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Hemodynamic monitoring response

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https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#1
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29130147/callous-unemotional-traits-modulate-brain-drug-craving-response-in-high-risk-young-offenders
#2
Gina M Vincent, Lora M Cope, Jean King, Prashanth Nyalakanti, Kent A Kiehl
Adults with psychopathy have a high propensity for substance abuse, generally starting from a young age. This investigation tested hypotheses about differences in the neural responses associated with drug craving among high-risk young offenders with histories of abuse of stimulants and other drugs as a function of psychopathic traits. Fifty-four male adolescents (44 with a history of stimulant abuse and 10 controls) incarcerated at a maximum-security facility (M age = 17.08 years) completed a drug-cue exposure task while brain hemodynamic activity was monitored using functional magnetic resonance imaging (fMRI) with a mobile MRI scanner stationed at the facility...
November 13, 2017: Journal of Abnormal Child Psychology
https://www.readbyqxmd.com/read/29117994/role-of-adenosine-1a-receptor-signaling-on-gfr-early-after-the-induction-of-sepsis
#3
Jonathan M Street, Erik H Koritzinsky, Tiffany R Bellomo, Xuzhen Hu, Peter S T Yuen, Robert A Star
Sepsis and acute kidney injury (AKI) synergistically increase morbidity and mortality in the ICU. How sepsis reduces GFR and causes AKI is poorly understood; one proposed mechanism includes tubuloglomerular feedback (TGF). When sodium reabsorption by the proximal tubules is reduced in normal animals, the macula densa senses increased luminal sodium chloride, then adenosine 1a receptor (A1aR) signaling triggers tubuloglomerular feedback, reducing GFR through afferent arteriole vasoconstriction. We measured GFR and systemic hemodynamics early during cecal ligation and puncture-induced sepsis in wild-type and A1aR knockout mice...
November 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29105684/-cardiogenic-shock-from-early-diagnosis-to-multiparameter-monitoring
#4
Marco Marini, Ilaria Battistoni, Alberto Lavorgna, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Giorgio Caretta, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Andrea Mortara, Daniela Pini, Renata De Maria, Nadia Aspromonte, Andrea Di Lenarda, Michele Massimo Gulizia, Serafina Valente
Cardiogenic shock (CS) is a life-threatening condition that occurs in response to reduced cardiac output, in the presence of adequate intravascular volume, and results in tissue hypoxia. CS can occur as a result of several etiologies but the most common is acute myocardial infarction. Despite the introduction of emergency revascularization for CS complicating acute myocardial infarction, mortality still remains exceptionally high, particularly in patients with refractory CS. The diagnosis of CS is sometimes challenging and it is based on clinical, hemodynamic, and biochemical signs...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29061119/computer-controlled-closed-loop-drug-infusion-system-for-automated-hemodynamic-resuscitation-in-endotoxin-induced-shock
#5
Kazunori Uemura, Toru Kawada, Can Zheng, Meihua Li, Masaru Sugimachi
BACKGROUND: Hemodynamic resuscitation in septic shock requires aggressive fluid replacement and appropriate use of vasopressors to optimize arterial pressure (AP) and cardiac output (CO). Because responses to these drugs vary between patients and within patient over time, strict monitoring of patient condition and repetitive adjustment of drug dose are required. This task is time and labor consuming, and is associated with poor adherence to resuscitation guidelines. To overcome this issue, we developed a computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in septic shock, and evaluated the performance of the system in a canine model of endotoxin shock...
October 23, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29047916/optical-mapping-of-prefrontal-activity-in-pathological-gamblers
#6
Xiaohong Lin, Shiyang Xu, Hada Fong-Ha Ieong, Zhen Yuan
Functional near-infrared spectroscopy (fNIRS) has emerged as a highly promising brain mapping technique that enables continuously and noninvasively monitoring the hemodynamic responses in the human brain. In this study, fNIRS was utilized to identify the different brain activation patterns between pathological gamblers (PGs) and healthy controls (HCs). Specifically, we examined the hemodynamic changes in the prefrontal cortex using fNIRS recordings during the completion of executive function and decision-making tasks for both PGs and HCs...
July 20, 2017: Applied Optics
https://www.readbyqxmd.com/read/29030623/monitoring-cerebral-hemodynamic-change-during-transcranial-ultrasound-stimulation-using-optical-intrinsic-signal-imaging
#7
Evgenii Kim, Eloise Anguluan, Jae Gwan Kim
Transcranial ultrasound stimulation (tUS) is a promising non-invasive approach to modulate brain circuits. The application is gaining popularity, however the full effect of ultrasound stimulation is still unclear and further investigation is needed. This study aims to apply optical intrinsic signal imaging (OISI) for the first time, to simultaneously monitor the wide-field cerebral hemodynamic change during tUS on awake animal with high spatial and temporal resolution. Three stimulation paradigms were delivered using a single-element focused transducer operating at 425 kHz in pulsed mode having the same intensity (ISPPA = 1...
October 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29027094/multimodal-functional-neuroimaging-by-simultaneous-bold-fmri-and-fiber-optic-calcium-recordings-and-optogenetic-control
#8
REVIEW
Franziska Albers, Lydia Wachsmuth, Timo Mauritz van Alst, Cornelius Faber
Recent developments of optogenetic tools and fluorescence-based calcium recording techniques enable the manipulation and monitoring of neural circuits on a cellular level. Non-invasive imaging of brain networks, however, requires the application of methods such as blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI), which is commonly used for functional neuroimaging. While BOLD fMRI provides brain-wide non-invasive reading of the hemodynamic response, it is only an indirect measure of neural activity...
October 12, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/29017455/the-ec90-of-remifentanil-for-blunting-cardiovascular-responses-to-head-fixation-for-neurosurgery-under-total-intravenous-anesthesia-with-propofol-and-remifentanil-based-on-bispectral-index-monitoring-estimation-with-the-biased-coin-up-and-down-sequential-method
#9
Jung-Man Lee, Jae-Hyon Bahk, Young-Jin Lim, Jiwon Lee, Leerang Lim
BACKGROUND: Head fixation can induce hemodynamic instability. Remifentanil is commonly used with propofol for total intravenous anesthesia (TIVA) during neurosurgery. This study investigated the 90% effective concentration (EC90) of remifentanil for blunting of cardiovascular responses to head fixation during neurosurgery via bispectral index (BIS) monitoring. METHODS: Fifty patients undergoing neurosurgery requiring head fixation were enrolled. This study was performed using the biased coin up-and-down design sequential method (BCD)...
October 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28991059/analgesia-nociception-index-monitoring-during-supratentorial-craniotomy
#10
Lakshman K Kommula, Sonia Bansal, Ganne S Umamaheswara Rao
BACKGROUND: Objective monitoring of pain during and after surgery has been elusive. Recently, Analgesia Nociception Index (ANI) monitor based on the high frequency component of heart rate variability has been launched into clinical practice. We monitored analgesia during craniotomy using ANI monitor and compared it with cardiovascular parameters and response entropy (RE) of entropy monitor. MATERIALS AND METHODS: In 21 patients undergoing a craniotomy for a supratentorial lesion, we monitored ANI, heart rate (HR), mean arterial pressure (MAP), state entropy, and RE throughout the surgery...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#11
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28973227/effect-of-an-early-resuscitation-protocol-on-in-hospital-mortality-among-adults-with-sepsis-and-hypotension-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Ben Andrews, Matthew W Semler, Levy Muchemwa, Paul Kelly, Shabir Lakhi, Douglas C Heimburger, Chileshe Mabula, Mwango Bwalya, Gordon R Bernard
Importance: The effect of an early resuscitation protocol on sepsis outcomes in developing countries remains unknown. Objective: To determine whether an early resuscitation protocol with administration of intravenous fluids, vasopressors, and blood transfusion decreases mortality among Zambian adults with sepsis and hypotension compared with usual care. Design, Setting, and Participants: Randomized clinical trial of 212 adults with sepsis (suspected infection plus ≥2 systemic inflammatory response syndrome criteria) and hypotension (systolic blood pressure ≤90 mm Hg or mean arterial pressure ≤65 mm Hg) presenting to the emergency department at a 1500-bed referral hospital in Zambia between October 22, 2012, and November 11, 2013...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28958965/bnp-response-during-berlin-heart-%C3%A2-support-in-child-a-case-report
#13
Nicolas Beranger, Charlotte Veyrat-Durebex, Philippe Pouard, Bernard Lacour, Stéphanie Vicca
A five-year-old boy is presented to Necker hospital for a dilated hypertrophic cardiomyopathy. The implantation of the Berlin Heart Excor(®) ventricular assist device was performed. This pediatric-sized Berlin Heart(®) device provides mechanical support for young infants and children of all ages to sustain the failing cardiac circulation over several months, until either recovery of myocardial function or heart transplantation. It remains difficult to identify patients with sufficient recovery and the right time for explantation of the Berlin Heart(®)...
October 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28925890/the-use-of-hemodynamic-and-cerebral-monitoring-to-study-pharmacodynamics-in-neonates
#14
A Smits, L Thewissen, A Dereymaeker, E Dempsey, A Caicedo, Gunnar Naulaers
BACKGROUND: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. METHODS: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28920777/heart-rate-and-indirect-blood-pressure-responses-to-four-different-field-anesthetic-protocols-in-wild-born-captive-chimpanzees-pan-troglodytes
#15
Rebeca Atencia, Eric J Stöhr, Aimee L Drane, Mike Stembridge, Glyn Howatson, Pablo Rodriguez Lopez Del Rio, Yedra Feltrer, Babila Tafon, Sharon Redrobe, Bruce Peck, Jaclyn Eng, Steve Unwin, Carlos R Sanchez, Rob E Shave
Limited data are available on hemodynamic responses to anesthetic protocols in wild-born chimpanzees (Pan troglodytes). Accordingly, this study characterized the heart rate (HR) and blood pressure responses to four anesthetic protocols in 176 clinically healthy, wild-born chimpanzees undergoing routine health assessments. Animals were anesthetized with medetomidine-ketamine (MK) (n = 101), tiletamine-zolazepam (TZ) (n = 30), tiletamine-zolazepam-medetomidine (TZM) (n = 24), or medetomidine-ketamine (maintained with isoflurane) (MKI) (n = 21)...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28900761/a-novel-multi-objective-physiological-control-system-for-rotary-left-ventricular-assist-devices
#16
Anastasios Petrou, Marcial Monn, Mirko Meboldt, Marianne Schmid Daners
Various control and monitoring algorithms have been proposed to improve the left-ventricular assist device (LVAD) therapy by reducing the still-occurring adverse events. We developed a novel multi-objective physiological control system that relies on the pump inlet pressure (PIP). Signal-processing algorithms have been implemented to extract the required features from the PIP. These features then serve for meeting various objectives: pump flow adaptation to the perfusion requirements, aortic valve opening for a predefined time, augmentation of the aortic pulse pressure, and monitoring of the LV pre- and afterload conditions as well as the cardiac rhythm...
September 12, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#17
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28874293/a-plea-for-an-early-ultrasound-clinical-integrated-approach-in-patients-with-acute-heart-failure-a-proactive-comment-on-the-esc-guidelines-on-heart-failure-2016
#18
G Tavazzi, A N Neskovic, A Hussain, G Volpicelli, G Via
BACKGROUND: The European Association of Cardiology (ESC) Guidelines on the diagnosis and treatment of acute heart failure (AHF) indicate prompt therapy initiation and performance of relevant investigations as paramount. Specifically, echocardiography prior to treatment is advocated only with hemodynamic instability, and the evaluation of clinical signs of peripheral perfusion and congestion is suggested as guidance for early interventions. Given the growing body of evidence on the diagnostic/monitoring capabilities of bedside ultrasound (including focused cardiac ultrasound, comprehensive echocardiography, lung ultrasound), we discuss the potential benefit of an integrated clinical/ultrasound approach at the very early stages of acute heart failure...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28838318/anesthetic-management-during-adenotonsillectomy-for-twins-with-congenital-insensitivity-to-pain-with-anhidrosis-two-case-reports
#19
Cong Wang, Xianwei Zhang, Shanna Guo, Jiaoli Sun, Ningbo Li
BACKGROUND: Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder characterized by hyperpyrexia, anhidrosis, pain insensitivity, self-inflicted injuries, and intellectual disability. The anesthetic management of these patients is challenging owing to the high risk of perioperative complications resulting from their autonomic dysfunction, such as hyperthermia, hypotension, and bradycardia, which result from autonomic nervous system dysfunction. CASE PRESENTATION: Two 3-year-old Han Chinese identical male twins (weighing 13...
August 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28828370/right-heart-function-during-acute-respiratory-distress-syndrome
#20
REVIEW
Xavier Repessé, Antoine Vieillard-Baron
Acute respiratory distress syndrome (ARDS) is burdened with significant mortality, mainly in connection with circulatory failure. The right ventricle (RV) is the weak link of hemodynamic stability among ARDS patients and its failure, also named "severe" acute cor pulmonale (ACP), is responsible for excess mortality. Driving pressure ≥18 cmH2O, PaCO2 ≥48 mmHg and PaO2/FiO2 <150 mmHg are three preventable factors recently identified as independently associated with ACP, on which ventilator strategy designed to protect the RV has to focus...
July 2017: Annals of Translational Medicine
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