PMID- 26118604
OWN - NLM
STAT- MEDLINE
DCOM- 20160310
LR  - 20191210
IS  - 1743-9159 (Electronic)
IS  - 1743-9159 (Linking)
VI  - 20
DP  - 2015 Aug
TI  - A novel approach to prevent post-operative ileus after continuous-flow left 
      ventricular assist device implantation: A retrospective cohort study.
PG  - 135-9
LID - S1743-9191(15)00327-1 [pii]
LID - 10.1016/j.ijsu.2015.06.054 [doi]
AB  - INTRODUCTION: Patients with postoperative ileus (POI), a common post-surgical 
      event, experience intense discomfort. Various treatments targeting prevention of 
      POI have shown to have an unpredictable effect. We introduced a novel 
      postoperative bowel management protocol in patients implanted with a 
      continuous-flow left ventricular assist device (CF-LVAD). The effect of this 
      protocol on POI was evaluated. METHODS: Patients receiving an old bowel 
      management protocol (OBMP; 01/2007-03/2009) were compared with those receiving a 
      new bowel management protocol (NBMP; 04/2009-12/2013). The OBMP consisted of 
      advancing the diet as tolerated, bisacodyl suppositories and enemas with the goal 
      of a bowel movement (BM) every 3 days. The NBMP consisted of clear liquids until 
      first BM is achieved, then full liquids until the second BM, then advancing to 
      goal diet. Docusate is given on postoperative day (POD) 1 and bisacodyl PR on 
      POD2 with enemas if ileus develops. Enemas are added POD3 if no BM has occurred. 
      Polyethylene glycol is considered daily for patients prone to constipation. The 
      goal is a BM every 2 days. Patients were made nil per os (NPO) with any signs of 
      ileus. RESULTS: One hundred eighteen patients were implanted with CF-LVADs during 
      the study period. The incidence of ileus significantly decreased from 19% in the 
      OBMP group to 4% percent in the NBMP group (p < 0.05). In-hospital mortality was 
      not different between the two groups (6% vs. 2% p = 0.35). CONCLUSIONS: A novel 
      postoperative bowel management protocol successfully decreased the incidence of 
      POI following CF-LVAD implant surgery at our institution.
CI  - Copyright (c) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Badami, Abbasali
AU  - Badami A
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Fehrenbach Prell, Erika A
AU  - Fehrenbach Prell EA
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Murray, Margaret A
AU  - Murray MA
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Johnson, Maryl R
AU  - Johnson MR
AD  - Department of Medicine, Division of Cardiovascular Medicine, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Akhter, Shahab A
AU  - Akhter SA
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Lozonschi, Lucian
AU  - Lozonschi L
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Osaki, Satoru
AU  - Osaki S
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
FAU - Lushaj, Entela
AU  - Lushaj E
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA. Electronic address: 
      lushaj@surgery.wisc.edu.
FAU - Kohmoto, Takushi
AU  - Kohmoto T
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin-Madison Hospital and Clinics, Madison, WI, USA.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150626
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
SB  - IM
CIN - Int J Surg. 2016 Apr;28:196-7. PMID: 26703379
MH  - Adult
MH  - Aged
MH  - *Cardiac Surgical Procedures
MH  - Female
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Ileus/epidemiology/etiology/*prevention & control
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Postoperative Care/*methods
MH  - Postoperative Complications/epidemiology/etiology/*prevention & control
MH  - *Prosthesis Implantation
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Gastrointestinal complications
OT  - Ileus
OT  - Implantation
OT  - Ventricular assist device
EDAT- 2015/06/30 06:00
MHDA- 2016/03/11 06:00
CRDT- 2015/06/30 06:00
PHST- 2014/12/11 00:00 [received]
PHST- 2015/05/31 00:00 [revised]
PHST- 2015/06/11 00:00 [accepted]
PHST- 2015/06/30 06:00 [entrez]
PHST- 2015/06/30 06:00 [pubmed]
PHST- 2016/03/11 06:00 [medline]
AID - S1743-9191(15)00327-1 [pii]
AID - 10.1016/j.ijsu.2015.06.054 [doi]
PST - ppublish
SO  - Int J Surg. 2015 Aug;20:135-9. doi: 10.1016/j.ijsu.2015.06.054. Epub 2015 Jun 26.