WETENSCHAPPELIJK jaarverslag 2012 ABSTRACTS VOORDRACHTEN WETENSCHAPSDAG SFG 2012 curve (93.1±114.1 au vs 68.6±121.4 au, P=0.04). After vitamin D3, a trend was observed at the postprandial triglyceride peak (T=4) with reduced expressions of CD11b and CD35 on neutrophils (24.01±5.3 au vs 21.1±7.1, P=0.06 and 3.0±1.0 vs 2.7±1.0 au, P=0.08, respectively) and CD11b on monocytes (16.5±2.2 au vs 14.9±2.6 au, P=0.09). CONCLUSION: Vitamin D3 increases postprandial arterial elasticity in healthy volunteers, potentially by reducing the expression of endothelial adhesion markers on monocytes and granulocytes. Comorbidity and complications in patients undergoing bariatric surgery: the value of ICU admission criteria. Nicole Meijer2 , Marcel de Quelerij1 Jan van der Voet3 Serge J.C. Verbrugge7 Anesthesiologist1 Surgeon-Intensivist5 , Chris van Velzen1 , Johan van der Klooster4 , Resident Anesthesiology2 , Surgeon6 , Ronald Luitwieler1 , Peter W. de Feiter5 , Anesthesiologist-Intensivist7 104 INTRODUCTION: In 2006 the bariatric surgical program in our hospital was expanded. We defined preselection criteria for routine postoperative Intensive Care admission of selected bariatric patients from risk factors for postoperative complications described in literature. We retrospectively analysed the data of 546 patients undergoing bariatric surgery to 1) analyse the value of these preselection criteria, 2) to register the problems encountered in bariatric patients postoperatively and 3) to identify predisposing factors for postoperative complications. METHODS: Basic characteristics, comorbidities and postoperative complications (dehydration, haematoma-bleeding, infectious complications, pulmonary embolism, anastomotic leakage, gastro-oesophageal reflux/obstruction, respiratory complications, cardiac complications, other) were evaluated for all patients. In patients admitted to the ICU, the reason for ICU admittance was recorded: 1) on the basis of preselection criteria, 2) due to perioperative complications or 3) after re-intervention in a later stage. Furthermore, in each of these ICU categories, the course on the ICU was identified: no, minor or major actions. Eventually this resulted in only 6 categories filled with patients. These groups of intensive care patients were statistically compared to all other patients for basic characteristics and comorbidities (normal distribution was tested using the Kolmogorov and Smirnov test. A t-test was used for normally distributed data; a Mann-Whitney test was used for data not normally distributed. Frequency distributed data were analysed using a contingency table with a Fisher’s exact test. Statistical significance was accepted at p < 0.05). RESULTS: No major actions were needed in patients admitted to our ICU directly postoperative (patients admitted on the basis of preselection criteria or due to perioperative factors). In these patients pulmonary problems were the most significant problems encountered. However, no specific actions were needed on the ICU that could not have been performed on the wards. Bodyweight was significantly higher in patients suffering postoperatively from an infection, pulmonary embolism or respiratory complications. In patients with a known bleeding diathesis there were significantly more postoperative bleedings and pulmonary embolisms. The bleeding diathesis was also significantly increased in the group of ICU patients admitted to the ICU on the basis of reintervention in a later stage with major actions on the ICU. CONCLUSIONS: Preselected criteria formed on the basis of literature are no good predictors , Resident of Surgery3 , Guido Mannaerts6 , Intensivist4 , , Ralph P.M. Gadiot3 , , Pagina 103
Pagina 105Heeft u een gids, publitas of digi-folders? Gebruik Online Touch: lesmateriaal naar een online publicatie converteren.
SFG Jaarverslag 2012 Lees publicatie 130Home