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Echocardiography hemodynamic monitoring

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https://www.readbyqxmd.com/read/29621027/cardiac-output-monitoring-how-to-choose-the-optimal-method-for-the-individual-patient
#1
Bernd Saugel, Jean-Louis Vincent
PURPOSE OF REVIEW: To review the different methods available for the assessment of cardiac output (CO) and describe their specific indications in intensive care and perioperative medicine. RECENT FINDINGS: In critically ill patients, persistent circulatory shock after initial resuscitation is an indication for the assessment of CO to monitor the response to fluids and vasoactive agents. In patients with circulatory shock associated with right ventricular dysfunction, pulmonary artery hypertension, or acute respiratory distress syndrome, invasive CO monitoring using indicator dilution methods is indicated...
April 4, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29608456/the-pulmonary-artery-catheter-is-it-still-alive
#2
Daniel De Backer, Jean-Louis Vincent
PURPOSE OF REVIEW: The present review discusses the current role of the pulmonary artery catheter (PAC) in the hemodynamic monitoring of critically ill patients. RECENT FINDINGS: The PAC has an important role in the characterization and management of hemodynamic alterations in critically ill patients. Use of the PAC has decreased in the last 30 years because of recent advances in less invasive hemodynamic monitoring techniques, in particular transpulmonary thermodilution and echocardiography, combined with the publication of the results of several randomized trials that failed to show improvements in outcome with the use of the PAC in various settings...
March 31, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29602588/-transesophageal-echocardiography-in-perioperative-period-guiding-the-decision-making-during-hemodynamic-instability-due-to-atrial-fibrillation
#3
João Paulo Jordão Pontes, Aline Tonin Dos Santos, Marcello Fonseca Salgado Filho
BACKGROUND AND OBJECTIVE: Atrial fibrillation is the most common cardiac arrhythmia, which may occur during the perioperative period and lead to hemodynamic instability due to loss of atrial systolic function. During atrial fibrillation management, electrical cardioversion is one of the therapeutic options in the presence of hemodynamic instability; however, it exposes the patient to thromboembolic event risks. Transesophageal echocardiography is a diagnostic tool for thrombi in the left atrium and left atrial appendage with high sensitivity and specificity, allowing early and safe cardioversion...
March 27, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29573481/safety-profile-during-initiation-of-propranolol-for-treatment-of-infantile-hemangiomas-in-an-ambulatory-day-care-hospitalization-setting
#4
Itay Fogel, Ayelet Ollech, Alex Zvulunov, Yulia Valdman-Greenshpon, Vered Atar-Sagie, Rivka Friedland, Moshe Lapidoth, Dan Ben-Amitai
BACKGROUND: Propranolol is the mainstay of treatment for infantile hemangioma. Despite its good safety profile, it is not risk-free. Guidelines for propranolol initiation and monitoring have been suggested, but protocols vary among practitioners. OBJECTIVE: This study sought to assess the prevalence of adverse events and clinically significant fluctuations in hemodynamic parameters in children with infantile hemangioma during initiation of treatment with propranolol in a day-hospitalization setting...
March 24, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29569424/left-atrial-volume-in-patients-with-her2-positive-breast-cancer-one-step-further-to-predict-trastuzumab-related-cardiotoxicity
#5
Corinna Bergamini, Giulia Dolci, Andrea Rossi, Flavia Torelli, Luca Ghiselli, Laura Trevisani, Giulia Vinco, Stella Truong, Francesca La Russa, Giorgio Golia, Annamaria Molino, Giovanni Benfari, Flavio Luciano Ribichini
BACKGROUND: Trastuzumab (TZ) therapy requires careful monitoring of left ventricular (LV) ejection fraction (LVEF) because it can be potentially cardiotoxic. However, LVEF is an imperfect parameter and there is a need to find other variables to predict cardiac dysfunction early. Left atrium (LA) enlargement has proven to be a powerful predictor of adverse outcomes in several disease entities. HYPOTHESIS: Baseline LA volume enlargement might predict TZ-related LV dysfunction...
March 22, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29525195/advanced-age-attenuates-left-ventricular-filling-efficiency-quantified-using-vortex-formation-time-a-study-of-octogenarians-with-normal-left-ventricular-systolic-function-undergoing-coronary-artery-surgery
#6
Paul S Pagel, Lonnie Dye, Brent T Boettcher, Julie K Freed
OBJECTIVE: Blood flow across the mitral valve during early left ventricular (LV) filling produces a 3-dimensional rotational fluid body, known as a vortex ring, that enhances LV filling efficiency. Diastolic dysfunction is common in elderly patients, but the influence of advanced age on vortex formation is unknown. The authors tested the hypothesis that advanced age is associated with a reduction in LV filling efficiency quantified using vortex formation time (VFT) in octogenarians undergoing coronary artery bypass graft (CABG) surgery...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29478967/clinical-outcomes-in-patients-with-nonobstructive-labile-and-obstructive-hypertrophic-cardiomyopathy
#7
Dai-Yin Lu, Iraklis Pozios, Bereketeab Haileselassie, Ioannis Ventoulis, Hongyun Liu, Lars L Sorensen, Marco Canepa, Susan Phillip, M Roselle Abraham, Theodore P Abraham
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac disease characterized by varying degrees of left ventricular outflow tract obstruction. In a large cohort, we compare the outcomes among 3 different hemodynamic groups. METHODS AND RESULTS: We prospectively enrolled patients fulfilling standard diagnostic criteria for HCM from January 2005 to June 2015. Detailed phenotypic characterization, including peak left ventricular outflow tract pressure gradients at rest and after provocation, was measured by echocardiography...
February 25, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29476380/new-onset-pericardial-effusion-during-transvenous-lead-extraction-incidence-causative-mechanisms-and-associated-factors
#8
François Regoli, Gabriele D'Ambrosio, Maria Luce Caputo, Stefano Svab, Giulio Conte, Tiziano Moccetti, Catherine Klersy, Tiziano Cassina, Stefanos Demertzis, Angelo Auricchio
PURPOSE: Pericardial effusion (PE) may occur during the lead extraction procedure (TLE). Little is known about the incidence, causes, and predictors of this complication. METHODS: From January 2009 to October 2016, TLE was attempted for 297 leads in 212 patients (age 69.3 ± 12.9 years, 169 male, BMI 27.2 ± 9.9 m²/kg, LVEF 43.4 ± 24.6%) for lead dysfunction (62.7%), upgrade (16.0%), infection (14.2%), or other (7.0%) indications. TLE was performed under general anesthesia with continuous invasive arterial blood pressure and transesophageal echocardiography (TEE) monitoring...
February 23, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29428185/lack-of-correlation-between-left-ventricular-outflow-tract-velocity-time-integral-and-stroke-volume-index-in-mechanically-ventilated-patients
#9
R Blancas, Ó Martínez-González, D Ballesteros, A Núñez, J Luján, D Rodríguez-Serrano, A Hernández, C Martínez-Díaz, C M Parra, B L Matamala, M A Alonso, M Chana
OBJECTIVE: To assess the correlation between left ventricular outflow tract velocity time integral (LVOT VTI) and stroke volume index (SVI) calculated by thermodilution methods in ventilated critically ill patients. DESIGN: A prospective, descriptive, multicenter study was performed. SETTING: Five intensive care units from university hospitals. PATIENTS: Patients older than 17 years needing mechanical ventilation and invasive hemodynamic monitoring were included...
February 7, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29338148/novel-applications-of-bedside-monitoring-to-plumb-patient-hemodynamic-state-and-response-to-therapy
#10
Fabio Guarracino, Pietro Bertini, Michael R Pinsky
Hemodynamic monitoring is essential during the treatment of the critically ill in order to address the hemodynamic alterations and assess the response to treatment. Traditionally classified causes of shock and underlying pathophysiological mechanisms are often neglected by resuscitative strategies included in the guidelines. Most of hemodynamic management focuses on the ability to early recognise patients susceptible to increase cardiac output (CO) and mean arterial pressure (MAP) after a defined fluid challenge by eliciting Starling's law of the heart, and less is known of the ones presenting in shock and not volume responsive...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29302948/the-hancock%C3%A2-valved-conduit-for-right-ventricular-outflow-tract-reconstruction-in-sheep-for-assessing-new-devices
#11
John P Carney, Lindsey M Zhang, Jeffrey J Larson, Matthew T Lahti, Nicholas A Robinson, Agustin P Dalmasso, Richard W Bianco
BACKGROUND AND AIM OF THE STUDY: Xenograft conduits have been used successfully to repair congenital heart defects, but are prone to failure over time. Hence, in order to improve patient outcomes, better xenografts are being developed. When evaluating a conduit's performance and safety it must first be compared against a clinically available control in a large animal model. The study aim was to evaluate a clinically available xenograft conduit used in right ventricular outflow tract (RVOT) reconstruction in a sheep model...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29258779/ultrasound-stroke-volume-variation-induced-by-passive-leg-raising-and-fluid-responsiveness-an-observational-cohort-study
#12
A Trifi, S Abdellatif, F Daly, R Nasri, Y Touil, S Ben Lakhal
OBJECTIVE: To assess the performance of the ultrasound measurement of stroke volume (SV) coupled to passive leg raising (PLR) in predicting fluid responsiveness (FR). DESIGN: A prospective cohort study was carried out in patients requiring volume expansion (VE). A transthoracic Doppler echocardiography (TTE) device was used for the measurement of SV. Four measurements were obtained: before and 90s after PLR, and before and after VE. The patients were subsequently classified according to their hemodynamic response to VE...
December 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29248289/is-hemodynamic-transesophageal-echocardiography-needed-for-patients-with-left-ventricular-assist-device
#13
Nataliya Bahatyrevich, Qiong Yang, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Interventions in patients with a left ventricular assist device (LVAD) in the intensive care unit (ICU) are typically performed based on the results of conventional monitoring, such as vital signs and Swan-Ganz catheter (SGC) and LVAD parameters. These variables might not always accurately reflect a patient's cardiac function, volume status, and interventricular septal configuration, however. To assess the accuracy of standard monitoring, we performed routine continuous hemodynamic transesophageal echocardiography (hTEE) to evaluate cardiac function, volume status, and septal position...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29223845/seeing-is-believing-a-call-for-routine-early-postoperative-hemodynamic-transesophageal-echocardiography-monitoring-after-left-ventricular-assist-device-implantation
#14
EDITORIAL
Juan N Pulido
No abstract text is available yet for this article.
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29200072/tailored-holder-for-continuous-echocardiographic-monitoring
#15
Haibo Song, Shen Kou Tsai, Jin Liu
Hemodynamic monitoring is essential for prompt and effective interventions in intensive care unit patients. We developed a custom-made transthoracic echocardiography transducer holder consisting of transducer holder and skin patch attachment. This holder allowed continuous transthoracic echocardiography monitoring in 5 adult patients with circulatory failure due to shock, and 6 pediatric patients after successful percutaneous closure of a ventricular septal defect. One case of an unexpected hemopericardium was promptly diagnosed and pericardiocentesis was performed, and 1 patient required extracorporeal membrane oxygenation support...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29174659/impact-of-a-monoplane-hemodynamic-tee-htee-monitoring-device-on-decision-making-in-a-heterogeneous-hemodynamically-unstable-intensive-care-unit-population-a-prospective-observational-study
#16
Maung Hlaing, Jianghua He, Nicholas Haglund, Hiroo Takayama, Brigid C Flynn
OBJECTIVE: This prospective observational study was undertaken to evaluate the utility of a miniature transesophageal echocardiography probe (ImaCor hemodynamic [hTEE]) in the management of hemodynamically unstable intensive care unit patients with and without various forms of mechanical circulatory support. DESIGN: A prospective observational study. SETTING: A single tertiary care cardiothoracic and surgical intensive care unit. PARTICIPANTS: Fifty-three cardiothoracic and surgical intensive care unit patients undergoing miniature transesophageal echocardiography examinations...
October 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29172784/good-agreement-between-echocardiography-and-impedance-cardiography-in-the-assessment-of-left-ventricular-performance-in-hypertensive-patients
#17
Rodrigo Nazário Leão, Pedro Marques Da Silva, Rita Marques Pocinho, Marta Alves, Daniel Virella, Roberto Palma Reis
BACKGROUND: Impedance cardiography (ICG) is a noninvasive hemodynamic monitoring tool which can define hypertensive patients' hemodynamic profiles and help to tailor antihypertensive therapy. This study assesses the concordance between ICG-derived indexes used to evaluate left ventricular performance and transthoracic echocardiography (TTE) in hypertensive patients. METHODS: In this IMPEDDANS post-hoc analysis, the ICG-derived indexes are compared with TTE by Bland-Altman method...
November 27, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29153929/accuracy-of-a-simulation-algorithm-for-modelling-lv-contractility-diastolic-capacitance-and-energetics-using-data-available-from-common-hemodynamic-monitors-and-echocardiography
#18
Paul M Heerdt, Scott Korfhagen, Hesham Ezz, Clara Oromendia
OBJECTIVE: To test the hypothesis that a simulation algorithm populated with data readily available from hemodynamic monitors and echocardiography can accurately model cardiac contractility, diastolic capacitance, and energetics. DESIGN: Bland-Altman analysis of paired data sets. SETTING: University laboratory. PARTICIPANTS: Archived data previously recorded from 7 anesthetized swine. MEASUREMENTS AND MAIN RESULTS: Left ventricular pressure and volume (LVV) data that had been continuously recorded over a range of inotropic conditions were used as reference data...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29153687/influence-of-non-dipping-pattern-of-blood-pressure-in-gestational-hypertension-on-maternal-cardiac-function-hemodynamics-and-intrauterine-growth-restriction
#19
A Ilic, D J Ilic, S Tadic, M Stefanovic, A Stojsic-Milosavljevic, K Pavlovic, A Redzek, L Velicki
BACKGROUND: An association between gestational hypertension (GH) and changes of maternal cardiac function was previously reported. AIM: The study assessed the effect of non-dipping pattern of blood pressure (BP) in GH on haemodynamic function and intrauterine growth restriction (IUGR). METHODS: This study included 126 women (91 with GH and 35 normotensive controls). Based on the BP values measured by ambulatory blood pressure monitoring (ABPM), all hypertensive women were classified in dipper (46 women) or in non-dipper group (45 women)...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#20
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...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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