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Vasopressors and inotropes

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https://www.readbyqxmd.com/read/29903693/mechanical-circulatory-support-in-patients-with-cardiogenic-shock-in-intensive-care-units-a-position-paper-of-the-unit%C3%A3-de-soins-intensifs-de-cardiologie-group-of-the-french-society-of-cardiology-endorsed-by-the-groupe-ath%C3%A3-rome-et-cardiologie-interventionnelle
#1
REVIEW
Laurent Bonello, Clement Delmas, Guillaume Schurtz, Guillaume Leurent, Eric Bonnefoy, Nadia Aissaoui, Patrick Henry
Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines...
June 11, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29861795/matrix-metalloproteinase-9-and-tissue-inhibitor-of-matrix-metalloproteinase-1-in-sepsis-after-major-abdominal-surgery
#2
Suzana Bojic, Jelena Kotur-Stevuljevic, Aleksandra Aleksic, Jasna Gacic, Lidija Memon, Sanja Simic-Ogrizovic
Background: The role of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in sepsis after major abdominal surgery and sepsis-associated organ dysfunction is unexplored. Materials and Methods: Fifty-three patients with sepsis after major abdominal surgery were compared to 50 operated and 50 nonoperated controls. MMP-9, TIMP-1, biomarkers of inflammation, kidney and liver injury, coagulation, and metabolic disorders were measured daily during 96 h following diagnosis of sepsis and once in controls...
2018: Disease Markers
https://www.readbyqxmd.com/read/29858926/epinephrine-and-short-term-survival-in-cardiogenic-shock-an-individual-data-meta-analysis-of-2583-patients
#3
REVIEW
Valentine Léopold, Etienne Gayat, Romain Pirracchio, Jindrich Spinar, Jiri Parenica, Tuukka Tarvasmäki, Johan Lassus, Veli-Pekka Harjola, Sébastien Champion, Faiez Zannad, Serafina Valente, Philip Urban, Horng-Ruey Chua, Rinaldo Bellomo, Batric Popovic, Dagmar M Ouweneel, José P S Henriques, Gregor Simonis, Bruno Lévy, Antoine Kimmoun, Philippe Gaudard, Mir Babar Basir, Andrej Markota, Christoph Adler, Hannes Reuter, Alexandre Mebazaa, Tahar Chouihed
OBJECTIVE: Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients. DESIGN: We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors...
June 1, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29848429/misplaced-central-venous-catheter-in-carotid-artery-during-emergency-surgery-for-the-total-correction-of-tetralogy-of-fallot-of-an-adolescent-boy
#4
Syed Shabbir Ahmed, Faisal Junejo, Fazal Hameed Khan
Ultrasound-guided central venous cannulation is now considered as the standard of care, and this has largely replaced blind central venous cannulation using anatomical landmarks. We are reporting a case of inadvertent placement of central venous catheter in the right common carotid artery with the use of ultrasound guidance during emergency surgery for the total correction of Tetralogy of Fallot (ToF). This patient luckily had a favourable outcome despite this inadvertent catheter placement which was not recognised even after completion of surgery ...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29767322/management-of-cardiogenic-shock-complicating-myocardial-infarction
#5
REVIEW
Alexandre Mebazaa, Alain Combes, Sean van Diepen, Alexa Hollinger, Jaon N Katz, Giovanni Landoni, Ludhmila Abrahao Hajjar, Johan Lassus, Guillaume Lebreton, Gilles Montalescot, Jin Joo Park, Susanna Price, Alessandro Sionis, Demetris Yannopolos, Veli-Pekka Harjola, Bruno Levy, Holger Thiele
Up to 10% of acute coronary syndromes are complicated by cardiogenic shock (CS) with contemporary mortality rates of 40-50%. The extent of ischemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis in this patient population. Individualized patient risk assessment plays an important role in determining appropriate revascularization, drug treatment with inotropes and vasopressors, mechanical circulatory support, intensive care support of other organ systems, hospital level of care triage, and allocation of clinical resources...
May 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29745073/hemodynamic-stability-achievement-by-application-of-goal-directed-fluid-therapy-with-different-infusion-solutions-in-colorectal-surgery
#6
Ana Cvetkovic, Nevena Kalezic, Biljana Milicic, Srdjan Nikolic, Milan Zegarac, Dejan Stojiljkovic, Merima Goran, Marina Stojanovic
PURPOSE: To determine whether there was a correlation between the type of administered infusion solutions intraoperatively with the quantity of administered infusion solutions, differences in values of cardiac output (CO) and cardiac index (CI) and need to use vasopressors and inotropes, between control and research groups. METHODS: This randomized prospective study included 55 patients with colorectal cancer. Subjects in the control group received only crystalloid solutions intraoperatively and postoperatively...
March 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#7
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29721682/-infarct-related-cardiogenic-shock-prognosis-and-treatment
#8
REVIEW
R Prondzinsky, H Lemm, A Geppert, M Buerke, M Russ, K Werdan
Patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) experience cardiogenic shock in about 6-10% of cases during the hospital treatment. In recent years, the incidence seems to be decreasing due to invasive diagnostics and therapy after myocardial infarction. Early diagnosis is important to initiate immediate revascularization using percutaneous coronary intervention (PCI) with stent implantation as part of cardiogenic shock treatment. Thus, a significant improvement in survival can be achieved...
May 2, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29716488/a-two-centre-observational-study-of-simultaneous-pulse-oximetry-and-arterial-oxygen-saturation-recordings-in-intensive-care-unit-patients
#9
S J Ebmeier, M Barker, M Bacon, R C Beasley, R Bellomo, C Knee Chong, G M Eastwood, J Gilchrist, H Kagaya, J Pilcher, S K Reddy, E Ridgeon, N Sarma, S Sprogis, A Tanaka, M Tweedie, M Weatherall, P J Young
The influence of variables that might affect the accuracy of pulse oximetry (SpO<sub>2</sub>) recordings in critically ill patients is not well established. We sought to describe the relationship between paired SpO<sub>2</sub>/SaO<sub>2</sub> (oxygen saturation via arterial blood gas analysis) in adult intensive care unit (ICU) patients and to describe the diagnostic performance of SpO<sub>2</sub> in detecting low SaO<sub>2</sub> and PaO<sub>2</sub>...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29652289/iatrogenic-atrio-esophageal-fistula-following-a-video-assisted-thoracoscopic-maze-procedure-is-esophageal-instrumentation-justified-even-when-the-diagnosis-is-equivocal
#10
Shvetank Agarwal, Muhammad Salman Tahir Janjua, Paramvir Singh, Nadine Odo, Manuel R Castresana
A 74-year-old female underwent an uneventful bilateral thoracoscopic maze procedure for persistent atrial fibrillation with continuous transesophageal echocardiographic (TEE) guidance. She presented six weeks later with persistent fever and focal neurological signs. Computed tomography of the thorax revealed air in the posterior LA, raising suspicion for an abscess versus an atrioesophageal fistula (AEF). Before undergoing an exploratory median sternotomy, an esophagogastroduodenoscopy (EGD) was performed by the surgeon to check for any esophageal pathology...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#11
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650049/variation-in-general-supportive-and-preventive-intensive-care-management-of-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-center-tbi-study
#12
Jilske A Huijben, Victor Volovici, Maryse C Cnossen, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma, Mathieu van der Jagt
BACKGROUND: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. METHODS: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
April 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29602841/effect-of-levosimendan-on-mortality-in-severe-sepsis-and-septic-shock-a-meta-analysis-of-randomised-trials
#13
Wei Chang, Jian-Feng Xie, Jing-Yuan Xu, Yi Yang
OBJECTIVE: We aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock. METHODS: A collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported...
March 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29576114/effect-of-goal-directed-haemodynamic-therapy-on-postoperative-complications-in-low-moderate-risk-surgical-patients-a-multicentre-randomised-controlled-trial-fedora-trial
#14
J M Calvo-Vecino, J Ripollés-Melchor, M G Mythen, R Casans-Francés, A Balik, J P Artacho, E Martínez-Hurtado, A Serrano Romero, C Fernández Pérez, S Asuero de Lis
BACKGROUND: The aim of this study was to evaluate postoperative complications in patients having major elective surgery using oesophageal Doppler monitor-guided goal-directed haemodynamic therapy (GDHT), in which administration of fluids, inotropes, and vasopressors was guided by stroke volume, mean arterial pressure, and cardiac index. METHODS: The FEDORA trial was a prospective, multicentre, randomised, parallel-group, controlled patient- and observer-blind trial conducted in adults scheduled for major elective surgery...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29572733/williams-syndrome-and-anesthesia-for-non-cardiac-surgery-high-risk-can-be-mitigated-with-appropriate-planning
#15
Morgan L Brown, Viviane G Nasr, Rebecca Toohey, James A DiNardo
Patients with Williams syndrome are considered at high risk for anesthesia-related adverse events. At our institution, all William syndrome patients undergoing cardiac surgical, cardiac catheterization/interventional procedures, and cardiac imaging studies are cared for by cardiac anesthesiologists. All William syndrome patients undergoing non-cardiac surgical, interventional, or imaging studies are cared for by main operating room pediatric anesthesiologists with consultative input from a cardiac anesthesiologist...
March 23, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29547230/external-validity-of-a-prognostic-score-for-acute-heart-failure-based-on-the-epidemiology-of-acute-heart-failure-in-emergency-departments-registry-the-eahfe-3d-scale
#16
Susana García-Gutiérrez, José M Quintana López, Ane Antón-Ladislao, María Soledad Gallardo Rebollal, Irene Rilo Miranda, Miren Morillas Bueno, Nekane Murga Eizagaetxebarria, Ricardo Palenzuela Arocena, Esther Pulido, Irantzu Barrio Beraza, Urko Aguirre Larracoechea, Inmaculada Arostegui
OBJECTIVES: To validate the EAHFE-3D scale, based on the Acute Heart Failure in Emergency Departments registry, in a cohort of patients attended for acute heart failure. MATERIAL AND METHODS: Study of a multipurpose cohort of patients with acute heart failure in 3 hospitals in the Basque Country between 2011 and 2013. We extracted age, baseline New York Heart Association functional class, systolic blood pressure, baseline arterial oxygen saturation, sodium level in blood, and emergency department treatments (noninvasive mechanical ventilation, use of inotropic agents and vasopressors) in order to calculate each patient's EAHFE-3D score...
2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29521923/predictors-of-pressure-injuries-in-a-critical-care-unit-in-lebanon-prevalence-characteristics-and-associated-factors
#17
Jihad El-Marsi, Salah Zein-El-Dine, Bana Zein, Rita Doumit, Lina Kurdahi Badr
PURPOSE: The purpose of this study was to identify factors associated with pressure injury in a medical-surgical intensive care unit (MSICU). DESIGN: Retrospective review of medical records. SUBJECTS AND SETTING: We reviewed the medical records of 145 patients who developed a new pressure injury in the MSICU of a 420-bed university medical center in Lebanon. METHODS: Medical records of all patients cared for in the MSICU from December 2014 to June 2017 were reviewed by a research assistant using a standardized form...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29487111/prognostic-value-of-early-postoperative-troponin-t-in-patients-undergoing-coronary-artery-bypass-grafting
#18
Brigitta Gahl, Volkhard Göber, Ayodele Odutayo, Hendrik T Tevaearai Stahel, Bruno R da Costa, Stephan M Jakob, G Martin Fiedler, Olivia Chan, Thierry P Carrel, Peter Jüni
BACKGROUND: Cardiac troponin T (cTnT) is elevated after coronary artery bypass grafting surgery. The aim of this study was to determine the association between cTnT elevations between 6 and 12 hours after coronary artery bypass grafting and in-hospital outcome. METHODS AND RESULTS: We prospectively studied 1722 patients undergoing isolated coronary artery bypass grafting. We assessed the association between conventional cTnT (749 patients) and high-sensitivity cTnT (hs-cTnT; 973 patients) 6 to 12 hours postoperatively with in-hospital major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, or stroke...
February 27, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#19
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#20
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
November 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
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