 335 | ||
| Patient selection | 335 | ||
| Mortality | 337 | ||
| Morbidity | 337 | ||
| Technical complications | 337 | ||
| Postoperative Hemorrhage | 337 | ||
| Patch Complications | 338 | ||
| Cardiovascular complications | 338 | ||
| Arrhythmias | 338 | ||
| Myocardial Infarction | 338 | ||
| Cardiac Arrest | 339 | ||
| Pulmonary Artery Hypertension | 339 | ||
| Mechanical Cardiac Complications | 339 | ||
| Constrictive inflammatory epicarditis | 339 | ||
| Cardiac herniation | 340 | ||
| Acute mediastinal shift | 340 | ||
| Tamponade | 340 | ||
| Respiratory complications | 340 | ||
| Pneumonia | 341 | ||
| Acute Respiratory Distress Syndrome | 341 | ||
| Postpneumonectomy Syndrome | 341 | ||
| Empyema | 342 | ||
| Bronchopleural Fistula | 342 | ||
| Hematologic complications | 343 | ||
| Summary | 345 | ||
| References | 345 | ||
| Video-Assisted Thoracic Surgery After Median Sternotomy for Cardiac Surgery | 349 | ||
| Key points | 349 | ||
| Introduction: nature of the problem | 349 | ||
| Surgical technique | 351 | ||
| Preoperative Planning | 351 | ||
| Preparation and Patient Positioning | 351 | ||
| Monitoring | 351 | ||
| Surgical Approach | 351 | ||
| Surgical Procedure | 352 | ||
| Incision placement | 352 | ||
| Camera and visualization considerations | 352 | ||
| Safe dissection of adhesions by internal mammary artery | 352 | ||
| Division of adhesions to mediastinum | 352 | ||
| Management of injury to internal mammary artery graft | 353 | ||
| Immediate postoperative care | 354 | ||
| Rehabilitation and recovery | 354 | ||
| Summary | 354 | ||
| References | 354 | ||
| Postlobectomy Early Complications | 355 | ||
| Key points | 355 | ||
| Introduction | 355 | ||
| Air leak | 355 | ||
| Prevention strategies | 356 | ||
| Bronchial Stump Buttressing with a Muscle Flap | 356 | ||
| Pleural Tent | 356 | ||
| Suture Closure of Identified Leaks | 356 | ||
| Buttressed Staple Line | 356 | ||
| Fissureless Operation | 357 | ||
| Sealants | 357 | ||
| Expedited Liberation from Mechanical Ventilation | 357 | ||
| Treatment strategies | 357 | ||
| Nonoperative Management | 357 | ||
| Operative Management | 357 | ||
| Pneumonia/Mucous Plugging | 357 | ||
| Prevention strategies | 358 | ||
| Chest Physiotherapy | 358 | ||
| Aggressive Strategies | 358 | ||
| Pain Control | 358 | ||
| Smoking Cessation | 358 | ||
| Treatment strategies | 358 | ||
| Antibiotic Treatment | 358 | ||
| Aggressive Chest Physiotherapy | 358 | ||
| Ventilatory Support | 358 | ||
| Atrial fibrillation | 359 | ||
| Prevention strategies | 359 | ||
| Treatment strategies | 359 | ||
| Right middle lobe torsion | 360 | ||
| Prevention strategies | 360 | ||
| Treatment strategies | 361 | ||
| Hemorrhage | 361 | ||
| Chylothorax | 361 | ||
| Nerve injury | 361 | ||
| Phrenic Nerve | 361 | ||
| Recurrent Laryngeal Nerve | 362 | ||
| Summary | 362 | ||
| References | 363 | ||
| Index | 365 |