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Vasopressors and inotropes

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https://www.readbyqxmd.com/read/28540841/lung-or-heart-lung-transplant-in-pulmonary-arterial-hypertension-what-is-the-impact-of-systemic-sclerosis
#1
Shruti K Gadre, Omar A Minai, Xiao-Feng Wang, Qi Zhang, Marie Budev, Adriano R Tonelli
OBJECTIVES: Little is known about recipient characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, particularly those with systemic sclerosis-associated disease. Here, we describe the characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, focusing on systemic sclerosis-associated disease. MATERIALS AND METHODS: This retrospective study included pulmonary arterial hypertension patients undergoing lung or heart-lung transplant between July 1992 and August 2013 at a single center...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28523028/peripheral-arterial-blood-pressure-versus-central-crterial-blood-pressure-monitoring-in-critically-ill-patients-after-cardio-pulmonary-bypass
#2
Rana Altaf Ahmad, Suhail Ahmad, Anjum Naveed, Mirza Ahmad Raza Baig
OBJECTIVE: To determine the accuracy of peripheral (radial) arterial access as compared to central (femoral) arterial access for measurement of invasive blood pressure (IBP) in critically ill patients after cardiopulmonary bypass. METHODS: Sixty patients (60) who required high inotropic/vasopressor support on weaning from cardio-pulmonary bypass and weaned off in 2(nd) attempt were included in this study. The duration of this study was from June 2015 to August 2016...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28506218/investigation-of-the-pathophysiology-of-cardiopulmonary-bypass-using-rodent-extracorporeal-life-support-model
#3
Ru-Wen Chang, Chien-Ming Luo, Hsi-Yu Yu, Yih-Sharng Chen, Chih-Hsien Wang
BACKGROUND: Extracorporeal life support (ECLS) systems are life-saving devices used for treating patients with severe cardiopulmonary failure. In this study, we implemented a rat model of ECLS without the administration of inotropes or vasopressors. METHODS: The rats underwent 5 min of untreated asphyxial cardiac arrest and were resuscitated by ECLS for 30 min. The right external jugular vein and right femoral artery were separately cannulated to the ECLS outflow and inflow, respectively...
May 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28503840/a-critical-note-on-treatment-of-a-severe-diltiazem-intoxication-high-dose-calcium-and-glucagon-infusions
#4
N M Van Veggel, G J Van der Veen, T C Jansen, E M Westerman
The morbidity and mortality of a severe calcium channel blocker intoxication is high due to serious toxic cardiac effects. Its treatment is supported by low-quality evidence from heterogeneous literature. We describe a case of a severe diltiazem intoxication and critically appraise the efficacy and role of high-dose calcium and glucagon infusions. A 53-year-old woman was admitted to the emergency department with a cardiogenic shock with complete AV block, not responding to atropine, isoprenaline and an external pacemaker...
May 15, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28489254/use-of-intra-aortic-counterpulsation-in-cardiogenic-shock-post-liver-transplantation
#5
Arun P Palanisamy, Satish N Nadig, Gabriel R Chedister, Jacob E Dowden, David G Koch, William D Stoll, John W McGillicuddy, Kenneth D Chavin
Left ventricular dysfunction resulting in cardiogenic shock occurs infrequently following organ reperfusion in liver transplantation. The etiology of the cardiogenic shock is often multifactorial and difficult to manage due to the complex nature of the procedure and the patient's baseline physiology. Traditionally, this hemodynamic instability is managed medically using inotropic agents and vasopressor support. If medical treatment is insufficient, the use of an intra-aortic balloon pump for counterpulsation may be employed to improve the hemodynamics and stabilize the patient...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28474097/advanced-hemodynamic-monitoring-in-intensive-care-medicine-a%C3%A2-german-web-based-survey-study
#6
B Saugel, P C Reese, J Y Wagner, M Buerke, W Huber, S Kluge, R Prondzinsky
BACKGROUND: Advanced hemodynamic monitoring is recommended in patients with complex circulatory shock. OBJECTIVES: To evaluate the current attitudes and beliefs among German intensivists, regarding advanced hemodynamic monitoring, the actual hemodynamic management in clinical practice, and the barriers to using it. MATERIALS AND METHODS: Web-based survey among members of the German Society of Medical Intensive Care and Emergency Medicine. RESULTS: Of 284 respondents, 249 (87%) agreed that further hemodynamic assessment is needed to determine the type of circulatory shock if no clear clinical diagnosis can be made...
May 4, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28438820/use-of-an-argatroban-based-purge-solution-in-a-percutaneous-ventricular-assist-device
#7
Benjamin Laliberte, Brent N Reed
PURPOSE: The use of an argatroban-based percutaneous ventricular assist device (pVAD) purge solution in a patient with suspected heparin-induced thrombocytopenia (HIT) is described. SUMMARY: A 70-year-old woman in cardiogenic shock was admitted to a coronary care unit after being discovered unresponsive at home. A transthoracic echocardiogram revealed a low ejection fraction and findings consistent with takotsubo cardiomyopathy. Administration of multiple inotropes and vasopressors was initially required for hemodynamic support...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28428483/a-retrospective-study-of-anesthesia-for-subcutaneous-ureteral-bypass-placement-in-cats-27-cases
#8
Geneviève C Luca, Beatriz P Monteiro, Marilyn Dunn, Paulo Vm Steagall
The goals of this retrospective clinical case series study were to describe the management of anesthesia, and to report perioperative complications in cats undergoing subcutaneous ureteral bypass (SUB) placement due to ureteral obstruction. Medical records of client-owned cats with ureteral obstruction and anesthetized for SUB placement between 2012 and 2015 in a veterinary teaching hospital were reviewed. Twenty-seven cases were identified. Duration of anesthesia and surgery (mean ± standard deviation) were 215 ± 42 min and 148 ± 36 min, respectively...
April 20, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28336302/-vasopressors-and-inotropes-use-in-pediatrics
#9
Adrián García-Canales, Rocío Alejandra Peña-Juárez, Luz de María Sandoval-Franco
The cardiovascular system is a dynamic system whose function is to ensure adequate delivery of oxygen, nutrients and hormones to the tissues, necessary for cell metabolism, also synthesizes and modifies vasoactive components to regulate vascular tone and myocardial function. These components have become critical in the management of pediatric patients in critical condition with heart failure and shock which has proven its beneficial effects, however its use and abuse brings harmful effects, increase mortality, associated with arrhythmias and increase myocardial oxygen consumption favoring the presence of ischemia, therefore is necessary to know the mechanism of action and indications of these drugs to minimize the harmful effects...
March 20, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28295151/use-of-life-support-in-acutely-admitted-icu-patients-an-international-cohort-study
#10
T S Meyhoff, M Krag, P B Hjortrup, A Perner, M H Møller
BACKGROUND: Use of life support in intensive care unit (ICU) patients has been associated with increased risk of poor outcome. The prognostic importance of the duration of support is less studied. We assessed the use of life support and the association between its duration and 90-day mortality in a contemporary cohort of acutely admitted adult ICU patients. METHODS: We performed a post-hoc analysis of the SUP-ICU 7-day inception cohort study (n = 1034), which was conducted in 97 ICUs in 11 countries...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28286823/protocol-adherence-for-severe-sepsis-and-septic-shock-management-in-the-emergency-department-a-clinical-audit
#11
Mostafa Alavi-Moghaddam, Ali Anvari, Reaza Soltani Delgosha, Hamid Kariman
INTRODUCTION: Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans' lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines. METHOD: This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28274560/antithrombin-iii-is-associated-with-acute-liver-failure-in-patients-with-end-stage-heart-failure-undergoing-mechanical-circulatory-support
#12
Judith Hoefer, Hanno Ulmer, Juliane Kilo, Raimund Margreiter, Michael Grimm, Peter Mair, Elfriede Ruttmann
OBJECTIVE: There are few data on the role of liver dysfunction in patients with end-stage heart failure supported by mechanical circulatory support. The aim of our study was to investigate predictors for acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support. METHODS: A consecutive 164 patients with heart failure with New York Heart Association class IV undergoing mechanical circulatory support were investigated for acute liver failure using the King's College criteria...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28261505/augmenting-function-for-infarction-from-infection-impella-2-5-for-ischemic-cardiogenic-shock-complicating-sepsis
#13
Praveen George, Mukta C Srivastava, Jonathan Ludmir, Robert M Reed, Semhar Z Tewelde, Anuj Gupta, Michael T McCurdy
Cardiac dysfunction is a common complication of sepsis in individuals with preexisting coronary disease and portends a poor prognosis when progressing to ischemic cardiogenic shock. In this setting, maximal medical therapy in isolation is often inadequate to maintain cardiac output for patients who are poor candidates for immediate revascularization. Furthermore, the use of vasopressors and inotropes increases myocardial demand and may lead to further injury. Percutaneous ventricular assist devices provide a viable option for management of severe shock with multiorgan failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28239476/prolonged-direct-hemoperfusion-using-a-polymyxin-b-immobilized-fiber-cartridge-provides-sustained-circulatory-stabilization-in-patients-with-septic-shock-a-retrospective-observational-before-after-study
#14
Kyohei Miyamoto, Yu Kawazoe, Seiya Kato
BACKGROUND: Direct hemoperfusion therapy with polymyxin B immobilized fiber cartridges (PMX-DHP) is widely used for septic shock in Japan and parts of Europe. Although this treatment is usually administered for 2 h, the optimal duration has not been established. METHODS: This retrospective study compared the effects of prolonged and conventional PMX-DHP durations (2 and 12 h, respectively) for septic shock. Between October 2013 and March 2015, 18 patients underwent conventional PMX-DHP, and between April 2015 and May 2016, 18 patients underwent prolonged PMX-DHP...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28236873/perianesthetic-refractory-anaphylactic-shock-with-cefuroxime-in-a-patient-with-history-of-penicillin-allergy-on-multiple-antihypertensive-medications
#15
Deb Sanjay Nag, Devi Prasad Samaddar, Shashi Kant, Pratap Rudra Mahanty
We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10mL of (1:10,000) epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#16
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28190548/venovenous-versus-venoarterial-extracorporeal-membrane-oxygenation-for-adult-patients-with-acute-respiratory-distress-syndrome-requiring-precannulation-hemodynamic-support-a-review-of-the-elso-registry
#17
Zachary N Kon, Gregory J Bittle, Chetan Pasrija, Si M Pham, Michael A Mazzeffi, Daniel L Herr, Pablo G Sanchez, Bartley P Griffith
BACKGROUND: In addition to severe hypoxia and hypercapnia, acute respiratory distress syndrome (ARDS) can present with substantial hemodynamic compromise, requiring inotropic or vasopressor support or both. Either venovenous (VV) or venoarterial (VA) extracorporeal membrane oxygenation (ECMO) can be offered in this situation. However, a contemporary comparison of these two cannulation strategies has yet to be well described. METHODS: The Extracorporeal Life Support Organization Registry was reviewed for all cases of adult ARDS in patients that required inotropic agents or vasopressors or both before ECMO initiation (2009 to 2013)...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28154601/cardiac-resynchronization-therapy-device-implantation-in-a-patient-with-cardiogenic-shock-under-percutaneous-mechanical-circulatory-support
#18
Kyunghee Lim, Jin-Oh Choi, Jeong Hoon Yang, Seung-Jung Park, Sun Hwa Kim, Jiseok Kang, Hyun Sung Joh, Sun Hye Shin
65-year-old woman was admitted to our hospital with acute decompensated heart failure with reduced left ventricular ejection fraction and severe mitral regurgitation. Electrocardiography revealed a typical left bundle branch block and atrial fibrillation. Her condition deteriorated despite administering high-doses of inotropes and vasopressors. Pending a decision to therapy, venoarterial extracorporeal membrane oxygenation (ECMO) was performed when the patient underwent a cardiogenic shock. Although the hemodynamic status stabilized with ECMO support, weaning the patient from ECMO was not possible...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28127638/ecmo-in-cardiac-arrest-and%C3%A2-cardiogenic-shock
#19
L C Napp, C Kühn, J Bauersachs
Cardiogenic shock is an acute emergency, which is classically managed by medical support with inotropes or vasopressors and frequently requires invasive ventilation. However, both catecholamines and ventilation are associated with a worse prognosis, and many patients deteriorate despite all efforts. Mechanical circulatory support is increasingly considered to allow for recovery or to bridge until making a decision or definite treatment. Of all devices, extracorporeal membrane oxygenation (ECMO) is the most widely used...
February 2017: Herz
https://www.readbyqxmd.com/read/28101622/-use-of-vasopressors-and-inotropics-in-cardiogenic-shock
#20
H Lemm, S Dietz, M Janusch, M Buerke
Vasoactive drugs and inotropic agents are important for the hemodynamic management of cardiogenic shock. In this article the use of different vasoactive and ionotropic drugs in cardiogenic shock is presented. Hemodynamic management during cardiogenic shock occurs after initial moderate volume delivery by dobutamine to increase inotropism. If adequate perfusion pressures are not achieved norepinephrine is administered. If a sufficient increase in cardiac performance can still not be achieved by the treatment, administration of levosimendan or phosphodiesterase (PDE) inhibitors may be necessary...
February 2017: Herz
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