Icu & Operating Theatre رعاية مركزة وعمليات

11/05/2025

⭐️Allengers C-Arm Digiscan S20 6 KW with Flat Panel Detector

06/05/2025

Weekday effect of surgery on in-hospital outcome in pancreatic surgery: a population-based study

ABSTRACT 👇 👇
Importance
There is conflicting evidence regarding weekday dependent outcome in complex abdominal surgery, including pancreatic resections.

Objective
To clarify weekday-dependency of outcome after pancreatic resections in a comprehensive nationwide context.

Design
Retrospective cross-sectional study of anonymized nationwide hospital billing data (DRG data).

Setting
Germany between 2010 and 2020.

Participants and exposure
all patient records with a procedural code for a pancreatic resection.

Main outcome and measures
Primary endpoint was complication occurrence and failure to rescue, i.e. mortality in case of complications, by weekday of index surgery.

Results
94,661 patient records with a pancreatic resection were analyzed, of whom 45.2% were female. Mean age was 65.3 years. In 46.3% of all patient records, the main diagnosis was pancreatic carcinoma. The most common index surgery was pancreaticoduodenectomy (61.2%). Occurrence of at least one of predefined complications was 67.6% (64,029 cases) and was highest following a Monday index surgery. In-hospital mortality in case of at least one complication, i.e. failure to rescue (FtR), accounted for 8,040 deaths (97.7% of 8,228 total deaths, 12.6% FtR, 8.7% in-hospital mortality). FtR was highest (13.1%) following a Monday index surgery and lowest (11.8%) after a Thursday index surgery. Overall in-hospital mortality followed the same trend as FtR. In a multivariable logistic regression, in the overall cohort, in addition to increased age, frailty, male s*x, benign entities, and total pancreatectomy performance, Wednesday (adjusted Odd’s Ratio, OR, 0.92, 95% Confidence Interval, CI, 0.85–0.99) and Thursday (adjusted OR, 0.89, CI, 0.82–0.96) index surgeries were associated with lower FtR in reference to Monday. Stratified by patient volume, complication occurrence and FtR was only dependent of the weekday of index surgery in low volume hospitals.

Conclusions and relevance
Pancreatic resections are complex procedures with high complication rates and FtR, resulting in high in-hospital mortality. Complication occurrence and FtR is dependent on the weekday of index surgery and mediates the same distribution pattern for overall in-hospital mortality. Stratified by patient volume, this weekday dependency of the index surgery on complication occurrence and FtR was only observed in low volume hospitals.

For article link send us on WhatsApp

01/05/2025

✨️✨️ Happy Labor Day ✨️✨️

20/04/2025

16/04/2025

Prone Position and Cardiopulmonary Resuscitation in the Operating Room: A Scoping Review

ABSTRACT 👇 👇
Background/Objectives: Cardiopulmonary resuscitation (CPR) in the prone position (P-CPR) is described in international guidelines for specific contexts but is not commonly included in operating room algorithms. This review aims to map P-CPR interventions in adult and pediatric patients experiencing cardiac arrest in the operating room while in the prone position. Methods: A scoping review was conducted following the “PRISMA Extension for Scoping Reviews” protocol. The databases searched included PubMed, CINAHL, ScienceDirect/Elsevier, Scopus, Web of Science, and Cochrane. Eligibility criteria included studies involving adult and pediatric populations, documented cardiac arrest (with presenting rhythm and cause), P-CPR interventions, and short-term outcomes (return of spontaneous circulation) as well as long-term outcomes when available. Results: Twenty international case reports were analyzed, indicating that P-CPR is effective in the operating room setting and has a positive impact on both short-term and long-term outcomes. Conclusions: This scoping review suggests that P-CPR yields comparable outcomes to supine CPR while saving time by eliminating the need for patient repositioning. However, due to limited evidence, further research is needed. Additionally, logistical, organizational, and educational considerations must be addressed before adopting P-CPR as routine practice.

For article link send us on WhatsApp

27/03/2025

Thirst in adult patients in the intensive care unit: A scoping review

ABSTRACT 👇 👇
Purpose
To review the literature on thirst in intensive care unit (ICU) patients and report potential causes, risk factors, diagnosis and measurement tools, as well as potential co-occurrence with other distressing symptoms, and the management of thirst in the ICU.
Design
A scoping review employing the Joanna Briggs Institute methodology.
Methods
PubMed, MEDLINE, EMBASE and CINAHL were searched from inception to April 2024. Any type of empirical study reporting thirst or associated xerostomia in adult patients (≥18 years) admitted to an ICU or high dependency unit for more than 24 h were included.
Results
The search yielded 907 unique records, and after evaluating 65 full-text publications, 21 studies were included. Thirst intensity was addressed most often (eleven studies), whereas the experience (or quality) of thirst and the validation of a measurement instrument, were addressed in only one study. Although co-occurrence of symptoms was addressed in four studies, only one pilot study looked into the interaction of thirst with other symptoms. Intervention studies have been focussing primarily on mouth-care interventions.
Conclusion
Thirst is a distressing symptom in the ICU, with reported high prevalence and intensity. Knowledge about its causes, interventions that incorporate minimising its risk, occurrence and intensity are limited.
Implications for clinical practice
Health care providers should acknowledge thirst as a prominent symptom for ICU patients. They should possess knowledge on the factors that potentially evoke or aggravate thirst. Regular and timely relief of thirst by oral care with cold swabs and the application of menthol can be regarded as a first choice of intervention.

For article link send us on WhatsApp

18/03/2025

Prediction of the upright articulated spine shape in the operating room using conditioned neural kernel fields
ABSTRACT 👇 👇
Anterior vertebral tethering (AVT) is a non-invasive spine surgery technique, treating severe spine deformations and preserving lower back mobility. However, patient positioning and surgical strategies greatly influences postoperative results. Predicting the upright geometry from pediatric spines is needed to optimize patient positioning in the operating room (OR) and improve surgical outcomes, but remains a complex task due to immature bone properties. We propose a framework used in the OR predicting the upright spine geometry at the first visit following surgery in idiopathic scoliosis patients. The approach first creates a 3D model of the spine while the patient is on the operating table. For this, multiview Transformers that combine images from different viewpoints are used to generate the intraoperative pose. The postoperative upright shape is then predicted on-the-fly using implicit neural fields, which are trained from geometries at different time points and conditioned with surgical parameters. A Signed Distance Function for shape constellations is used to handle the variability in spine appearance, capturing a disentangled latent domain of the articulation vectors, with separate encoding vectors representing both articulation and shape parameters. A regularization criterion based on a pre-trained group-wise trajectory of spine transformations generates complete spine models. A training set of 652 patients with 3D models was used to train the model, tested on a distinct cohort of 83 surgical patients. The framework based on neural kernels predicted upright 3D geometries with a mean 3D error of
in landmarks points, and IoU of 95.9% in vertebral shapes when compared to actual postop models, falling within the acceptable margins of error below 2 mm.

👉 For article link send us on WhatsApp

06/03/2025

✨️✨️ شركة الهلال للتجارة و الاستيراد تهنئ مستشفى الفخراني بتركيب و تشغيل أحدث أجهزة التخدير penlon
✅️ كما يسعدنا أن تكون شركة الهلال هي الوكيل المعتمد لشركة penlon لأجهزة التخدير

03/03/2025

Systematic Risk Analysis and Mitigation Strategies for Near-Miss Events in Interventional Operating Room Nursing

ABSTRACT 👇👇
Purpose
The aim of this study is to examine the characteristics of intraoperative nursing near-miss events in interventional operating rooms, systematically identify and analyze associated risks, and propose effective mitigation strategies.

Patients and Methods
A retrospective study was conducted using a specially designed survey focused on nursing near-miss events in Interventional operating rooms. Records of intraoperative near-miss events voluntarily reported by medical and nursing staff between January 2023 and March 2024 were analyzed. Grey relational analysis was used to evaluate and identify the associated risk factors.

Results
A total of 81 near-miss events were reported, with the majority (50%) occurring after 8 PM. These events were categorized into 6 main types: medication errors (60.49%), issues with consumables (16.05%), tubing-related incidents (8.64%), specimen handling errors (7.4%), transfer handover issues (4.93%), and patient transport problems (2.46%). Grey relational analysis identified air embolism formation during pressurized fluid administration as the highest risk event (ξ1 = 0.369). The risk factors were ranked as follows: weak coordination ability and lack of responsibility among nurses > operational interruptions > inadequate professional capability > poor communication between medical staff and nurses > equipment malfunction > frequent emergency surgeries and a fast paced working environment.

Conclusion
Medication administration errors are frequently encountered, with air embolisms during pressurized fluid infusion representing the most significant risk. Operational interruptions are major contributors to these errors, often influenced by the coordination skills and professional competencies of nurses. Clinically, it is crucial to enhance the identification and management of near-miss events to reduce the incidence of adverse outcomes during surgical procedures.

For article link send us on WhatsApp

26/02/2025

Key Concepts in Machine Learning and Clinical Applications in the Cardiac Intensive Care Unit

ABSTRACT👇👇
Purpose of Review
Artificial Intelligence (AI) technology will significantly alter critical care cardiology, from our understanding of diseases to the way in which we communicate with patients and colleagues. We summarize the potential applications of AI in the cardiac intensive care unit (CICU) by reviewing current evidence, future developments and possible challenges.

Recent Findings
Machine Learning (ML) methods have been leveraged to improve interpretation and discover novel uses for diagnostic tests such as the ECG and echocardiograms. ML-based dynamic risk stratification and prognostication may help optimize triaging and CICU discharge procedures. Latent class analysis and K-means clustering may reveal underlying disease sub-phenotypes within heterogeneous conditions such as cardiogenic shock and decompensated heart failure.

Summary
AI technology may help enhance routine clinical care, facilitate medical education and training, and unlock individualized therapies for patients in the CICU. However, robust regulation and improved clinician understanding of AI is essential to overcome important practical and ethical challenges.

👉 For article link send us on WhatsApp

25/02/2025

أعمال فريق قسم الصيانة ⭐️