Critical care challenges in orthopedic surgery patients

Taylor, John M.; Gropper, Michael A.

doi:10.1097/01.ccm.0000231880.18476.d8

Cited by 28 publications

(18 citation statements)

References 58 publications

(80 reference statements)

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“…The stated goal of such treatment is ' to restore acceptability and help mitigate future social and psychological disadvantage ' [72], not to restore or maintain health and function. Even routine PF testing for scoliosis patients prior to surgery is described as 'controversial ' [73]. As long ago as 1964, however, Mankin and coauthors [21] noted, "Most physicians think that IS is a 'cosmetic' problem and that its major effect is to deform an individual with no harm to the internal organs.…”

Section: Discussionmentioning

confidence: 99%

Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

2009

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BackgroundSome patients with mild or moderate thoracic scoliosis (Cobb angle <50-60 degrees) suffer disproportionate impairment of pulmonary function associated with deformities in the sagittal plane and reduced flexibility of the spine and chest cage. Long-term improvement in the clinical signs and symptoms of childhood onset scoliosis in an adult, without surgical intervention, has not been documented previously.Case presentationA diagnosis of thoracic scoliosis (Cobb angle 45 degrees) with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52) was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996); outpatient psychological therapy (1992-1993); a daily home exercise program focused on mobilization of the chest wall (1992-2005); and manipulative medicine (1994-1995, 1999-2000). Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature.ConclusionThis report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis.

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Section: Discussionmentioning

confidence: 99%

Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

2009

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“…[50] The intensivist is also intimately involved in and responsible for the effective intervention and coordination of consultants involved in any particular case. The intensivist is thus, in effect, a concierge, making sure interactions between the patient, family members, nurses, consultants, and the primary surgical team proceed smoothly, and that as few as possible perturbations occur in the encounters with, and care of, patients and their families.…”

Section: Intensivist Perspectivementioning

confidence: 99%

The right team at the right time – Multidisciplinary approach to multi-trauma patient with orthopedic injuries

Bach

Leskovan

Scharschmidt

et al. 2017

Int J Crit Illn Inj Sci

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Integrated, multidisciplinary team approach to the multiply injured patient can help optimize care, minimize morbidity, and reduce mortality. It also provides a framework for accelerated postinjury rehabilitation course. The characteristics and potential benefits of this approach, including team dynamics and interactions, are discussed in this brief review. Emphasis is placed on synergies provided by specialty teams working together in the framework of care coordination, timing of surgical and nonsurgical interventions, and injury/physiologic considerations.Republished with permission from:Bach JA, Leskovan JJ, Scharschmidt T, Boulger C, Papadimos TJ, Russell S, Bahner DP, Stawicki SPA. Multidisciplinary approach to multi-trauma patient with orthopedic injuries: the right team at the right time. OPUS 12 Scientist 2012;6(1):6-10.

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“…Além disso, a intervenção precoce da reabilitação, com vistas à melhor recuperação pós-operatória, 6,9---11 pode reduzir o tempo de internação hospitalar e o retorno às atividades de vida diária. 12,13 Existem diversas técnicas de analgesia, porém é cada vez mais presente nos hospitais o uso de analgesia controlada pelo paciente (PCA ---patient controlled analgesia). Esse método, considerado seguro e eficaz no tratamento da dor moderada a intensa, 6,14,15 é usado desde a década de 1970.…”

Section: Introductionunclassified

O impacto da analgesia controlada pelos pacientes submetidos a cirurgias ortopédicas

Dias

Rinaldi

Barbosa

2016

Brazilian Journal of Anesthesiology

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Como citar este artigo: Dias AS, et al. O impacto da analgesia controlada pelos pacientes submetidos a cirurgias ortopé-dicas. Rev Bras Anestesiol. 2014. http://dx. ResumoIntrodução: As disfunções musculoesqueléticas, comuns atualmente, têm sido cada vez mais tratadas cirurgicamente e a dor é pode ser um fator limitante na reabilitação pós-operatória. Justificativa: A analgesia controlada pelo paciente (PCA) controla a dor, porém seus efeitos adversos podem interferir no processo de reabilitação e alta dos pacientes. Esta pesquisa torna--se importante, pois poucos estudos avaliam essa correlação. Objetivos: Comparar a evolução dos pacientes que usaram e não usaram PCA no pós-operatório de cirurgias ortopédicas em relação à dor, à necessidade de O 2 (oxigênio) não programada e ao tempo de imobilização e internação hospitalar. Métodos: Estudo observacional, prospectivo, feito no Hospital da AACD de maio a agosto de 2012. Obtiveram-se dados diários por meio de avaliação e entrevista dos pacientes submetidos à artroplastia total de quadril (ATQ) e joelho (ATJ), artrodese de coluna toracolombar (AVP longa), coluna cervical (AVA cervical) e coluna lombar (AVP lombar). Resultados: O estudo evidenciou algumas diferenças entre os grupos: o nível álgico foi maior no grupo submetido à AVP lombar sem PCA em relação ao com PCA (p = 0,03) e no grupo de AVP longa sem PCA no primeiro pós-operatório. Nesse último grupo, houve uso de O 2 por mais tempo (p = 0,09). Conclusão: Neste estudo, a PCA mostrou-se útil para analgesia em pacientes submetidos à AVP lombar e provavelmente teria influência no tempo de uso de O 2 no grupo de AVP longa caso a amostra fosse maior. O uso da PCA não influenciou no tempo de saída do leito e de internação hospitalar nos pacientes estudados.

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Critical care challenges in orthopedic surgery patients

Cited by 28 publications

References 58 publications

Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

The right team at the right time – Multidisciplinary approach to multi-trauma patient with orthopedic injuries

O impacto da analgesia controlada pelos pacientes submetidos a cirurgias ortopédicas

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