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4 results on '"vascular emergencies"'

1. Differences in hub and spoke vascular units practice during the novel Coronavirus-19 (COVID-19) outbreak in Lombardy, Italy

Author

Bellosta, Raffaello, Bissacco, Daniele, Rossi, Giovanni, Pirrelli, Stefano, Lanza, Gaetano, Frigerio, Dalmazio, Chiesa, Roberto, Castelli, Patrizio, Bonardelli, Stefano, Trimarchi, Santi, Stefano Aiello, Aldo Arzini, Luca Attisani, Vittorio Baratta, Luca Bassi, Giovanni Bonalumi, Antonio Bozzani, Franco Briolini, Cristina Busoni, Gianluca Canu, Michele Carmo, Roberto Caronno, Claudio Carugati, Pietro Cefali, Efrem Civilini, Emidio Costantini, Matteo Crippa, Ruggiero Curci, Raffaello Dallatana, Gaetano Deleo, Domenico Diaco, Matteo Ferraris, Davide Foresti, Marco Franchin, Francesca Giovannini, Viviana Grassi, Andrea Kahlberg, Jessica Lanza, Davide Logaldo, Chiara Lomazzi, Sergio Losa, Alfredo Lista, Gianluca Lussardi, Luca Luzzani, Clara Magri, Enrico M Marone, Daniele Mascia, Daniela Mazzaccaro, Roberto Mezzetti, Alessandro C Molinari, Giovanni Nano, Matteo A Pegorer, Gabriele Piffaretti, Tiziano Porretta, Franco Ragni, Andrea Rignano, Federico Romani, Piergiorgio Sala, Vittorio Segramora, Marco Setti, Antonino Silvestro, Giovanna Simonetti, Anna M Socrate, Silvia Stegher, Valerio Tolva, Matteo Tozzi, Piero Trabattoni, Pierluigi Vandone, Monica Vescovi, Marco Viani, Stefano Zoli, Bellosta, Raffaello, Bissacco, Daniele, Rossi, Giovanni, Pirrelli, Stefano, Lanza, Gaetano, Frigerio, Dalmazio, Chiesa, Roberto, Castelli, Patrizio, Bonardelli, Stefano, Trimarchi, Santi, Stefano, Aiello, Aldo, Arzini, Luca, Attisani, Vittorio, Baratta, Luca, Bassi, Giovanni, Bonalumi, Antonio, Bozzani, Franco, Briolini, Cristina, Busoni, Gianluca, Canu, Michele, Carmo, Roberto, Caronno, Claudio, Carugati, Pietro, Cefali, Efrem, Civilini, Emidio, Costantini, Matteo, Crippa, Ruggiero, Curci, Raffaello, Dallatana, Gaetano, Deleo, Domenico, Diaco, Matteo, Ferrari, Davide, Foresti, Marco, Franchin, Francesca, Giovannini, Viviana, Grassi, Kahlberg, ANDREA LUITZ, Jessica, Lanza, Davide, Logaldo, Chiara, Lomazzi, Sergio, Losa, Alfredo, Lista, Gianluca, Lussardi, Luca, Luzzani, Clara, Magri, Enrico, M Marone, Daniele, Mascia, Daniela, Mazzaccaro, Roberto, Mezzetti, Alessandro, C Molinari, Giovanni, Nano, Matteo, A Pegorer, Gabriele, Piffaretti, Tiziano, Porretta, Franco, Ragni, Andrea, Rignano, Federico, Romani, Piergiorgio, Sala, Vittorio, Segramora, Marco, Setti, Antonino, Silvestro, Giovanna, Simonetti, Anna, M Socrate, Silvia, Stegher, Valerio, Tolva, Matteo, Tozzi, Piero, Trabattoni, Pierluigi, Vandone, Monica, Vescovi, Marco, Viani, and Stefano, Zoli

Subjects
Adult, Male, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Pneumonia, Viral, COVID-19, Vascular surgical procedures, Multicenter registry, Emergencies, Disease, Vascular surgery, Vascular emergencies, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Clinical endpoint, Humans, Registries, Vascular Diseases, Pandemics, Referral and Consultation, Aged, Retrospective Studies, business.industry, Vascular disease, SARS-CoV-2, Mortality rate, General Medicine, Middle Aged, medicine.disease, Hospitalization, Pneumonia, 030228 respiratory system, Amputation, Italy, Surgery, Female, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND: To highlight clinical practice among referral (Hub, HH) or satellite (Spoke, SH) hospitals Vascular Surgery Units (VSUs) in Lombardy, during the COVID-19 pandemic "phase 1" period (March 8 - May 3, 2020). METHODS: The Vascular Surgery Group of Regione Lombardia Register, a real-word, multicenter, retrospective register was interrogated. All patients admitted with vascular disease were included. Patients' data on demographics, COVID-19 positivity, comorbidities and outcomes were extrapolated. Two cohorts were obtained: patients admitted to HH or SH. Primary endpoint was 30- day mortality rate. Secondary outcomes were 30-day complications and amputation (in case of peripheral artery disease [PAD]) rates. Univariate and multivariate analysis were used to compare HH and SH groups and predictors of poor outcomes. RESULTS: During the study period, 659 vascular patients in 4 HH and 27 SH were analyzed. Among these, 321 (48.7%) were admitted to a HH. No difference in COVID-19 positive patients was described (21.7% in HH vs 15.9% in SH; p=.058). After 30 days from intervention, HH and SH experienced similar mortality and no-intervention-related complication rate (12.1% vs 10.0%; p=.427 and 10.3% vs 8.3%; p=.377, respectively). Conversely, in HH postoperative complications were higher (23.4% vs 16.9%, p=.038) and amputations in patients treated for PAD were lower (10.8% vs 26.8%; p

Published
2020

2. Vascular emergencies-The new COVID-19 crisis?

Author

Gianni D Angelini and Pradeep Narayan

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, COVID-19, COVID‐19, Invited Commentary, Emergency medicine, acute limb ischemia, medicine, vascular emergencies, Humans, Surgery, Emergencies, business, Cardiology and Cardiovascular Medicine, Vascular Surgical Procedures, DVT, cardiac surgery
Published
2020

3. The open abdomen in trauma and non-trauma patients: WSES guidelines

Author

Osvaldo Chiara, Matteo Tomasoni, Peter T. Masiakos, Marco Ceresoli, Tino Martino Valetti, Viktor Reva, Kaoru Kike, Mircea Chirica, Fausto Catena, Stefania Cimbanassi, Lena M. Napolitano, Gustavo Pereira Fraga, Carlos A. Ordoñez, Yuan Kuo-Ching, Ingo Martzi, Federico Coccolini, Marc de Moya, Emiliano Gamberini, Walter L. Biffl, Zaza Demetrashvili, Kenneth D. Boffard, Paola Fugazzola, Martha Larrea, Andrew B. Peitzman, Nicola de’Angelis, Ernest E. Moore, Giulia Montori, Miklosh Bala, Paula Ferrada, Neil Parry, Zsolt J. Balogh, Manu L N G Malbrain, Matti Tolonen, Catherine Arvieux, Yoram Kluger, Fikri M. Abu-Zidan, Salomone Di Saverio, Luca Ansaloni, Alain Chichom Mefire, Carlos Augusto Gomes, Vanni Agnoletti, Francesco Salvetti, Dieter G. Weber, Rifat Latifi, Massimo Sartelli, Camilla Bing, Philippe Montravers, R. V. Maier, Jeffry L. Kashuk, Rita Maria Melotti, Raul Coimbra, Joseph M. Galante, Kenji Inaba, Tal M. Hörer, Belinda De Simone, Andreas Hecker, Sandro Rizoli, Rao R. Ivatury, Juan Alberto Martinez Hernandez, Michael Sugrue, Thomas M. Scalea, Noel Naidoo, Heng Fu Lin, Ari Leppäniemi, Kjetil Søreide, Andrew W. Kirkpatrick, George C. Velmahos, Vladimir Khokha, Bruno M. Pereira, Imtiaz Wani, Derek J. Roberts, Boris Sakakushev, Tarek Razek, Lauri Handolin, Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, E, Coimbra, R, Kirkpatrick, A, Pereira, B, Montori, G, Ceresoli, M, Abu-Zidan, F, Sartelli, M, Velmahos, G, Fraga, G, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, R, Salvetti, F, Valetti, T, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, J, Larrea, M, Hernandez, J, Lin, H, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, Deangelis, N, Kike, K, Balogh, Z, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordonez, C, Rizoli, S, Gomes, C, De Moya, M, Wani, I, Mefire, A, Boffard, K, Napolitano, L, Catena, F, Coccolini, Federico, Roberts, Derek, Ansaloni, Luca, Ivatury, Rao, Gamberini, Emiliano, Kluger, Yoram, Moore, Ernest E., Coimbra, Raul, Kirkpatrick, Andrew W., Pereira, Bruno M., Montori, Giulia, Ceresoli, Marco, Abu-Zidan, Fikri M., Sartelli, Massimo, Velmahos, George, Fraga, Gustavo Pereira, Leppaniemi, Ari, Tolonen, Matti, Galante, Joseph, Razek, Tarek, Maier, Ron, Bala, Miklosh, Sakakushev, Bori, Khokha, Vladimir, Malbrain, Manu, Agnoletti, Vanni, Peitzman, Andrew, Demetrashvili, Zaza, Sugrue, Michael, Di Saverio, Salomone, Martzi, Ingo, Soreide, Kjetil, Biffl, Walter, Ferrada, Paula, Parry, Neil, Montravers, Philippe, Melotti, Rita Maria, Salvetti, Francesco, Valetti, Tino M., Scalea, Thoma, Chiara, Osvaldo, Cimbanassi, Stefania, Kashuk, Jeffry L., Larrea, Martha, Hernandez, Juan Alberto Martinez, Lin, Heng-Fu, Chirica, Mircea, Arvieux, Catherine, Bing, Camilla, Horer, Tal, De Simone, Belinda, Masiakos, Peter, Reva, Viktor, DeAngelis, Nicola, Kike, Kaoru, Balogh, Zsolt J., Fugazzola, Paola, Tomasoni, Matteo, Latifi, Rifat, Naidoo, Noel, Weber, Dieter, Handolin, Lauri, Inaba, Kenji, Hecker, Andrea, Kuo-Ching, Yuan, Ordoñez, Carlos A., Rizoli, Sandro, Gomes, Carlos Augusto, De Moya, Marc, Wani, Imtiaz, Mefire, Alain Chichom, Boffard, Ken, Napolitano, Lena, Catena, Fausto, Supporting clinical sciences, Intensive Care, II kirurgian klinikka, Clinicum, Department of Surgery, I kirurgian klinikka (Töölö), HUS Abdominal Center, and HUS Musculoskeletal and Plastic Surgery

Subjects
Fistula, Abdominal Wound Closure Techniques, Abdominal compartment syndrome, medicine.medical_treatment, SEVERE ACUTE-PANCREATITIS, Review, Guideline, 030230 surgery, Cardiovascular, Abdominal wall, Postoperative Complications, 0302 clinical medicine, ACELLULAR DERMAL MATRIX, Laparotomy, Abdomen, Open abdomen, NEGATIVE-PRESSURE THERAPY, Medicine(all), DAMAGE CONTROL SURGERY, Peritoniti, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Abdominal Wound Closure Technique, Abdominal Cavity, VENTRAL HERNIA REPAIR, Prophylactic Surgical Procedures, 3. Good health, Vascular emergencie, medicine.anatomical_structure, Emergency Medicine, Technique, Re-exploration, ABDOMINAL COMPARTMENT SYNDROME, Intra-Abdominal Hypertension, ACUTE MESENTERIC ISCHEMIA, Human, medicine.medical_specialty, Physical Injury - Accidents and Adverse Effects, Closure, Resuscitation, PRIMARY FASCIAL CLOSURE, lcsh:Surgery, Non-trauma, Peritonitis, Guidelines as Topic, Reintervention, Guidelines, Trauma, Prophylactic Surgical Procedure, 03 medical and health sciences, LONG-TERM COMPLICATIONS, Intra-abdominal infection, Rare Diseases, Clinical Research, medicine, Humans, ddc:610, Timing, Intensive care medicine, Nutrition, Mesh, Pancreatiti, Laparostomy, business.industry, Synthetic, Vascular emergencies, 030208 emergency & critical care medicine, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, Biological, medicine.disease, Pancreatitis, Negative-Pressure Wound Therapy, RANDOMIZED-CONTROLLED-TRIAL, Surgery, Postoperative Complication, business
Abstract

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

Published
2018
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4. The role of open abdomen in non-trauma patient: WSES Consensus Paper

Author

Federico Coccolini, Fausto Catena, Manu L N G Malbrain, Giulia Montori, Vladimir Khokha, Salomone Di Saverio, Marja A. Boermeester, Boris Sakakushev, Ernest E. Moore, Ewen A. Griffiths, Ignacio Martin-Loeches, Michael Sugrue, George C. Velmahos, Gianmariano Marchesi, Marco Ceresoli, Andrew B. Peitzman, Gustavo Pereira Fraga, Kjetil Søreide, Andrew W. Kirkpatrick, Bruno M. Pereira, Osvaldo Chiara, Ari Leppäniemi, Vanni Agnoletti, Tino Martino Valetti, Addison K. May, Walter L. Biffl, Luca Ansaloni, Thomas M. Scalea, Fikri M. Abu-Zidan, Yoram Kluger, Francesco Salvetti, Jeffry L. Kashuk, Rita Maria Melotti, Miklosh Bala, Raul Coimbra, Michele Pisano, Massimo Sartelli, John E. Mazuski, Philippe Montravers, R. V. Maier, Rao R. Ivatury, Sandro Rizoli, Marc de Moya, Coccolini, Federico, Montori, Giulia, Ceresoli, Marco, Catena, Fausto, Moore, Ernest E, Ivatury, Rao, Biffl, Walter, Peitzman, Andrew, Coimbra, Raul, Rizoli, Sandro, Kluger, Yoram, Abu-Zidan, Fikri M, Sartelli, Massimo, De Moya, Marc, Velmahos, George, Fraga, Gustavo Pereira, Pereira, Bruno M, Leppaniemi, Ari, Boermeester, Marja A, Kirkpatrick, Andrew W, Maier, Ron, Bala, Miklosh, Sakakushev, Bori, Khokha, Vladimir, Malbrain, Manu, Agnoletti, Vanni, Martin-Loeches, Ignacio, Sugrue, Michael, Di Saverio, Salomone, Griffiths, Ewen, Soreide, Kjetil, Mazuski, John E, May, Addison K, Montravers, Philippe, Melotti, Rita Maria, Pisano, Michele, Salvetti, Francesco, Marchesi, Gianmariano, Valetti, Tino M, Scalea, Thoma, Chiara, Osvaldo, Kashuk, Jeffry L, Ansaloni, Luca, II kirurgian klinikka, University of Helsinki, Clinicum, Department of Surgery, HUS Abdominal Center, Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Moore, E, Ivatury, R, Biffl, W, Peitzman, A, Coimbra, R, Rizoli, S, Kluger, Y, Abu-Zidan, F, Sartelli, M, Moya, M, Velmahos, G, Fraga, G, Pereira, B, Leppaniemi, A, Boermeester, M, Kirkpatrick, A, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Martin-Loeches, I, Sugrue, M, Saverio, S, Griffiths, E, Soreide, K, Mazuski, J, May, A, Montravers, P, Melotti, R, Pisano, M, Salvetti, F, Marchesi, G, Valetti, T, Scalea, T, Chiara, O, Kashuk, J, Ansaloni, L, Supporting clinical sciences, and Intensive Care

Subjects
Fistula, Abdominal Wound Closure Techniques, Abdominal compartment syndrome, Re-intervention, medicine.medical_treatment, TOPICAL NEGATIVE-PRESSURE, Review, 030230 surgery, VACUUM-ASSISTED CLOSURE, 0302 clinical medicine, ACELLULAR DERMAL MATRIX, Laparotomy, Medicine, Open abdomen, Biological Closure, Medicine(all), Trauma patient, Peritoniti, POSTOPERATIVE ENTEROCUTANEOUS FISTULAS, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Consensus conference, VENTRAL HERNIA REPAIR, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Emergency Medicine, Technique, Re-exploration, ABDOMINAL COMPARTMENT SYNDROME, CRITICALLY-ILL PATIENTS, ACUTE MESENTERIC ISCHEMIA, medicine.medical_specialty, Consensus, Closure, Critical Illness, PRIMARY FASCIAL CLOSURE, lcsh:Surgery, Non-trauma, Peritonitis, Biological, Laparostomy, Mesh, Nutrition, Pancreatitis, Synthetic, Timing, Vascular emergencies, Humans, Lower Body Negative Pressure, 03 medical and health sciences, Intensive care medicine, DAMAGE-CONTROL LAPAROTOMY, Pancreatiti, business.industry, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Abdomen, Surgery, business
Abstract

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.

Published
2017
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