Why are thoracic operations postponed?

<p>Abstract</p> <p>Aim</p> <p>To investigate and present the reasons that cause the postponement of thoracic surgical operations.</p> <p>Methods</p> <p>We retrospectively included in the study all patients submitted to elective thoracic surgery in our department during the 4-year period 2007-2010 and noted all cases of postponement after official inclusion in the operating schedule.</p> <p>Results</p> <p>81 out of a total of 542 patients (14.9%) scheduled for elective thoracic operation had their procedure postponed. The reasons were mainly organisatory (in 42 cases, 51.85%), which in order of significance were: shortage in matching erythrocyte units, shortage in anaesthetic/nursing staff and unavailability in operating rooms. The rest of the cases (39, 48.1%) were postponed due to medical reasons, which in descending order of significance were: respiratory infections and exacerbations of COPD, cardiological problems, misregulation of antiplatelet/antithrombotic drugs and infections from other systems (gastrointestinal, urinary, etc.). Elderly male patients planned for major/oncologic surgery were most possible to have their operation postponed for medical reasons.</p> <p>Discussion-Conclusions</p> <p>Thoracic operations are postponed owed to organisatory as well as medical reasons, the latter mainly affecting elderly, morbid patients awaiting for major/oncologic surgery.</p

Blood flow measurements within optic nerve head during on-pump cardiovascular operations. A window to the brain?

This observational study is conducted to demonstrate optic nerve head (ONH) blood flow alterations during extracorporeal circulation (ECC) in routine on-pump cardiovascular operations in order to evaluate the perfusion status of important autoregulatory tissue vascular beds during moderate hypothermia. Twenty-one patients free from eye disease were prospectively enrolled in our database. Perioperative ONH blood flow measurements were performed using a hand-held portable ocular laser Doppler flowmeter just after administration of general anesthesia and during cardiopulmonary bypass (CPB) upon the lowest temperature point of moderate hypothermia. Important operative flow variables were correlated to optic nerve blood flow during surgical phases. Statistical analysis showed significant reduction of 32.1±14.5% of mean ONH blood flow in phase 2 (P<0.0001) compared to the reference flow values of phase 1. A negative univariate association between ECC time and ONH blood flow in phase 2 (P=0.031) is noted. This angiokinetic approach can detect changes of flow within autoregulatory vascular tissue beds like ONH, thus creating a ‘window’ on cerebral microvasculature. ONH blood flow is reduced during CPB. Our data suggest that it is of paramount importance to avoid extracorporeal prolongation even in moderate hypothermic cardiovascular operations