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Iatrogenic Complications (iatrogenic + complications)

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Medical Sciences100%

Selected Abstracts

Iatrogenic complications and risks of nerve conduction studies and needle electromyography

MUSCLE AND NERVE, Issue 5 2003
Amer Al-Shekhlee MD
Abstract Electrodiagnostic procedures are routinely performed in patients with a variety of neuromuscular disorders. These studies are generally well tolerated and rarely thought to be associated with any significant side effects. However, needle electromyography is an invasive procedure and under certain situations has the potential to be associated with iatrogenic complications, including bleeding, infection, nerve injury, pneumothorax, and other local trauma. Similar complications are possible if needles are used for either stimulating or recording. In addition, like all other electrical devices and monitoring equipment connected to patients, electrodiagnostic testing carries the risk of stray leakage currents that under certain circumstances can result in electrical injury, especially in patients in the intensive care setting. Similarly, certain precautions are required during nerve conduction studies (NCS) in patients with pacemakers and other similar cardiac devices. In this review, we address the known and theoretical complications of NCS and needle electrode examination, and the possible methods to avoid such hazards. Muscle Nerve 27: 517,526, 2003 [source]

Perioperative fluid management: prospective audit

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2008
S. R. Walsh
Summary Background:, Postoperative fluid management is a core surgical skill but there are few data regarding current fluid management practice and the incidence of potential fluid-related complications in general surgical units. We conducted a prospective audit of postoperative fluid management and fluid-related complications in a consecutive cohort of patients undergoing midline laparotomy. Methods:, Over a 6-month period, the peri-operative fluid management of 106 consecutive patients was prospectively audited. Serum electrolyte data, fluid balance data, co-morbidities, operative and anaesthetic variables and quantities of fluid and electrolytes prescribed were recorded. The development of fluid-related and other complications was noted. Results:, There were no correlations between routinely available fluid balance parameters and the quantities of fluid and electrolytes prescribed, suggesting that doctors do not consult fluid balance data when prescribing. Fifty-seven patients (54%) developed at least one fluid-related complication. These patients received significantly greater volumes of fluid and sodium each day postoperatively. They had higher rates of other non-fluid-related complications and death. They had a longer hospital stay. In a multivariate model, mean daily fluid load predicted the development of fluid-related complications. Conclusion:, Fluid prescription practice in general surgical units is sub-optimal, resulting in avoidable iatrogenic complications. Involvement of senior staff, education and possibly the introduction of prescribing protocols may improve the situation. [source]

Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers

LIVER TRANSPLANTATION, Issue 10 2007
Rafael López-Andújar
The aim of this study is to contribute our experience to the knowledge of the anatomic variations of the hepatic arterial supply. The surgical anatomy of the extrahepatic arterial vascularization was investigated prospectively in 1,081 donor cadaveric livers, transplanted at La Fe University Hospital from January 1991 to August 2004. The vascular anatomy of the hepatic grafts was classified according to Michels description (Am J Surg 1966;112:337-347) plus 2 variations. Anatomical variants of the classical pattern were detected in 30% of the livers (n = 320). The most common variant was a replaced left artery arising from the left gastric artery (9.7%) followed by a replaced right hepatic artery arising from the superior mesenteric artery (7.8%). In conclusion, the information about the different hepatic arterial patterns can help in reducing the risks of iatrogenic complications, which in turn may result in better outcomes not only following surgical interventions but also in the context of radiological treatments. Liver Transpl 13:1401,1404, 2007. © 2007 AASLD [source]

Iatrogenic complications and risks of nerve conduction studies and needle electromyography

MUSCLE AND NERVE, Issue 5 2003
Amer Al-Shekhlee MD
Abstract Electrodiagnostic procedures are routinely performed in patients with a variety of neuromuscular disorders. These studies are generally well tolerated and rarely thought to be associated with any significant side effects. However, needle electromyography is an invasive procedure and under certain situations has the potential to be associated with iatrogenic complications, including bleeding, infection, nerve injury, pneumothorax, and other local trauma. Similar complications are possible if needles are used for either stimulating or recording. In addition, like all other electrical devices and monitoring equipment connected to patients, electrodiagnostic testing carries the risk of stray leakage currents that under certain circumstances can result in electrical injury, especially in patients in the intensive care setting. Similarly, certain precautions are required during nerve conduction studies (NCS) in patients with pacemakers and other similar cardiac devices. In this review, we address the known and theoretical complications of NCS and needle electrode examination, and the possible methods to avoid such hazards. Muscle Nerve 27: 517,526, 2003 [source]

Recent developments of ocular allergy in children

ACTA OPHTHALMOLOGICA, Issue 2009
F CHIAMBARETTA
First we summarize the clinical presentations associated with the classification of ocular allergy, and present the last agreement for treatment. Vernal keratoconjunctivitis is the more severe form affecting children and iatrogenic complications must be avoided. In vernal keratoconjunctivitis, a new grading system is introduced based on clinical signs and symptoms of ocular surface inflammation. Based on this new grading of vernal keratoconjunctivitis, different treatment options are proposed, essentially steroid sparing. Based on new information about the pathogenesis of vernal keratoconjunctivitis, recent and more selective drugs like anti-chemokine receptor antibodies and leukotriene receptor antagonists and cyclosporine are evaluated. [source]