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https://www.readbyqxmd.com/read/29457538/effects-of-dexmedetomidine-infusion-during-spinal-anesthesia-on-hemodynamics-and-sedation
#1
Ebru Tarıkçı Kılıç, Gaye Aydın
We evaluated the effects of intravenous dexmedetomidine during spinal anesthesia on hemodynamics, respiratory rate, oxygen saturation, sedpain, and compared them with those of saline infusion. Sixty American Society of Anesthesiologists physical status I and II cases were randomly divided into two groups. Patients were connected to the monitor after premedication, and spinal anesthesia was administered. Sensory and motor blockades were assessed using pinprick test and Bromage scale, respectively. Group I received dexmedetomidine infusion and Group II received saline infusion...
December 2018: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/29455273/updates-on-device-based-therapies-for-patients-with-heart-failure
#2
REVIEW
Jad Al Danaf, Javed Butler, Amin Yehya
PURPOSE OF REVIEW: Heart failure is a growing epidemic. Optimal medical therapy remains the cornerstone of heart failure management but device-based therapies have been shown to contribute to morbidity and mortality reduction. RECENT FINDINGS: Multiple investigational trials had been conducted in the past decade that helped us better understand and manage heart failure. In this manuscript, we will discuss the major device related trials of year 2017 in the fields of defibrillators, hemodynamic monitoring, remote monitoring, autonomic nervous system modulation, ventricular assist devices, and device-based valvular heart disease management...
February 17, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29451742/real-time-monitoring-prefrontal-activities-during-online-video-game-playing-by-functional-near-infrared-spectroscopy
#3
Yue Li, Lei Zhang, Kehong Long, Hui Gong, Hao Lei
A growing body of literature has suggested that video game playing can induce functional and structural plasticity of the brain. The underlying mechanisms, however, remain poorly understood. In this study, functional near-infrared spectroscopy (fNIRS) was used to record prefrontal activities in 24 experienced game players when they played a massively multiplayer online battle arena (MOBA) video game, League of Legends (LOL), under naturalistic conditions. It was observed that game onset was associated with significant activations in the ventrolateral prefrontal cortex (VLPFC) and concomitant deactivations in the dorsolateral prefrontal cortex (DLPFC) and frontal pole area (FPA)...
February 16, 2018: Journal of Biophotonics
https://www.readbyqxmd.com/read/29448986/continuous-hemoglobin-monitoring-in-pediatric-trauma-patients-with-solid-organ-injury
#4
Emily Welker, Jennifer Novak, Lindsey Jelsma, Tracy Koehler, Alan Davis, James DeCou, Emily Durkin
BACKGROUND/PURPOSE: Hemoglobin monitoring is required in pediatric trauma patients with solid organ injury. We hypothesized that noninvasive hemodynamic monitoring (NIHM) represents an effective, safe alternative to laboratory hemoglobin (LabHb) monitoring in clinically stable patients. METHODS: A retrospective cohort study was conducted regarding pediatric trauma patients (<18 years old) with blunt solid organ injury over six consecutive months. Continuous NIHM was initiated at the time of admission, and LabHb measurements were obtained per institutional guidelines...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#5
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#6
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/29441177/anesthetic-management-of-the-first-forearm-transplantation-in-korea
#7
Jinyeol Kwon, Sung Mee Jung, Sae-Yeon Kim, Nyeong Keon Kwon, Sang-Jin Park
Vascularized composite allotransplantation for the forearm is a complex surgical procedure, requiring multidisciplinary collaboration. It is important to provide optimal blood flow to the grafts, effective immunosuppression, and early rehabilitation for graft survival and good functional outcomes. As ischemia-reperfusion injury and substantial but unquantifiable blood loss are inevitable in this type of surgery, anesthetic management should focus on providing adequate hemodynamic management with proper monitoring, and anesthetic and analgesic strategies to prevent vasoconstriction in the graft...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29433942/fontan-associated-liver-disease
#8
Luis Téllez, Enrique Rodríguez de Santiago, Agustín Albillos
Fontan-associated liver disease refers to the disturbance in the liver secondary to hemodynamic changes and systemic venous congestion following Fontan surgery. Although the natural history of this disease has not yet been established, patients with more advanced liver injury develop the complications of portal hypertension, such as ascites, variceal haemorrhage, or encephalopathy. Moreover, patients with Fontan surgery may have an increased risk of hepatocellular carcinoma. Periodic liver monitoring is essential to prevent this disease and provide early treatment of liver complications...
February 9, 2018: Revista Española de Cardiología
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/29425051/carbohydrate-antigen-125-a-promising-tool-for-risk-stratification-in-heart-diseases
#10
Felipe Falcão, Flávio R A de Oliveira, Flávio R A de Oliveira, Maria Cleide F C da Silva, Dário C Sobral Filho
All patients with heart diseases should undergo risk stratification to predict those who are at high risk for short- and long-term adverse outcomes. Carbohydrate antigen 125 (CA125) is a glycoprotein produced by mesothelium that has clinical role in ovarian cancer monitoring. However, as it is not specific for ovarian cells, CA125 could also be used in heart diseases to monitor congestion and inflammation. Pericarditis, atrial fibrillation, heart failure and coronary artery disease are some scenarios in which this biomarker was studied...
February 9, 2018: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29424263/intraoperative-transesophageal-echocardiogram-during-orthotopic-liver-transplantation-tee-to-the-rescue
#11
Lorenzo De Marchi, Janice Lee, Nina Rawtani, Vinh Nguyen
Supported by a growing number of studies and case reports in the literature, perioperative use of TEE in non-cardiac cases has significantly increased the past two decades. The utility of TEE in monitoring hemodynamic, and diagnosing causes of hypotension refractory to conventional therapy, have made it an almost indispensible tool during major surgeries, such liver transplantation. Despite this fact, compared to the adult population, there is a lack of an equivalent amount of literature on the perioperative use of TEE in pediatric cases...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29419946/photoacoustic-microscopy-for-evaluating-combretastatin-a4-phosphate-induced-vascular-disruption-in-orthotopic-glioma
#12
Renzhe Bi, Ghayathri Balasundaram, Seungwan Jeon, Hui Chien Tay, Yang Pu, Xiuting Li, Mohesh Moothanchery, Chulhong Kim, Malini Olivo
The use of an optical resolution photoacoustic microscopy system (OR-PAM) to evaluate the vascular disruptive effect of Combretastatin A4 Phosphate (CA4P) on a murine orthotopic glioma with intact skull is described here. Second generation optical-resolution PAM scanner with a 532 nm pulsed diode-pumped solid-state (DPSS) laser that specifically matches the absorption maximum of haemoglobin in tissues was used to image orthotopic glioma inoculated in mouse brain. 2D maps of brain vasculature with a lateral resolution of 5 μm and a depth of 700 μm at a field of view 5 × 4 mm were acquired on normal brain and glioma brain...
February 8, 2018: Journal of Biophotonics
https://www.readbyqxmd.com/read/29416458/randomized-comparison-between-dexmedetomidine-and-midazolam-for-prevention-of-emergence-agitation-after-nasal-surgeries
#13
Pranjali Kurhekar, Krishnagopal Vinod, Buddhan Rajarathinam, J Shesha Dhiviya Krishna, M S Raghuraman
Background: Emergence agitation (EA) in nasal surgeries is seen in around 22% of patients, which can go to dangerous levels. Dexmedetomidine is effective in prevention of EA in such patients. Midazolam given as premedication fails to prevent EA due to its short half-life. In this study, we compared efficacy of dexmedetomidine and midazolam by intravenous infusion for prevention of EA in adult nasal surgeries. Materials and Methods: Seventy patients belonging to American society of anesthesiologist Status I and II, between 18 and 60 years of age posted for elective nasal surgeries were randomly divided into two groups...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29415505/in-vivo-evaluation-of-cerebral-hemodynamics-and-tissue-morphology-in-rats-during-changing-fraction-of-inspired-oxygen-based-on-spectrocolorimetric-imaging-technique
#14
Afrina Mustari, Takuya Kanie, Satoko Kawauchi, Shunichi Sato, Manabu Sato, Yasuaki Kokubo, Izumi Nishidate
During surgical treatment for cerebrovascular diseases, cortical hemodynamics are often controlled by bypass graft surgery, temporary occlusion of arteries, and surgical removal of veins. Since the brain is vulnerable to hypoxemia and ischemia, interruption of cerebral blood flow reduces the oxygen supply to tissues and induces irreversible damage to cells and tissues. Monitoring of cerebral hemodynamics and alteration of cellular structure during neurosurgery is thus crucial. Sequential recordings of red-green-blue (RGB) images of in vivo exposed rat brains were made during hyperoxia, normoxia, hypoxia, and anoxia...
February 6, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29411044/second-consensus-on-the-assessment-of-sublingual-microcirculation-in-critically-ill-patients-results-from-a-task-force-of-the-european-society-of-intensive-care-medicine
#15
Can Ince, E Christiaan Boerma, Maurizio Cecconi, Daniel De Backer, Nathan I Shapiro, Jacques Duranteau, Michael R Pinsky, Antonio Artigas, Jean-Louis Teboul, Irwin K M Reiss, Cesar Aldecoa, Sam D Hutchings, Abele Donati, Marco Maggiorini, Fabio S Taccone, Glenn Hernandez, Didier Payen, Dick Tibboel, Daniel S Martin, Alexander Zarbock, Xavier Monnet, Arnaldo Dubin, Jan Bakker, Jean-Louis Vincent, Thomas W L Scheeren
PURPOSE: Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables...
February 6, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29409786/cine-mri-during-spontaneous-cramps-in-women-with-menstrual-pain
#16
Kevin M Hellman, Caroline S Kuhn, Frank F Tu, Katlyn E Dillane, Nathan A Shlobin, Sangeeta Senapati, Xiaojie Zhou, Wei Li, Pottumarthi V Prasad
BACKGROUND: The lack of non-invasive methods to study dysmenorrhea has resulted in poor understanding of the mechanisms underlying pain, insufficient diagnostic tests, and limited treatment options. To address this knowledge gap, we have developed an MRI-based strategy for continuously monitoring the uterus in relation to participants' spontaneous pain perception. OBJECTIVE: The study objective was to evaluate whether MRI can detect real-time changes in myometrial activity during cramping episodes in women with dysmenorrhea, with a hand-held squeeze bulb for pain reporting...
January 31, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29406374/cerebral-oxygen-metabolism-before-and-after-rbc-transfusion-in-infants-following-major-surgical-procedures
#17
Felix Neunhoeffer, Michael Hofbeck, Martin Ulrich Schuhmann, Jörg Fuchs, Christian Schlensak, Martin Esslinger, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Matthias Kumpf, Jörg Michel
OBJECTIVE: Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants. DESIGN: Prospective observational cohort study. SETTING: Pediatric critical care unit of a tertiary referral center...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29406045/comparing-changes-in-carotid-flow-time-and-stroke-volume-induced-by-passive-leg-raising
#18
Bilal Jalil, Patton Thompson, Rodrigo Cavallazzi, Paul Marik, Jason Mann, Karim El-Kersh, Juan Guardiola, Mohamed Saad
BACKGROUND: Determining volume responsiveness in critically ill patients is challenging. We sought to determine if passive leg raise (PLR) induced changes in pulsed wave Doppler of the carotid artery flow time could predict fluid responsiveness in critically ill patients. MATERIALS AND METHODS: Medical intensive care unit patients ≥18 years old with a radial arterial line and FloTrac/Vigileo monitor in place were enrolled. Pulsed wave Doppler of the carotid artery was performed to measure the change in carotid flow time (CFTC) in response to a PLR...
February 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29405326/hemodynamic-effects-of-connection-to-continuous-renal-replacement-therapy-in-a-pediatric-animal-model
#19
Sarah Nicole Fernández Lafever, Maria Jose Santiago, Jorge López, Rafael González, María José Solana, Javier Urbano, Jesus Lopez-Herce
To assess the hemodynamic effects of connection to continuous renal replacement therapy (CRRT) in a pediatric experimental animal model. Prospective experimental study was performed using piglets between 2 and 3 months of age and 9-11 kg. CRRT with a PrismaflexR monitor and HF20 filter (surface of 0.2 m2 ) was started after monitoring and anesthetic induction with an initial blood flow at 20 mL/min with 10 mL/min increases every minute until the goal flow of 5 mL/kg/min was achieved. Heart rate, blood pressure, central venous pressure, cardiac index, and renal blood flow were registered at baseline, 5, 15, 30, 60, 120, 180, 240, and 360 min...
February 6, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29392157/prefrontal-hemodynamic-changes-measured-using-near-infrared-spectroscopy-during-the-valsalva-maneuver-in-patients-with-orthostatic-intolerance
#20
Yoo Hwan Kim, Zephaniah Phillips V, Seung-Ho Paik, Nam-Joon Jeon, Beop-Min Kim, Byung-Jo Kim
The Valsalva maneuver (VM) with beat-to-beat blood pressure and heart rate monitoring are used to evaluate orthostatic intolerance (OI). However, they lack the ability to detect cerebral hemodynamic changes, which may be a cause of OI symptoms. Therefore, we utilized near-infrared spectroscopy during VM. Patients with OI symptoms and normal healthy subjects were recruited. Patients were subgrouped according to VM results: patients with normal VM (NVM) and abnormal VM (AbVM). Oxyhemoglobin (HbO), deoxyhemoglobin, and total hemoglobin changes were measured at four different source-detector distances (SD) (15, 30, 36, and 45 mm), and latency, amplitude, duration, and integrated total signal were calculated...
January 2018: Neurophotonics
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