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Cardiopulmonary test

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https://www.readbyqxmd.com/read/28548476/is-cold-blood-cardioplegia-absolutely-superior-to-cold-crystalloid-cardioplegia-in-aortic-valve-surgery
#1
Daniel A Lerman, Matilde Otero-Losada, Kiddy Ume, Pablo A Salgado, Sai Prasad, Kelvin Lim, Bruno Péault, Nasri Alotti
BACKGROUND: Experimental evidence suggests that blood cardioplegia (BCP) may be superior to cold crystalloid cardioplegia (CCP) for myocardial protection. However, robust clinical data are lacking. We compared post-operative outcome of patients undergoing aortic valve replacement (AVR) using cold anterograde-retrograde intermittent BCP versus anterograde (CCP). METHODS: Adult consecutive isolated AVR performed between April 2006 and February 2011 at the Royal Infirmary Hospital of Edinburgh were retrospectively analyzed...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28546280/absolute-values-of-lung-function-explain-the-sex-difference-in-breathlessness-in-the-general-population
#2
Magnus Ekström, Linus Schiöler, Rune Grønseth, Ane Johannessen, Cecilie Svanes, Benedicte Leynaert, Deborah Jarvis, Thorarinn Gislason, Pascal Demoly, Nicole Probst-Hensch, Isabelle Pin, Angelo G Corsico, Bertil Forsberg, Joachim Heinrich, Dennis Nowak, Chantal Raherison-Semjen, Shyamali C Dharmage, Giulia Trucco, Isabel Urrutia, Jesús Martinez-Moratalla Rovira, José Luis Sánchez-Ramos, Christer Janson, Kjell Torén
Activity-related breathlessness is twice as common among females as males in the general population and is associated with adverse health outcomes. We tested whether this sex difference is explained by the lower absolute forced expiratory volume in 1 s (FEV1) or forced vital capacity (FVC) in females.This was a cross-sectional analysis of 3250 subjects (51% female) aged 38-67 years across 13 countries in the population-based third European Community Respiratory Health Survey. Activity-related breathlessness was measured using the modified Medical Research Council (mMRC) scale...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28541745/graphical-data-display-for-clinical-cardiopulmonary-exercise-testing
#3
Daniel Dumitrescu, Stephan Rosenkranz
Cardiopulmonary exercise testing is a well-known, valuable tool in the clinical evaluation of patients with different causes of exercise limitation, and unexplained dyspnea. A wealth of data is generated by each individual test. This may be challenging with regard to a comprehensive and reliable interpretation of an exercise study in a timely manner. An optimized graphical display of exercise data may substantially help to improve the efficacy and reliability of the interpretation process. However, there are limited and heterogeneous recommendations on standardized graphical display in current exercise testing guidelines...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#4
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538301/proposal-of-a-new-specific-cardiopulmonary-exercise-test-for-taekwondo-athletes
#5
Marcus P Araujo, Antônio C L Nóbrega, Gabriel Espinosa, Matheus R Hausen, Renata R T Castro, Pedro P Soares, Jonas L Gurgel
Araujo, MP, Nóbrega, ACL, Espinosa, G, Hausen, MR, Castro, RRT, Soares, PP, and Gurgel, JL. Proposal of a new specific cardiopulmonary exercise test for taekwondo athletes. J Strength Cond Res 31(6): 1525-1535, 2017-The objective of this study is to evaluate the cardiorespiratory variables of Taekwondo athletes while performing incremental exercise test on an ergometer using a ramp protocol and to propose a specific protocol for assessing these physiological variables during Taekwondo practice. Fourteen athletes participated in 2 incremental exercise tests: a treadmill exercise test (TREADtest) and a Taekwondo-specific exercise test (TKDtest)...
June 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28537454/transfusion-requirements-in-elective-cardiopulmonary-bypass-surgery-patients-predictive-value-of-multiplate-and-thromboelastography-teg-platelet-mapping-assay
#6
Praleene Sivapalan, Anne Caroline Bäck, Sisse Rye Ostrowski, Hanne Berg Ravn, Pär Ingemar Johansson
Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures...
May 24, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28535744/leukocyte-filtration-of-the-cardiotomy-suction-does-it-affect-systemic-leukocyte-activation-or-pulmonary-function
#7
Richard Issitt, Jon Ball, Indie Bilkhoo, Adnan Mani, Bronagh Walsh, David Voegeli
BACKGROUND: Cardiopulmonary bypass is thought to propagate a global systemic response through contact with the non-physiological surfaces of the extracorporeal circuit, leading to the stimulation of leukocytes, their adherence to endothelial cells and the release of cytotoxic molecules. This, in turn, has been shown to accelerate pulmonary injury. This study tested a new leukocyte-filtration system (RemoweLL) against a conventional system with no leukocyte-depleting capacity to determine the efficacy of the filtration system and its effects on pulmonary function...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28530671/cardiopulmonary-assessment-of-patients-with-systemic-sclerosis-for-hematopoietic-stem-cell-transplantation-recommendations-from-the-european-society-for-blood-and-marrow-transplantation-autoimmune-diseases-working-party-and-collaborating-partners
#8
REVIEW
D Farge, R K Burt, M-C Oliveira, E Mousseaux, M Rovira, Z Marjanovic, J de Vries-Bouwstra, N Del Papa, R Saccardi, S J Shah, D C Lee, C Denton, T Alexander, D G Kiely, J A Snowden
Systemic sclerosis (SSc) is a rare disabling autoimmune disease with a similar mortality to many cancers. Two randomized controlled trials of autologous hematopoietic stem cell transplantation (AHSCT) for SSc have shown significant improvement in organ function, quality of life and long-term survival compared to standard therapy. However, transplant-related mortality (TRM) ranged from 3-10% in patients undergoing HSCT. In SSc, the main cause of non-transplant and TRM is cardiac related. We therefore updated the previously published guidelines for cardiac evaluation, which should be performed in dedicated centers with expertize in HSCT for SSc...
May 22, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28528994/clinical-significance-of-the-overshoot-phenomena-of-respiratory-gas-indices-during-recovery-from-maximal-exercise-testing
#9
Yuta Takayanagi, Akira Koike, Osamu Nagayama, Arisa Nagamine, Rujie Qin, Jo Kato, Isao Nishi, Tomoko Himi, Yuko Kato, Akira Sato, Takeshi Yamashita, Kazutaka Aonuma
BACKGROUND: Overshoot phenomena of the gas exchange ratio (R:VCO2/VO2), ventilatory equivalent for O2 (VE/VO2), and end-tidal O2 pressure (PETO2) are commonly observed during recovery from maximal cardiopulmonary exercise testing (CPX). We investigated the clinical significance of the overshoots of these indices by comparing their magnitudes between healthy subjects and cardiac patients with left ventricular dysfunction. METHODS: In total, 121 subjects (73 healthy subjects and 48 cardiac patients with left ventricular ejection fraction<40%) who underwent CPX and achieved peak R≥1...
May 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28525624/early-and-asymptomatic-cardiac-dysfunction-in-chronic-kidney-disease
#10
Shanmugakumar Chinnappa, Edward White, Nigel Lewis, Omer Baldo, Yu-Kang Tu, Griet Glorieux, Raymond Vanholder, Meguid El Nahas, Andrew Mooney
Background: . Heart failure (HF) is highly prevalent and associated with high mortality in chronic kidney disease (CKD). However, the pathophysiology of cardiac dysfunction in CKD, especially in the early asymptomatic stage, is not well understood. We studied subclinical cardiac dysfunction in asymptomatic CKD patients without comorbid cardiac disease or diabetes mellitus by evaluating peak cardiac performance. Methods.: In a cross-sectional study ( n  = 130) we investigated 70 male non-diabetic CKD patients (21 CKD stage 2-3a, 27 CKD stage 3b-4 and 22 CKD stage 5) employing specialized cardiopulmonary exercise testing to measure peak cardiac output and cardiac power output non-invasively...
May 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28523162/a-preliminary-exploration-of-the-intravoxel-incoherent-motion-applied-in-the-preoperative-evaluation-of-mediastinal-lymph-node-metastasis-of-lung-cancer
#11
Xin Ye, Shuo Chen, Yaru Tian, Bin You, Wenqian Zhang, Yan Zhao, Tao Jiang, Bin Hu, Hui Li
BACKGROUND: The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for distinguishing non-metastatic from metastatic mediastinal lymph nodes in lung cancer. METHODS: IVIM-diffusion weighted imaging (DWI) exams were performed preoperatively on 66 patients with lung cancer from October 2015 to June 2016 in Beijing Chao-Yang Hospital, Capital Medical University. Fifty patients underwent enhanced chest computed tomography (CT) in our hospital, while the other 16 patients already had enhanced chest CT images when they were admitted...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522101/cardiovascular-fitness-in-narcolepsy-is-inversely-related-to-sleepiness-and-the-number-of-cataplexy-episodes
#12
Martin Matoulek, Vladimír Tuka, Magdalena Fialová, Soňa Nevšímalová, Karel Šonka
OBJECTIVE: Cardiopulmonary fitness depends on daily energy expenditure or the amount of daily exercise. Patients with narcolepsy spent more time being sleepy or asleep than controls; thus we may speculate that they have a lower quantity and quality of physical activity. The aim of the present study was thus to test the hypothesis that exercise tolerance in narcolepsy negatively depends on sleepiness. PATIENTS AND METHODS: The cross-sectional study included 32 patients with narcolepsy with cataplexy, 10 patients with narcolepsy without cataplexy, and 36 age- and gender-matched control subjects, in whom a symptom-limited exercise stress test with expired gas analysis was performed...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#13
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28516519/exercise-training-in-diastolic-heart-failure-ex-dhf-rationale-and-design-of-a-multicentre-prospective-randomized-controlled-parallel-group-trial
#14
Frank Edelmann, Anna Bobenko, Götz Gelbrich, Gerd Hasenfuss, Christoph Herrmann-Lingen, André Duvinage, Silja Schwarz, Meinhard Mende, Christiane Prettin, Tobias Trippel, Ruhdja Lindhorst, Daniel Morris, Elisabeth Pieske-Kraigher, Kathleen Nolte, Hans-Dirk Düngen, Rolf Wachter, Martin Halle, Burkert Pieske
Heart failure with preserved ejection fraction (HFpEF) is a common disease with high incidence and increasing prevalence. Patients suffer from functional limitation, poor health-related quality of life, and reduced prognosis. A pilot study in a smaller group of HFpEF patients showed that structured, supervised exercise training (ET) improves maximal exercise capacity, diastolic function, and physical quality of life. However, the long-term effects of ET on patient-related outcomes remain unclear in HFpEF. The primary objective of the Exercise training in Diastolic Heart Failure (Ex-DHF) trial is to investigate whether a 12 month supervised ET can improve a clinically meaningful composite outcome score in HFpEF patients...
May 17, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28515114/cardiopulmonary-resuscitation-training-disparities-in-the-united-states
#15
Audrey L Blewer, Said A Ibrahim, Marion Leary, David Dutwin, Bryan McNally, Monique L Anderson, Laurie J Morrison, Tom P Aufderheide, Mohamud Daya, Ahamed H Idris, Clifton W Callaway, Peter J Kudenchuk, Gary M Vilke, Benjamin S Abella
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with increased survival from cardiac arrest, yet bystander CPR rates are low in many communities. The overall prevalence of CPR training in the United States and associated individual-level disparities are unknown. We sought to measure the national prevalence of CPR training and hypothesized that older age and lower socioeconomic status would be independently associated with a lower likelihood of CPR training. METHODS AND RESULTS: We administered a cross-sectional telephone survey to a nationally representative adult sample...
May 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28511305/-value-of-heart-rate-as-an-optimum-index-in-evaluating-physical-labor-intensity
#16
J Wang, L Cai, X W Chen, G H An, H X Shen, Q Ma
Objective: To investigate the possibility of heart rate as an optimum index for evaluating physical labor intensity. Methods: From September to October, 2015, a total of 111 male young adults were selected as study subjects. A cycle ergometer was used for exercise at different intensities (20, 40, 60, 80, 100, 120, 140, 160, and 180 W) , and the exercise at each intensity lasted for 6 minutes. The subjects wore the K4b2 portable cardiopulmonary function testing instrument for the real-time monitoring of heart rate (HR) , pulmonary ventilation volume (Ve) , oxygen consumption (VO(2)) , and energy metabolic rate (E) ...
March 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28511070/impact-of-exaggerated-blood-pressure-response-in-normotensive-individuals-on-future-hypertension-and-prognosis-systematic-review-according-to-prisma-guideline
#17
REVIEW
Karsten Keller, Kathrin Stelzer, Mir Abolfazl Ostad, Felix Post
PURPOSE: Arterial hypertension (aHT) is the leading risk factor for morbidity and mortality worldwide. Blood pressure (BP) deviation at rest is well defined and accompanies risk for cardiovascular events and cardiovascular mortality. A growing body of evidence emphasises that an exaggerated blood pressure response (EBPR) in cardiopulmonary exercise testing (CPET) could help to identify seemingly cardiovascular healthy and normotensive subjects, who have an increased risk of developing aHT and cardiovascular events in the future...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28511024/cardiopulmonary-exercise-testing-and-surgery
#18
Paul O Older, Denny Zh Levett
The surgical patient population is increasingly elderly and comorbid and poses challenges to perioperative physicians. Accurate pre-operative risk stratification is important to direct perioperative care. Reduced aerobic fitness is associated with increased post-operative morbidity and mortality. Cardiopulmonary exercise testing is an integrated and dynamic test that gives an objective measure of aerobic fitness or functional capacity and identifies the cause of exercise intolerance. Cardiopulmonary exercise testing provides an individualized estimate of patient risk that can be used to predict post-operative morbidity and mortality...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28510741/early-or-late-fresh-frozen-plasma-administration-in-newborns-and-small-infants-undergoing-cardiac-surgery-the-appear-randomized-trial
#19
P Bianchi, M Cotza, C Beccaris, S Silvetti, G Isgrò, G Pomè, A Giamberti, M Ranucci
Background: In newborns and small infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) and blood priming, it is unclear whether there is reduced blood loss if fresh frozen plasma (FFP) is added to the CPB priming volume. This single-centre, randomized trial tested the hypothesis that the administration of FFP after CPB (late FFP group) is superior to FFP priming (early FFP group) in terms of postoperative bleeding and overall red blood cell (RBC) transfusion. Methods: Seventy-three infants weighing <10 kg were randomly allocated to receive FFP to supplement RBCs in the CPB priming solution ( n =36) or immediately after CPB ( n =37)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28510738/pharmacokinetic-pharmacodynamic-model-for-unfractionated-heparin-dosing-during-cardiopulmonary-bypass
#20
X Delavenne, E Ollier, S Chollet, F Sandri, J Lanoiselée, S Hodin, A Montmartin, J-F Fuzellier, P Mismetti, L Gergelé
Background: High-dose heparin is used during cardiopulmonary bypass (CPB) to prevent thrombosis in the circuits used for extracorporeal circulation. The aim of this study was, initially, to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model to assess the variability of PK/PD parameters and their correlation with the results of the routine haemostatic test activated clotting time (ACT) and thereafter to develop a Bayesian estimator enabling an individualized dosing strategy...
May 1, 2017: British Journal of Anaesthesia
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