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https://www.readbyqxmd.com/read/29028910/assessment-of-changes-in-lactate-concentration-with-intravascular-microdialysis-during-high-risk-cardiac-surgery-using-the-trend-interchangeability-method
#1
C Gouëzel, E Lorne, V Bonnet, S Fradin, V Saplacan, J-L Gérard, J-L Hanouz, J-L Fellahi, M-O Fischer
Background: Blood lactate is a strong predictor of mortality, and repeated blood lactate assays are recommended during surgery in high-risk patients. We hypothesized that the use of intravascular microdialysis incorporated in a central venous catheter would be interchangeable with the reference blood gas technique to monitor changes in blood lactate. Methods: Microdialysis and central venous blood lactate measurements were recorded simultaneously in high-risk cardiac surgical patients...
October 3, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29027094/multimodal-functional-neuroimaging-by-simultaneous-bold-fmri-and-fiber-optic-calcium-recordings-and-optogenetic-control
#2
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/29026684/combined-multi-distance-frequency-domain-and-diffuse-correlation-spectroscopy-system-with-simultaneous-data-acquisition-and-real-time-analysis
#3
Stefan A Carp, Parisa Farzam, Norin Redes, Dennis M Hueber, Maria Angela Franceschini
Frequency domain near infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS) have emerged as synergistic techniques for the non-invasive assessment of tissue health. Combining FD-NIRS oximetry with DCS measures of blood flow, the tissue oxygen metabolic rate can be quantified, a parameter more closely linked to underlying physiology and pathology than either NIRS or DCS estimates alone. Here we describe the first commercially available integrated instrument, called the "MetaOx", designed to enable simultaneous FD-NIRS and DCS measurements at rates of 10 + Hz, and offering real-time data evaluation...
September 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#4
Christopher L Wray
Liver transplantation (LT) is a unique surgical procedure that has major hemodynamic and cardiovascular implications. Recently, there has been significant interest focused on cardiovascular issues that affect LT patients in all phases of the perioperative period. The preoperative cardiac evaluation is a major step in the selection of LT candidates. LT candidates are aging in concordance with the general population; cardiovascular disease and their risk factors are highly associated with older age. Underlying cardiovascular disease has the potential to affect outcomes in LT patients and has a major impact on candidate selection...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29022204/the-relationship-between-single-and-two-dimensional-indices-of-left-ventricular-size-using-hemodynamic-transesophageal-echocardiography-in-trauma-and-burn-patients
#5
Duraid Younan, T Mark Beasley, David C Pigott, C Blayke Gibson, John P Gullett, Jeffrey Richey, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: Conventional echocardiographic technique for assessment of volume status and cardiac contractility utilizes left ventricular end-diastolic area (LVEDA) and fractional area of change (FAC), respectively. Our goal was to find a technically reliable yet faster technique to evaluate volume status and contractility by measuring left ventricular end-diastolic diameter (LVEDD) and fractional shortening (FS) in a cohort of mechanically ventilated trauma and burn patients using hemodynamic transesophageal echocardiographic (hTEE) monitoring...
October 11, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29019471/infantile-hemangioma-factors-causing-recurrence-after-propranolol-treatment
#6
Lei Chang, Dongze Lv, Zhang Yu, Gang Ma, Hanru Ying, Yajing Qiu, Yifei Gu, Yunbo Jin, Hui Chen, Xiaoxi Lin
BackgroundPropranolol is the first-choice treatment for severe infantile hemangioma (IH). However, 10- 30% of lesions relapse after propranolol treatment. The mechanisms underlying IH recurrence after propranolol treatment have not been completely elucidated.MethodsThis study combined an examination of hemodynamic changes with research regarding hemangioma stem cells (hscs) with differentially expressed microRNAs (miRNAs) to identify the factors affecting IH recurrence after propranolol treatment. Hemodynamic changes were monitored in 21 recurrent cases using high-frequency color Doppler ultrasound, and hscs were treated with different concentrations of propranolol...
October 11, 2017: Pediatric Research
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
#7
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/29017156/the-missing-link-in-the-pathophysiology-of-vascular-cognitive-impairment-design-of-the-heart-brain-study
#8
Astrid M Hooghiemstra, Anne Suzanne Bertens, Anna E Leeuwis, Esther E Bron, Michiel L Bots, Hans-Peter Brunner-La Rocca, Anton J M de Craen, Rob J van der Geest, Jacoba P Greving, L Jaap Kappelle, Wiro J Niessen, Robert J van Oostenbrugge, Matthias J P van Osch, Albert de Roos, Albert C van Rossum, Geert Jan Biessels, Mark A van Buchem, Mat J A P Daemen, Wiesje M van der Flier
BACKGROUND: Hemodynamic balance in the heart-brain axis is increasingly recognized as a crucial factor in maintaining functional and structural integrity of the brain and thereby cognitive functioning. Patients with heart failure (HF), carotid occlusive disease (COD), and vascular cognitive impairment (VCI) present themselves with complaints attributed to specific parts of the heart-brain axis, but hemodynamic changes often go beyond the part of the axis for which they primarily seek medical advice...
October 10, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28993402/exercise-intolerance-in-hfpef-diagnosing-and-ranking-its-causes-using-personalized-o2-pathway-analysis
#9
Nicholas E Houstis, Aaron S Eisman, Paul P Pappagianopoulos, Luke Wooster, Cole S Bailey, Peter D Wagner, Gregory D Lewis
Background -Heart failure with preserved ejection fraction (HFpEF) is a common syndrome with a pressing shortage of therapies. Exercise intolerance is a cardinal symptom of HFpEF, yet its pathophysiology remains uncertain. Methods -We investigated the mechanism of exercise intolerance in each of 134 patients referred for cardiopulmonary exercise testing (CPET): 79 with HFpEF and 55 controls. We performed CPET with invasive monitoring to measure hemodynamics, blood gases, and gas exchange during exercise. We used these measurements to quantify 6 steps of oxygen transport and utilization (the "O2 pathway") in each HFpEF patient, identifying the defective steps that impair each one's exercise capacity (peak VO2)...
October 9, 2017: Circulation
https://www.readbyqxmd.com/read/28992869/valproic-acid-overdose-review-of-a-case-with-electrocardiographic-changes
#10
Antonio E Muñiz
BACKGROUND: Valproic acid (VPA) is increasingly used to treat a variety of medical disorders, such as seizures, psychiatric disorders, and headaches. Therefore, accidental and intentional ingestions with valproic acid are increasing. OBJECTIVES: A case is presented in an adolescent with ischemic electrocardiographic changes after an acute overdose with VPA. DISCUSSION: Major features of a valproic acid overdose include respiratory depression, progressive coma, hepatotoxicity, thrombocytopenia, and hemodynamic instability...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28991060/hemodynamic-instability-and-cardiovascular-events-after-traumatic-brain-injury-predict-outcome-after-artifact-removal-with-deep-belief-network-analysis
#11
Hakseung Kim, Seung-Bo Lee, Yunsik Son, Marek Czosnyka, Dong-Joo Kim
BACKGROUND: Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the signals. A machine-learning model for the elimination of artifactual events shows promising results for improving signal quality. However, the actual impact of the improvements on the performance of the clinical parameters after the elimination of the artifacts is not well studied...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28991059/analgesia-nociception-index-monitoring-during-supratentorial-craniotomy
#12
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/28987428/vascular-access-complications-an-emergency-medicine-approach
#13
REVIEW
Erica Marie Simon, Shane Matthew Summers
Millions of central venous and arterial catheters are placed across the United States annually as mechanisms of obtaining advanced hemodynamic monitoring and facilitating acute resuscitation. Although presumably life saving or sustaining in many circumstances, current literature identifies the preprocedural and postprocedural complications of infection, thrombosis, embolism, and iatrogenic injury as resulting in patient morbidity and mortality. Today, through the application of aseptic technique, performance of operator training, and the utilization of ultrasound, emergency physicians may limit vascular access complications and improve patient outcomes...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28986814/effect-of-shen-fu-injection-on-hemodynamics-in-early-volume-resuscitation-treated-septic-shock-patients
#14
Kai-Liang Fan, Jun-Hui Wang, Li Kong, Fei-Hu Zhang, Hao Hao, Hao Zhao, Zheng-Yun Tian, Ming-Xin Yin, Hua Fang, Hui-Hui Yang, Yang Liu
OBJECTIVE: To investigate the hemodynamic effect of Shen-Fu Injection (, SFI) in early volume resuscitation treated septic shock patients by monitoring pulse indicator continuous cardiac output (PICCO). METHODS: All septic shock patients admitted in the Intensive Care Unit of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1st, 2014 to December 31th, 2015, were reviewed, and totally 65 were enrolled in this study. They were assigned to SFI group (33 cases) and control group (32 cases)...
October 6, 2017: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28986400/preoperative-selective-versus-non-selective-%C3%AE-blockade-in-ppgl-patients-undergoing-adrenalectomy
#15
Caojie Liu, Qingguo Lv, Xinlei Chen, Guangcheng Ni, Liru Hu, Yuwei Zhang, Nan Wei Tong
PURPOSE: Preoperative preparation for adrenalectomy for pheochromocytomas and paragangliomas (PPGL) is universally recognized as necessary, while the optimal strategy remains controversial. Our aims were to increase intraoperative hemodynamic stability, expedite postoperative recovery, decrease side effects, and reduce costs for patients with PPGL undergoing adrenalectomy. METHODS: We identified 526 patients undergoing open adrenalectomy for PPGL in the West China Hospital of Sichuan University between May, 2007 and December, 2016...
October 6, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28984094/mucosal-and-cutaneous-capnometry-for-the-assessment-of-tissue-hypoperfusion
#16
Jihad Mallat, Benoit Vallet
In critically ill patients, tissue hypoperfusion is an important cause leading to multi- organ dysfunction and death, and it cannot always be detected by measuring standard global hemodynamic and oxygen-derived parameters. Gastric intramucosal PCO2 as measured by gastric tonometry has been recognized to be of clinical value as a prognostic factor, in assessing the effects of particular therapeutic interventions, and as an end-point of resuscitation. However, this technique has several limitations that have hampered its implementation in clinical practice...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28982501/pulmonary-artery-pressure-guided-management-of-patients-with-heart-failure-and-reduced-ejection-fraction
#17
Michael M Givertz, Lynne W Stevenson, Maria R Costanzo, Robert C Bourge, Jordan G Bauman, Gregg Ginn, William T Abraham
BACKGROUND: Despite increased use of guideline-directed medical therapy (GDMT), some patients with heart failure and reduced ejection fraction (HFrEF) remain at high risk for hospitalization and mortality. Remote monitoring of pulmonary artery (PA) pressures provides clinicians with actionable information to help further optimize medications and improve outcomes. OBJECTIVES: CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients trial) analyzed PA pressure-guided heart failure (HF) management in patients with HFrEF based on their ability to tolerate GDMT...
October 10, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28982177/adipose-derived-stem-cells-attenuate-pulmonary-microvascular-hyperpermeability-after-smoke-inhalation
#18
Koji Ihara, Satoshi Fukuda, Baigalmaa Enkhtaivan, Raul Trujillo, Dannelys Perez-Bello, Christina Nelson, Anita Randolph, Suzan Alharbi, Hira Hanif, David Herndon, Donald Prough, Perenlei Enkhbaatar
BACKGROUND: Pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS). Smoke inhalation causes ARDS, thus significantly increasing the mortality of burn patients. Adipose-derived stem cells (ASCs) exert potent anti-inflammatory properties. The goal of the present study was to test the safety and ecfficacy of ASCs, in a well-characterized clinically relevant ovine model of ARDS. METHODS: Female sheep were surgically prepared. ARDS was induced by cooled cotton smoke inhalation...
2017: PloS One
https://www.readbyqxmd.com/read/28979559/clostridium-perfringens-sepsis-complicated-by-right-ventricular-cardiogenic-shock
#19
Cosmin Balan, Graham Barker, David Garry
Clostridium perfringens sepsis has been ascribed a dismal prognosis when associated with massive intravascular haemolysis. We present a 71-year-old woman's fatal case which was compounded by isolated right ventricular cardiogenic shock. In this context, combined use of transthoracic echocardiography and pulmonary artery catheter monitoring is able to yield an individualized hemodynamic resuscitation. We discuss key aspects related to right and left heart mechanical efficiency, hypothesize as to the pulmonary hypertension mechanism of our case and set to emphasize a physiologically based framework for right ventricular failure hemodynamic management...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28977264/recent-advances-in-bedside-microcirculation-assessment-in-critically-ill-patients
#20
Philipe Franco do Amaral Tafner, Felipe Ko Chen, Roberto Rabello, Thiago Domingos Corrêa, Renato Carneiro de Freitas Chaves, Ary Serpa
Parameters related to macrocirculation, such as the mean arterial pressure, central venous pressure, cardiac output, mixed venous saturation and central oxygen saturation, are commonly used in the hemodynamic assessment of critically ill patients. However, several studies have shown that there is a dissociation between these parameters and the state of microcirculation in this group of patients. Techniques that allow direct viewing of the microcirculation are not completely disseminated, nor are they incorporated into the clinical management of patients in shock...
April 2017: Revista Brasileira de Terapia Intensiva
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