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https://www.readbyqxmd.com/read/28738010/effects-of-the-%C3%AE-2-adrenoceptor-agonist-medetomidine-on-the-distribution-and-clearance-of-alfaxalone-during-coadministration-by-constant-rate-infusion-in-dogs
#1
Rachel C Bennett, Kati M Salla, Marja R Raekallio, Mika Scheinin, Outi M Vainio
OBJECTIVE To assess the possible impact of medetomidine on concentrations of alfaxalone in plasma, when coadministered as a constant rate infusion (CRI) to dogs, and to determine the possible impact of medetomidine on the cardiopulmonary effects of alfaxalone during CRI. ANIMALS 8 healthy adult Beagles. PROCEDURES 3 treatments were administered in a randomized crossover design as follows: 1 = saline (0.9% NaCl) solution injection, followed in 10 minutes by induction of anesthesia with alfaxalone (loading dose, 2...
August 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28708703/preparticipation-sports-physicals-a-comparison-of-single-provider-and-station-based-models
#2
David Lick, Karim Abdel-Aty, Daniel Diaz, Jaspaul Dulku, Sandeep Lochub, Kamran Mir, Robert Ricketts
BACKGROUND: Preparticipation physical examinations (PPEs) are required for children and adolescents before sports participation to identify at-risk athletes. These evaluations can be completed in a traditional office-based setting or in a station-based format. It is unclear if one format is superior to the other in identifying at-risk athletes. METHODS: We performed a retrospective chart review of children and adolescents between the ages 10 and 18 years who received their PPE in our office or in a station-based setting in a local high school between the years 2009 and 2015...
July 11, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28649460/pulmonary-diseases-induced-by-ambient-ultrafine-and-engineered-nanoparticles-in-twenty-first-century
#3
Tian Xia, Yifang Zhu, Lina Mu, Zuo-Feng Zhang, Sijin Liu
Air pollution is a severe threat to public health globally, affecting everyone in developed and developing countries alike. Among different air pollutants, particulate matter (PM), particularly combustion-produced fine PM (PM2.5) has been shown to play a major role in inducing various adverse health effects. Strong associations have been demonstrated by epidemiological and toxicological studies between increases in PM2.5 concentrations and premature mortality, cardiopulmonary diseases, asthma and allergic sensitization, and lung cancer...
December 2016: National Science Review
https://www.readbyqxmd.com/read/28510738/pharmacokinetic-pharmacodynamic-model-for-unfractionated-heparin-dosing-during-cardiopulmonary-bypass
#4
X Delavenne, E Ollier, S Chollet, F Sandri, J Lanoiselée, S Hodin, A Montmartin, J-F Fuzellier, P Mismetti, L Gergelé
Background: High-dose heparin is used during cardiopulmonary bypass (CPB) to prevent thrombosis in the circuits used for extracorporeal circulation. The aim of this study was, initially, to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model to assess the variability of PK/PD parameters and their correlation with the results of the routine haemostatic test activated clotting time (ACT) and thereafter to develop a Bayesian estimator enabling an individualized dosing strategy...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28485317/early-kinetics-of-procalcitonin-in-predicting-surgical-outcomes-in-type-a-aortic-dissection-patients
#5
Hua Liu, Zhe Luo, Lan Liu, Xiao-Mei Yang, Ya-Min Zhuang, Ying Zhang, Guo-Wei Tu, Guo-Guang Ma, Guang-Wei Hao, Jian-Feng Luo, Ji-Li Zheng, Chun-Sheng Wang
BACKGROUND: In cardiac surgery, elevation of procalcitonin (PCT) could be observed postoperatively in the absence of any evidence of infection and also seems to be a prognostic marker. PCT levels measured in patients undergoing Type A aortic dissection (TAAD) were used to determine prognostic values for complications and surgical outcomes. METHODS: Measurements of PCT, C-reactive protein (CRP), and leukocyte count were observed in TAAD surgery patients (n = 251; average age: 49...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28457076/improvement-in-creatinine-clearance-after-open-heart-surgery-in-infants-as-an-early-indicator-of-surgical-success
#6
Amit Dagan, Ovadia Dagan
BACKGROUND: Early surgical correction of congenital heart malformations in neonates and small infants may be complicated by acute kidney injury (AKI), which is associated with higher morbidity and mortality rates, especially in patients who require dialysis. Glomerular filtration rate (GFR) is considered the best measurement of renal function which, in neonates and infants, is highly dependent on heart function. OBJECTIVES: To determine whether measurements of creatinine clearance after open heart surgery in neonates and young infants can serve as an early indicator of surgical success or AKI...
December 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28456134/improvement-in-baroreflex-control-of-renal-sympathetic-nerve-activity-in-obese-sprague-dawley-rats-following-immunosuppression
#7
S A Khan, M Z A Sattar, N A Abdullah, H A Rathore, A Ahmad, M H Abdulla, E J Johns
AIM: This investigation explored the hypothesis that in obesity an inflammatory response in the kidney contributed to a renal nerve-dependent blunting of the baroreflex regulation of renal sympathetic nerve activity. METHODS: Rats received a normal (12% kcal) or high-fat (45% kcal) diet for 8 weeks plus daily injections of vehicle (0.9% NaCl i.p) or tacrolimus (0.25 mg kg(-1) day(-1) i.p) from weeks 3-8. Following anaesthesia, left renal sympathetic nerve activity was recorded, baroreflex gain curves were generated, by infusing phenylephrine and sodium nitroprusside, and cardiopulmonary baroreceptors challenged by infusing a saline load...
April 29, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28444697/population-pharmacokinetics-of-dexmedetomidine-in-infants
#8
Rachel G Greenberg, Huali Wu, Matthew Laughon, Edmund Capparelli, Stevie Rowe, Kanecia O Zimmerman, P Brian Smith, Michael Cohen-Wolkowiez
Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of dexmedetomidine in infants receiving dexmedetomidine per clinical care, ≤10 blood samples per infant were collected. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling in NONMEM. Covariates including postmenstrual age (PMA), serum creatinine, and recent history of cardiac surgery requiring cardiopulmonary bypass were investigated for their influence on PK parameters...
April 25, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28396605/bypassing-adverse-injection-reactions-to-nanoparticles-through-shape-modification-and-attachment-to-erythrocytes
#9
Peter Popp Wibroe, Aaron C Anselmo, Per H Nilsson, Apoorva Sarode, Vivek Gupta, Rudolf Urbanics, Janos Szebeni, Alan Christy Hunter, Samir Mitragotri, Tom Eirik Mollnes, Seyed Moein Moghimi
Intravenously injected nanopharmaceuticals, including PEGylated nanoparticles, induce adverse cardiopulmonary reactions in sensitive human subjects, and these reactions are highly reproducible in pigs. Although the underlying mechanisms are poorly understood, roles for both the complement system and reactive macrophages have been implicated. Here, we show the dominance and importance of robust pulmonary intravascular macrophage clearance of nanoparticles in mediating adverse cardiopulmonary distress in pigs irrespective of complement activation...
July 2017: Nature Nanotechnology
https://www.readbyqxmd.com/read/28325788/decompression-illness-with-hypovolemic-shock-and-neurological-failure-symptoms-after-two-risky-dives-a-case-report
#10
Sebastian Klapa, Johannes Meyne, Wataru Kähler, Frauke Tillmans, Henning Werr, Andreas Binder, Andreas Koch
Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28254373/dosing-antibiotic-prophylaxis-during-cardiopulmonary-bypass-a-higher-level-of-complexity-a-structured-review
#11
REVIEW
Fathima Paruk, Fekade B Sime, Jeffrey Lipman, Jason A Roberts
In highly invasive procedures such as open heart surgery, the risk of post-operative infection is particularly high due to exposure of the surgical field to multiple foreign devices. Adequate antibiotic prophylaxis is an essential intervention to minimise post-operative morbidity and mortality. However, there is a lack of clear understanding on the adequacy of traditional prophylactic dosing regimens, which are rarely supported by data. The aim of this structured review is to describe the relevant pharmacokinetic/pharmacodynamic (PK/PD) considerations for optimal antibiotic prophylaxis for major cardiac surgery including cardiopulmonary bypass (CPB)...
April 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28245519/pharmacokinetics-of-tranexamic-acid-in-neonates-and-infants-undergoing-cardiac-surgery
#12
Ralph Gertler, Michael Gruber, Stanislas Grassin-Delyle, Saïk Urien, Klaus Martin, Peter Tassani-Prell, Siegmund Braun, Simon Burg, Gunther Wiesner
AIM: Tranexamic acid (TXA) continues to be one of the antifibrinolytics of choice during paediatric cardiac surgery. However, in infants less than 1 year of age, the optimal dosing based on pharmacokinetic (PK) considerations is still under discussion. METHODS: Forty-three children less than 1 year of age were enrolled, of whom 37 required the use of cardiopulmonary bypass (CPB) and six were operated on without CPB. Administration of 50 mg kg(-1) TXA intravenously at the induction of anaesthesia was followed by 50 mg kg(-1) into the CPB prime in the CPB group...
August 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28221198/red-cell-transfusion-associated-hemolysis-in-cardiac-surgery-an-observational-cohort-study
#13
Keyvan Karkouti, Jeannie L Callum, Jason P Acker, Paul Yip, Vivek Rao
BACKGROUND: Red cell viability is impaired during storage, resulting in excess hemolysis during storage and after transfusion. As a result, transfusions may oversaturate the hemoglobin clearance pathways, resulting in cell-free hemoglobin and iron toxicity in susceptible patients, such as those undergoing cardiac surgery with cardiopulmonary bypass. To explore this hypothesis, we assessed the relationship of red cell transfusions with cell-free hemoglobin and transferrin saturation levels in a consecutive cohort of cardiac surgical patients...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28077373/determination-of-renal-function-and-injury-using-near-infrared-fluorimetry-in-experimental-cardiorenal-syndrome
#14
Mizuko Ikeda, Rumie Wakasaki, Katie J Schenning, Thomas Swide, Jeong Heon Lee, M Bernie Miller, Hak Soo Choi, Sharon Anderson, Michael P Hutchens
Cardiorenal syndrome type 1 causes acute kidney injury but is poorly understood; animal models and diagnostic aids are lacking. Robust noninvasive measurements of glomerular filtration rate are required for injury models and clinical use. Several have been described but are untested in translational models and suffer from biologic interference. We developed a mouse model of cardiorenal syndrome and tested the novel near-infrared fluorophore ZW800-1 to assess renal and cardiac function. We performed murine cardiac arrest and cardiopulmonary resuscitation followed by transthoracic echocardiography, 2 and 24 h later...
April 1, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27999040/population-pharmacokinetics-of-cefazolin-before-during-and-after-cardiopulmonary-bypass-to-optimize-dosing-regimens-for-children-undergoing-cardiac-surgery
#15
Pieter A J G De Cock, Hussain Mulla, Sarah Desmet, Filip De Somer, Brett C McWhinney, Jacobus P J Ungerer, Annelies Moerman, Sabrina Commeyne, Johan Vande Walle, Katrien Francois, Johan G C Van Hasselt, Peter De Paepe
Objectives: The objective of this study was to characterize cefazolin serum pharmacokinetics in children before, during and after cardiopulmonary bypass (CPB), in order to derive an evidence-based dosing regimen. Patients and methods: This study included children who received cefazolin before surgical incision, before cessation of CPB and after surgery. Blood samples of total and unbound cefazolin concentrations were collected before, during and after CPB. The cefazolin concentration-time profiles were analysed using population pharmacokinetic modelling and predictors for interindividual variability in pharmacokinetic parameters were investigated...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27885446/post-cardiotomy-rescue-extracorporeal-cardiopulmonary-resuscitation-in-neonates-with-single-ventricle-after-intractable-cardiac-arrest-attrition-after-hospital-discharge-and-predictors-of-outcome
#16
Anastasios C Polimenakos, Vincent Rizzo, Chawki F El-Zein, Michel N Ilbawi
Extracorporeal cardiopulmonary resuscitation (ECPR) in children with cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) has been reported with encouraging results. We reviewed outcomes of neonates with functional single ventricle (FSV) surviving post-cardiotomy ECPR after hospital discharge. Fifty-eight patients who required post-cardiotomy extracorporeal membrane oxygenation (ECMO) since the introduction of our ECPR protocol (January 2007-December 2011) were identified. Forty-one were neonates...
February 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27862675/the-physiotherapist-and-the-esophageal-cancer-patient-from-prehabilitation-to-rehabilitation
#17
E M Guinan, J Dowds, C Donohoe, J V Reynolds, J Hussey
Esophageal cancer is a serious malignancy often treated with multimodal interventions and complex surgical resection. As treatment moves to centers of excellence with emphasis on enhanced recovery approaches, the role of the physiotherapist has expanded. The aim of this review is to discuss the rationale behind both the evolving prehabilitative role of the physiotherapist and more established postoperative interventions for patients with esophageal cancer. While a weak association between preoperative cardiopulmonary fitness and post-esophagectomy outcome is reported, cardiotoxicity during neoadjuvant chemotherapy and/or radiotherapy may heighten postoperative risk...
January 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27833481/cardiac-and-renal-protective-effects-of-dexmedetomidine-in-cardiac-surgeries-a-randomized-controlled-trial
#18
A S Ammar, K M Mahmoud, Z A Kasemy, M A Helwa
BACKGROUND: Cardiac and renal injuries are common insults after cardiac surgeries that contribute to perioperative morbidity and mortality. Dexmedetomidine has been shown to protect several organs against ischemia/reperfusion-(I/R) induced injury. We performed a randomized controlled trial to assess the effect of dexmedetomidine on cardiac and renal I/R injury in patients undergoing cardiac surgeries. MATERIALS AND METHODS: Fifty patients scheduled for elective cardiac surgeries were randomized to dexmedetomidine group that received a continuous infusion of dexmedetomidine initiated 5 min before cardiopulmonary bypass (1 μg/kg over 15 min, followed by 0...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27812147/left-atrial-structure-and-function-in-heart-failure-with-preserved-ejection-fraction-a-relax-substudy
#19
Siddique A Abbasi, Ravi V Shah, Steven E McNulty, Adrian F Hernandez, Marc J Semigran, Gregory D Lewis, Michael Jerosch-Herold, Raymond J Kim, Margaret M Redfield, Raymond Y Kwong
Given the emerging recognition of left atrial structure and function as an important marker of disease in heart failure with preserved ejection fraction (HF-pEF), we investigated the association between left atrial volume and function with markers of disease severity and cardiac structure in HF-pEF. We studied 100 patients enrolled in the PhosphdiesteRasE-5 Inhibition to Improve CLinical Status and EXercise Capacity in Diastolic Heart Failure (RELAX) trial who underwent cardiac magnetic resonance (CMR), cardiopulmonary exercise testing, and blood collection before randomization...
2016: PloS One
https://www.readbyqxmd.com/read/27601212/associations-with-30-day-survival-following-extracorporeal-membrane-oxygenation-in-patients-with-acute-st-segment-elevation-myocardial-infarction-and-profound-cardiogenic-shock
#20
Wei-Chieh Lee, Chih-Yuan Fang, Huang-Chung Chen, Chien-Jen Chen, Cheng-Hsu Yang, Chi-Ling Hang, Hon-Kan Yip, Hsiu-Yu Fang, Chiung-Jen Wu
BACKGROUND: Limited data are available regarding the role of percutaneous cardiopulmonary support for the treatment of ST segment elevation myocardial infarction (STEMI) with profound cardiogenic shock (CS). The aim of this study is to identify the determinant factors for survival of patients with STEMI who underwent extracorporeal membrane oxygenation (ECMO) support. METHOD: From January 2005 to December 2013, 192 patients experienced STEMI with CS needed intra-aortic balloon pumping and support with vasoactive agents at our hospital...
November 2016: Heart & Lung: the Journal of Critical Care
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