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https://www.readbyqxmd.com/read/28928561/periprocedural-management-of-vein-of-galen-aneurysmal-malformation-patients-an-11-year-experience
#1
Ajay Prasad Hrishi, Karen Ruby Lionel
CONTEXT: The vein of Galen aneurysmal malformation (VGAM) is a rare arteriovenous malformation where a dilated median prosencephalic vein provides a low-resistance conduit for intracerebral blood flow resulting in high-output cardiac failure, severe pulmonary hypertension, with or without central nervous system symptoms secondary to hydrocephalus, in the neonatal and pediatric population. AIM: This study aims to analysis of the anesthetic management of this unique subset of patients with VGAM...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28919370/with-age-a-lower-individual-breathing-reserve-is-associated-with-a-higher-maximal-heart-rate
#2
Martin Burtscher, Hannes Gatterer, Martin Faulhaber, Johannes Burtscher
INTRODUCTION: Maximal heart rate (HRmax) is linearly declining with increasing age. Regular exercise training is supposed to partly prevent this decline, whereas sex and habitual physical activity do not. High exercise capacity is associated with a high cardiac output (HR x stroke volume) and high ventilatory requirements. Due to the close cardiorespiratory coupling, we hypothesized that the individual ventilatory response to maximal exercise might be associated with the age-related HRmax...
September 14, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28916637/effect-of-increases-in-cardiac-contractility-on-cerebral-blood-flow-in-humans
#3
Shigehiko Ogoh, Gilbert Moralez, Takuro Washio, Satyam Sarma, Michinari Hieda, Steven A Romero, Matthew N Cramer, Manabu Shibasaki, Craig G Crandall
The effect of acute increases in cardiac contractility on cerebral blood flow (CBF) remains unknown. We hypothesized that the external carotid artery (ECA) downstream vasculature modifies the direct influence of acute increases in heart rate and cardiac function on CBF regulation. Twelve healthy subjects received two infusions of dobutamine (first a low dose; 5 μg/kg/min and then a high dose; 15 μg/kg/min) for 12 min each. Cardiac output, blood flow through the internal carotid artery (ICA) and ECA and echocardiographic measurements were performed during dobutamine infusions...
September 15, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28915538/long-term-t3-and-t4-treatment-as-an-alternative-to-aerobic-exercise-training-in-improving-cardiac-function-post-myocardial-infarction
#4
Rayane Brinck Teixeira, Alexsandra Zimmer, Alexandre Luz de Castro, Bruna Gazzi de Lima-Seolin, Patrick Türck, Rafaela Siqueira, Adriane Belló-Klein, Pawan K Singal, Alex Sander da Rosa Araujo
Here we aimed to compare the beneficial effects of T3 and T4 hormone treatment to those provided by aerobic exercise training in Wistar rats post-myocardial infarction (MI). Rats in one group were SHAM-operated and in the other group were subjected to MI surgery. One week after surgery, the MI group animals either received T3 and T4 hormones by gavage or underwent a low intensity aerobic exercise training protocol on a treadmill, and both treatments lasted until 10 weeks after MI. Untreated SHAM-operated and MI groups were also followed for the same duration...
September 11, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28915226/pulmonary-vascular-function-and-aerobic-exercise-capacity-at-moderate-altitude
#5
Vitalie Faoro, Gael Deboeck, Marco Vicenzi, Anne-Fleur Gaston, Bamodi Simaga, Grégory Doucende, Ilona Hapkova, Emma Roca, Enric Subirats, Fabienne Durand, Robert Naeije
PURPOSE: There has been suggestion that a greater "pulmonary vascular reserve" defined by a low pulmonary vascular resistance (PVR) and a high lung diffusing capacity (DL) allow for a superior aerobic exercise capacity. How pulmonary vascular reserve might affect exercise capacity at moderate altitude is not known. METHODS: Thirty-eight healthy subjects underwent an exercise stress echocardiography of the pulmonary circulation, combined with measurements of DL for nitric oxide (NO) and carbon monoxide (CO) and a cardiopulmonary exercise test at sea level and at an altitude of 2250 m...
October 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28895094/fluid-loading-and-norepinephrine-infusion-mask-the-left-ventricular-preload-decrease-induced-by-pleural-effusion
#6
Kristian Borup Wemmelund, Viktor Kromann Ringgård, Simon Tilma Vistisen, Janus Adler Hyldebrandt, Erik Sloth, Peter Juhl-Olsen
BACKGROUND: Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determine the impact of fluid loading and norepinephrine infusion on physiologic determinants of cardiac function obtained by ultrasonography during PLE. METHODS: In this randomised, blinded, controlled laboratory study, 30 piglets (21.9 ± 1.3 kg) had bilateral PLE (75 mL/kg) induced...
September 11, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28885662/differential-diagnosis-of-alterations-in-arterial-flow-and-tissue-oxygenation-on-venoarterial-extracorporeal-membrane-oxygenation
#7
Anna Hofer, Sylvia Leitner, Michaela Kreuzer, Jens Meier
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) may be life-saving in several clinical situations, but it is also one of the most invasive therapeutic procedures, with significant potential for life-threatening complications. Pulse pressure waves are typically very small or even absent at the onset of ECMO therapy, and will reappear with the improvement of cardiac function. A low pulse pressure may indicate low cardiac output due to heart failure during sustained ECMO support...
September 5, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28885097/predictors-of-a-high-defibrillation-threshold-test-during-routine-icd-implantation
#8
B Al-Atia, B Vandenberk, G Vörös, C Garweg, J Ector, R Willems
BACKGROUND: There is growing evidence that routine defibrillation threshold (DFT) testing during implantable cardioverter defibrillator (ICD) implantation is not necessary. However a small group of patients might be at risk if no DFT testing is performed. METHODS: Patients with a new pectoral ICD implantation in our hospital between 2006 and 2014 were included in a retrospective registry. A clinical high DFT was defined as a safety margin <10 J of the maximal device output...
September 8, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28884833/circulatory-flow-restoration-versus-cardiopulmonary-resuscitation-new-therapeutic-approach-in-sudden-cardiac-arrest
#9
Sayed Nour, Daniel Carbognani, Juan Carlos Chachques
Sudden cardiac arrest (SCA) remains a major problem for health authorities worldwide. Insufficiencies of current cardiopulmonary resuscitation (CPR) are most probably related to an inappropriate concept and applied methods that still concentrate on heartbeat as priority, instead of blood circulation to maintain organs' perfusions. The aim of this works is to propose a new therapeutic approach for SCA in a more effective and secure manner compared with current CPR methods. It correlates to a non-invasive circulatory flow restoration (CFR) device composed of a multilayered thoracic and infradiaphragmatic compartments that will be pulsated alternatively and in fixed frequencies using a low-pressure pneumatic generator...
September 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28884218/use-of-levosimendan-in-postoperative-setting-after-surgical-repair-of-congenital-heart-disease-in-children
#10
Vivianne Amiet, Marie-Hélène Perez, David Longchamp, Tatiana Boulos Ksontini, Julia Natterer, Sonia Plaza Wuthrich, Jacques Cotting, Stefano Di Bernardo
Low cardiac output is one of the most common complications after cardiac surgery. Levosimendan, a new inotrope agent, has been demonstrated in adult patient to be an effective treatment for this purpose when classical therapy is not effective. The aim of this study was to evaluate the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS.). We carried out a retrospective analysis on 62 children hospitalized in our pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy...
September 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28877293/thermodilution-vs-estimated-fick-cardiac-output-measurement-in-clinical-practice-an-analysis-of-mortality-from-the-veterans-affairs-clinical-assessment-reporting-and-tracking-va-cart-program-and-vanderbilt-university
#11
Alexander R Opotowsky, Edward Hess, Bradley A Maron, Evan L Brittain, Anna E Barón, Thomas M Maddox, Laith I Alshawabkeh, Bradley M Wertheim, Meng Xu, Tufik R Assad, Jonathan D Rich, Gaurav Choudhary, Ryan J Tedford
Importance: Thermodilution (Td) and estimated oxygen uptake Fick (eFick) methods are widely used to measure cardiac output (CO). They are often used interchangeably to make critical clinical decisions, yet few studies have compared these approaches as applied in medical practice. Objectives: To assess agreement between Td and eFick CO and to compare how well these methods predict mortality. Design, Setting, and Participants: This investigation was a retrospective cohort study with up to 1 year of follow-up...
September 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28866972/comparison-of-continous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#12
Ahmad Elgendy, Ian M Seppelt, Andrew S Lane
BACKGROUND: Continuous-wave Doppler (CWD) ultrasound through the left ventricular outflow tract is one modality used for non-invasive cardiac output measurement. The ultrasonic cardiac output monitor (USCOM) is a relatively new monitor which uses a small, transcutaneous ultrasound probe to measure cardiac output with CWD via the suprasternal window. It is faster and less complex to train new users than conventional echocardiography. In addition to stroke volume (SV), the USCOM can calculate stroke volume variation (SVV) and the Smith-Madigan inotropy index (SMII), which is an estimate of the pre-load independent contractility of the myocardium...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28864438/measuring-stroke-volume-impedance-cardiography-vs-phase-contrast-magnetic-resonance-imaging
#13
Matthew Borzage, Kimia Heidari, Thomas Chavez, Istvan Seri, John C Wood, Stefan Blüml
BACKGROUND: Determination of cardiac output requires measurement of both heart rate and stroke volume. Techniques for measuring heart rate are widespread, and 1 technique for bedside monitoring of stroke volume is electrical impedance cardiography. OBJECTIVES: To determine the accuracy and precision of stroke volume measured via impedance cardiography and whether the technique can be used to detect trends. METHODS: Eleven healthy research participants (22-52 years old) were examined with simultaneous impedance cardiography and phase-contrast magnetic resonance imaging at rest and during exercise...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28863020/validating-the-physiologic-model-hummod-as-a-substitute-for-clinical-trials-involving-acute-normovolemic-hemodilution
#14
Charles R Sims, Luis R Delima, Arthur Calimaran, Robert Hester, W Andrew Pruett
BACKGROUND: Blood conservation strategies and transfusion guidelines remain a heavily debated clinical topic. Previous investigational trials have shown that acute isovolemic hemodilution does not limit adequate oxygen delivery; however, a true critical hemoglobin level has never been investigated or defined due to safety concerns for human volunteers. Validated physiologic modeling may be useful to investigate hemodilution at critical hemoglobin levels without the ethical or safety hazards of clinical trials...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28861269/defunctioning-stoma-a-prognosticator-for-leaks-in-low-rectal-restorative-cancer-resection-a-retrospective-analysis-of-stoma-database
#15
Haytham Abudeeb, Ahmed Hammad, Ajogwu Ugwu, Jamshid Darabnia, Lee Malcomson, Min Maung, Khurram Khan, Clare Mclaughlin, Arijit Mukherjee
AIMS: Low anterior resection (LAR) has higher risk of anastomotic leak with its attendant morbidity -mortality. De-functioning loop ileostomy (DLI), claimed to mitigate the consequences of anastomotic leak, has been questioned in recent years. This study aims to evaluate the impact of ileostomy on LAR. METHODS: A retrospective analysis of stoma database. 136 patients with stoma (March 2011-July 2015) were assessed. Data was analysed in respect to LAR anastomotic leak rate, impact on morbidity-mortality, short and long-term stoma complications, rate of ileostomy reversal and reasons for non-reversal...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28857356/different-predictivity-of-fluid-responsiveness-by-pulse-pressure-variation-in-children-after-surgical-repair-of-ventricular-septal-defect-or-tetralogy-of-fallot
#16
Ding Han, Shoudong Pan, Xiaonan Wang, Qingyan Jia, Yi Luo, Jia Li, Chuan Ou-Yang
BACKGROUND: Pulse pressure variation derived from the varied pulse contour method is based on heart-lung interaction during mechanical ventilation. It has been shown that pulse pressure variation is predictive of fluid responsiveness in children undergoing surgical repair of ventricular septal defect. Right ventricle compliance and pulmonary vascular capacitance in children with tetralogy of Fallot are underdeveloped as compared to those in ventricular septal defect. We hypothesized that the difference in the right ventricle-pulmonary circulation in the two groups of children would affect the heart-lung interaction and therefore pulse pressure variation predictivity of fluid responsiveness following cardiac surgery...
August 31, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28843329/safety-and-feasibility-of-the-transcatheter-approach-to-create-a-reverse-potts-shunt-in-children-with-idiopathic-pulmonary-arterial-hypertension
#17
Younes Boudjemline, Aleksander Sizarov, Sophie Malekzadeh-Milani, Cristian Mirabile, Marien Lenoir, Diala Khraiche, Marilyne Lévy, Damien Bonnet
BACKGROUND: The reversed Potts shunt improves right ventricular (RV) function in patients with suprasystemic pulmonary arterial hypertension (PAH). The proximity of the left pulmonary artery (LPA) to the descending aorta (DAo) permits the creation of a transcatheter connection. We sought to assess the safety, feasibility, and hemodynamic efficacy of the transcatheter Potts shunt (TPS) in children. METHODS: The TPS procedure was performed using radiofrequency energy for vessel perforation and deployment of a covered stent to connect the DAo and LPA...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28837595/novel-axolotl-cardiac-function-analysis-method-using-magnetic-resonance-imaging
#18
Pedro Gomes Sanches, Roel C Op 't Veld, Wolter de Graaf, Gustav J Strijkers, Holger Grüll
The salamander axolotl is capable of complete regeneration of amputated heart tissue. However, non-invasive imaging tools for assessing its cardiac function were so far not employed. In this study, cardiac magnetic resonance imaging is introduced as a non-invasive technique to image heart function of axolotls. Three axolotls were imaged with magnetic resonance imaging using a retrospectively gated Fast Low Angle Shot cine sequence. Within one scanning session the axolotl heart was imaged three times in all planes, consecutively...
2017: PloS One
https://www.readbyqxmd.com/read/28834858/diuretic-resistance-in-acute-decompensated-heart-failure-a-challenging-clinical-conundrum
#19
Brent N Reed, Sandeep Devabhakthuni
Most patients with acute decompensated heart failure (ADHF) present with signs and symptoms of volume overload, and those with a significant history of diuretic exposure may demonstrate varying degrees of diuretic resistance. Although this phenomenon is commonly reported, no consensus definition exists and recommendations regarding an optimal therapeutic approach remain limited. Optimizing the use of intravenous (IV) loop diuretic therapy is the most common initial approach, and therapy may be augmented by the addition of a thiazide-type diuretic or an IV vasodilator...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28822023/pulse-contour-derived-cardiac-output-measurements-in-morbid-obesity-influence-of-actual-ideal-and-adjusted-bodyweight
#20
Chantal A Boly, Pieter Schraverus, Floris van Raalten, Jan-Willem Coumou, Christa Boer, Simone van Kralingen
The non-invasive Nexfin cardiac output (CO) monitor shows a low level of agreement with the gold standard thermodilution method in morbidly obese patients. Here we investigate whether this disagreement is related to excessive bodyweight, and can be improved when bodyweight derivatives are used instead. We performed offline analyses of cardiac output recordings of patient data previously used and partly published in an earlier study by our group. In 30 morbidly obese patients (BMI > 35 kg/m(2)) undergoing laparoscopic gastric bypass, cardiac output was simultaneously determined with PiCCO thermodilution and Nexfin pulse-contour method...
August 18, 2017: Journal of Clinical Monitoring and Computing
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