High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.”
“Background: The anesthetic risks and outcomes of the first 100 consecutive spring-assisted surgeries (SAS) for cranial expansion from a single institution are reported. The effect of number of procedures was also tested on hematocrit postoperative day 1 (POD I), anesthesia time, and surgery time of the first procedure.

Methods: The records of 100 consecutive patients undergoing SAS were reviewed. Anesthesia management and related complications are presented. Time series linear regression analysis was performed on hematocrit POD I, anesthesia

time, and surgery time of the first procedure.

Results: The average age of the first insertion procedure was 4.4 and 9.0 months for the second removal procedure. Two patients were inadvertently extubated Selleckchem GANT61 during positioning. Thirty-eight children had a decrease in blood pressure > 20% from baseline. No child was admitted to the intensive care unit. No patient received any

blood or blood product transfusion. Anesthesia time, surgery time, and hematocrit POD I were correlated with procedure number or experience.

Conclusions: Changes in anesthetic management resulted from changing the procedure. The reduction in volume resuscitation reduces the need for invasive monitoring. Facility and comfort with the surgical procedure increase with time and number of procedures performed. This experience further reduces blood loss and risk of transfusion.”
“The aim of the Best Practice guidelines on peritoneal selleck chemicals ultrafiltration (UF)

in patients with Cl-amidine molecular weight treatment-resistant advanced decompensated heart failure (TR-AHDF) is to achieve a common approach to the management of decompensated heart failure in those situations in which all conventional treatment options have been unsuccessful, and to stimulate a closer cooperation between nephrologists and cardiologists.

The standardization of the case series of different centers would allow a better definition of the results published in the literature, without which they are nothing more than anecdotes.

TR-AHDF is characterized by the persistence of severe symptoms even when all possible pharmacological and surgical options have been exhausted. These patients are often treated with methods that allow extracorporeal UF – slow continuous ultrafiltration (SCUF) and continuous renal replacement therapy (CRRT) – which have to be performed in hospital facilities.

Peritoneal ultrafiltration (PUF) can be considered a treatment option in patients with TR-AHDF when, despite the fact that all treatment options have been used, patients meet the following criteria:

stage D decompensated heart failure (ACC/AHA classification);

INTERMACS level 4 decompensated heart failure;

INTERMACS frequent flyer profile;

chronic renal failure (estimated glomerular filtration rate <50 ml/min per 1.