The association between the type of anesthesia and hemodynamic instability during pheochromocytoma surgery: a retrospective cohort study

Author(s):  
Won Woong Kim ◽  
Doo-Hwan Kim ◽  
Jae Won Cho ◽  
Cheong-Sil Rah ◽  
Yu-mi Lee ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheng-Yuan Ruan ◽  
Chun-Ta Huang ◽  
Ying-Chun Chien ◽  
Chun-Kai Huang ◽  
Jung-Yien Chien ◽  
...  

Abstract Background Heterogeneity in acute respiratory distress syndrome (ARDS) has led to many statistically negative clinical trials. Etiology is considered an important source of pathogenesis heterogeneity in ARDS but previous studies have usually adopted a dichotomous classification, such as pulmonary versus extrapulmonary ARDS, to evaluate it. Etiology-associated heterogeneity in ARDS remains poorly described. Methods In this retrospective cohort study, we described etiology-associated heterogeneity in gas exchange abnormality (PaO2/FiO2 [P/F] and ventilatory ratios), hemodynamic instability, non-pulmonary organ dysfunction as measured by the Sequential Organ Failure Assessment (SOFA) score, biomarkers of inflammation and coagulation, and 30-day mortality. Linear regression was used to model the trajectory of P/F ratios over time. Wilcoxon rank-sum tests, Kruskal–Wallis rank tests and Chi-squared tests were used to compare between-etiology differences. Results From 1725 mechanically ventilated patients in the ICU, we identified 258 (15%) with ARDS. Pneumonia (48.4%) and non-pulmonary sepsis (11.6%) were the two leading causes of ARDS. Compared with pneumonia associated ARDS, extra-pulmonary sepsis associated ARDS had a greater P/F ratio recovery rate (difference = 13 mmHg/day, p = 0.01), more shock (48% versus 73%, p = 0.01), higher non-pulmonary SOFA scores (6 versus 9 points, p < 0.001), higher d-dimer levels (4.2 versus 9.7 mg/L, p = 0.02) and higher mortality (43% versus 67%, p = 0.02). In pneumonia associated ARDS, there was significant difference in proportion of shock (p = 0.005) between bacterial and non-bacterial pneumonia. Conclusion This study showed that there was remarkable etiology-associated heterogeneity in ARDS. Heterogeneity was also observed within pneumonia associated ARDS when bacterial pneumonia was compared with other non-bacterial pneumonia. Future studies on ARDS should consider reporting etiology-specific data and exploring possible effect modification associated with etiology.


2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Nathan J. Smischney ◽  
Onur Demirci ◽  
Bryce D. Ricter ◽  
Christina C. Hoeft ◽  
Lisa M. Johnson ◽  
...  

Gland Surgery ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 892-900
Author(s):  
Magdalena Pisarska-Adamczyk ◽  
Karolina Zawadzka ◽  
Krzysztof Więckowski ◽  
Krzysztof Przęczek ◽  
Piotr Major ◽  
...  

2020 ◽  
Vol 158 (6) ◽  
pp. S-1161
Author(s):  
Amrit K. Kamboj ◽  
Amandeep Gujral ◽  
Elida Voth ◽  
Daniel Penrice ◽  
Jessica McGoldrick ◽  
...  

2016 ◽  
Vol 33 (S 01) ◽  
Author(s):  
S. Fustolo-Gunnink ◽  
R. Vlug ◽  
V. Smits-Wintjens ◽  
E. Heckman ◽  
A. Te Pas ◽  
...  

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