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https://www.readbyqxmd.com/read/29134245/esophageal-pressure-research-or-clinical-tool
#1
REVIEW
E Baedorf Kassis, S H Loring, D Talmor
Esophageal manometry has traditionally been utilized for respiratory physiology research, but clinicians have recently found numerous applications within the intensive care unit. Esophageal pressure (PEs) is a surrogate for pleural pressures (PPl), and the difference between airway pressure (PAO) and PEs provides a good estimate for the pressure across the lung also known as the transpulmonary pressure (PL). Differentiating the effects of mechanical ventilation and spontaneous breathing on the respiratory system, chest wall, and across the lung allows for improved personalization in clinical decision making...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29113716/plethysmography-variability-index-for-prediction-of-fluid-responsiveness-during-graded-haemorrhage-and-transfusion-in-sevoflurane-anaesthetized-mechanically-ventilated-dogs
#2
Yusuke Endo, Koudai Kawase, Taku Miyasho, Tadashi Sano, Kazuto Yamashita, William W Muir
OBJECTIVE: To examine the accuracy of plethysmography variability index (PVI) as a noninvasive indicator of fluid responsiveness in hypovolaemic dogs. STUDY DESIGN: Prospective experimental study. ANIMALS: Six adult healthy sevoflurane-anaesthetized Beagle dogs. METHODS: Dogs were anaesthetized with 1.3-fold their individual minimum alveolar concentration of sevoflurane. The lungs were mechanically ventilated after neuromuscular blockade with vecuronium bromide...
August 25, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29090260/assessment-of-method-agreement-between-two-minimally-invasive-hemodynamic-measurements-in-septic-shock-patients-on-high-doses-of-vasopressor-drugs-a-preliminary-study
#3
Oana Antal, Mihai Mărginean, Natalia Hagău
BACKGROUND: Minimally invasive hemodynamic monitoring is still controversial among the methods used to assess the hemodynamic profile of the septic shock patient. The aim of this study was to test the level of agreement between two different devices. METHODS: We collected 385 data entries during 12-hour intervals from four critically ill patients with septic shock and high doses of vasoactive therapy using two minimally invasive methods at the same time: Vigileo™ device which uses the pulse contour principle, and EV1000™ monitoring platform which uses the transpulmonary thermodilution principle...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29089460/measurements-obtained-from-esophageal-balloon-catheters-are-affected-by-the-esophageal-balloon-filling-volume-in-children-with-ards
#4
Justin C Hotz, Cary T Sodetani, Jeffrey Van Steenbergen, Robinder G Khemani, Timothy W Deakers, Christopher J Newth
INTRODUCTION: Esophageal balloon inflation volume may affect the accuracy of transpulmonary pressure estimates in adults, but the effect is unknown in pediatrics. Using a combination bench and human study, we sought to determine a range of optimal filling volumes for esophageal balloon catheters and to derive a technique to inflate catheters to yield the most accurate estimates of pleural pressure. METHODS: In the laboratory study, we evaluated 4 pediatric and adult esophageal balloon catheters, a liquid-filled catheter, and a micro-tip catheter, both with and without a model esophagus...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29077613/pressure-waveform-analysis
#5
Mathieu Jozwiak, Xavier Monnet, Jean-Louis Teboul
Monitoring cardiac output is of special interest for detecting early hemodynamic impairment and for guiding its treatment. Among the techniques that are available to monitor cardiac output, pressure waveform analysis estimates cardiac output from the shape of the arterial pressure curve. It is based on the general principle that the amplitude of the systolic part of the arterial curve is proportional to cardiac output and arterial compliance. Such an estimation of cardiac output has the advantage of being continuous and in real time...
October 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29058315/atelectasis-is-inversely-proportional-to-transpulmonary-pressure-during-weaning-from-ventilator-support-in-a-large-animal-model
#6
M Gudmundsson, G Perchiazzi, M Pellegrini, A Vena, G Hedenstierna, C Rylander
BACKGROUND: In mechanically ventilated, lung injured, patients without spontaneous breathing effort, atelectasis with shunt and desaturation may appear suddenly when ventilator pressures are decreased. It is not known how such a formation of atelectasis is related to transpulmonary pressure (PL ) during weaning from mechanical ventilation when the spontaneous breathing effort is increased. If the relation between PL and atelectasis were known, monitoring of PL might help to avoid formation of atelectasis and cyclic collapse during weaning...
October 23, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29040264/comparison-of-pulmonary-vascular-permeability-index-pvpi-and-global-ejection-fraction-gef-derived-from-jugular-and-femoral-indicator-injection-using-the-picco-2-device-a-prospective-observational-study
#7
COMPARATIVE STUDY
Wolfgang Huber, Andrea Gruber, Maximilian Eckmann, Felicia Elkmann, Ines Klein, Tobias Lahmer, Ulrich Mayr, Raphael Schellnegger, Jochen Schneider, Gonzalo Batres-Baires, Lisa Fekecs, Analena Beitz, Helena Berbara, Roland Schmid, Alexander Herner
BACKGROUND: Transpulmonary thermodilution (TPTD) is used to derive cardiac output CO, global end-diastolic volume GEDV and extravascular lung water EVLW. To facilitate interpretation of these data, several ratios have been developed, including pulmonary vascular permeability index (defined as EVLW/(0.25*GEDV)) and global ejection fraction ((4*stroke volume)/GEDV). PVPI and GEF have been associated to the aetiology of pulmonary oedema and systolic cardiac function, respectively. Several studies demonstrated that the use of femoral venous access results in a marked overestimation of GEDV...
2017: PloS One
https://www.readbyqxmd.com/read/29030937/changes-in-blood-volume-indicators-and-dynamic-indicators-measured-with-transpulmonary-ultrasound-velocity-during-blood-depletion-and-repletion-in-a-neonatal-swine-model
#8
Manuel Martin-Flores, Alvaro F Cisternas, Robin D Gleed
BACKGROUND: Dynamic indicators such as pulse pressure and stroke volume variations can be measured to track changes in preload during hemorrhage, and evaluate fluid therapy. However, these dynamic indicators require mechanical ventilation, and might be affected by cardiac dysrhythmias and changes in vascular tone. Blood volume indicators may offer alternatives for assessing changes in volume status. AIMS: The aims of this study were to measure changes in blood volume indicators and dynamic indicators during removal of blood in two stages and subsequent blood replacement in anesthetized, mechanically ventilated, neonatal pigs...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29025576/the-prevalence-correlates-and-impact%C3%A2-on%C3%A2-cardiac-mortality-of-right%C3%A2-ventricular-dysfunction-in-nonischemic%C3%A2-cardiomyopathy
#9
Andreas Pueschner, Pairoj Chattranukulchai, John F Heitner, Dipan J Shah, Brenda Hayes, Wolfgang Rehwald, Michele A Parker, Han W Kim, Robert M Judd, Raymond J Kim, Igor Klem
OBJECTIVES: This study sought to determine the prevalence, correlates, and impact on cardiac mortality of right ventricular (RV) dysfunction in nonischemic cardiomyopathy. BACKGROUND: Current heart failure guidelines place little emphasis on RV assessment due to limited available data on determinants of RV function, mechanisms leading to its failure, and relation to outcomes. METHODS: We prospectively studied 423 patients with cardiac magnetic resonance (CMR)...
October 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29019966/transthoracic-balloon-pulmonary-valvuloplasty-for-treatment-of-congenial-pulmonary-atresia-patients-with-intact-ventricular-septum
#10
Zhi-Qin Lin, Qiang Chen, Hua Cao, Liang-Wan Chen, Gui-Can Zhang, Dao-Zhong Chen, Qin-Min Wang, Han-Fan Qiu, Dong-Shan Liao, Feng Lin
BACKGROUND To summarize our clinical experience in performing transthoracic balloon pulmonary valvuloplasty for the treatment of patients suffering from congenial pulmonary atresia with intact ventricular septum (PA/IVS). MATERIAL AND METHODS Between April 2009 and April 2016, 38 patients with PA/IVS underwent transthoracic balloon pulmonary valvuloplasty in our hospital. All of them were combined with patent ductus arteriosus, tricuspid insufficiency, and atrial septal defect or patent foramen ovale. The valvuloplasty was performed from the right ventricular outflow tract through a median sternotomy incision under TEE guidance for all cases...
October 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28986852/effect-of-inspiratory-synchronization-during-pressure-controlled-ventilation-on-lung-distension-and-inspiratory-effort
#11
Nuttapol Rittayamai, François Beloncle, Ewan C Goligher, Lu Chen, Jordi Mancebo, Jean-Christophe M Richard, Laurent Brochard
BACKGROUND: In pressure-controlled (PC) ventilation, tidal volume (V T) and transpulmonary pressure (P L ) result from the addition of ventilator pressure and the patient's inspiratory effort. PC modes can be classified into fully, partially, and non-synchronized modes, and the degree of synchronization may result in different V T and P L despite identical ventilator settings. This study assessed the effects of three PC modes on V T, P L , inspiratory effort (esophageal pressure-time product, PTPes), and airway occlusion pressure, P 0...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28984797/validation-of-radial-artery-based-uncalibrated-pulse-contour-method-pulsioflex-in-critically-ill-patients-a-observational-study
#12
Jörn Grensemann, Jerome M Defosse, Meike Willms, Uwe Schiller, Frank Wappler, Samir G Sakka
BACKGROUND: Because of their simplicity, uncalibrated pulse contour (UPC) methods have been introduced into clinical practice in critical care but are often validated with a femoral arterial waveform. OBJECTIVE: We aimed to test the accuracy of cardiac index (CI) measurements and trending ability from a radial artery with one UPC. DESIGN: An observational study. SETTING: Tertiary care mixed-surgical ICU. Data were obtained from April 2015 to July 2016...
November 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28982803/bilious-pleuritis-following-transpulmonary-radiofrequency-ablation-of-liver-metastases
#13
Asli Kalin, Maged Hassan, Mark Anderson, Najib Rahman
No abstract text is available yet for this article.
October 5, 2017: Thorax
https://www.readbyqxmd.com/read/28977981/effects-of-liraglutide-on-hemodynamic-parameters-in-patients-with-heart-failure
#14
Jin Ying Zhang, Xin Yun Wang, Xiang Wang
Glucagon-like peptide-1 analogues improve left ventricular function in patients with acute myocardial infarction. This study aimed to evaluate the effects of liraglutide on hemodynamic parameters in patients with heart failure. A total of 78 patients with heart failure were enrolled in this study between August 2014 and November 2015. Of these, 52 patients were randomized 1:1 to receive either liraglutide or placebo for 7 days. Hemodynamic measurements were made using transpulmonary thermodilution and arterial pulse contour analysis...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28934895/high-early-fluid-input-after-aneurysmal-subarachnoid-hemorrhage-combined-report-of-association-with-delayed-cerebral-ischemia-and-feasibility-of-cardiac-output-guided-fluid-restriction
#15
Leonie J M Vergouw, Mohamud Egal, Bas Bergmans, Diederik W J Dippel, Hester F Lingsma, Mervyn D I Vergouwen, Peter W A Willems, Annemarie W Oldenbeuving, Jan Bakker, Mathieu van der Jagt
BACKGROUND: Guidelines on the management of aneurysmal subarachnoid hemorrhage (aSAH) recommend euvolemia, whereas hypervolemia may cause harm. We investigated whether high early fluid input is associated with delayed cerebral ischemia (DCI), and if fluid input can be safely decreased using transpulmonary thermodilution (TPT). METHODS: We retrospectively included aSAH patients treated at an academic intensive care unit (2007-2011; cohort 1) or managed with TPT (2011-2013; cohort 2)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28930639/50-years-of-research-in-ards-tidal-volume-selection-in-the-acute-respiratory-distress-syndrome
#16
Sarina K Sahetya, Jordi Mancebo, Roy G Brower
Mechanical ventilation (MV) is critical in the management of many patients with the acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate tidal volume is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower tidal volumes, the use of tidal volumes of 6 mL/kg predicted body weight (PBW, based on sex and height) has been recommended in clinical practice guidelines...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28912263/hemodynamic-phenotyping-of-pulmonary-hypertension-in-left-heart-failure
#17
REVIEW
Robert Naeije, Mario Gerges, Jean-Luc Vachiery, Sergio Caravita, Christian Gerges, Irene M Lang
Increased pulmonary venous pressure secondary to left heart disease is the most common cause of pulmonary hypertension (PH). The diagnosis of PH due to left heart disease relies on a clinical probability assessment followed by the invasive measurements of a mean pulmonary artery pressure (PAP) ≥25 mm Hg and mean wedged PAP (PAWP) >15 mm Hg. A combination of mean PAP and mean PAWP defines postcapillary PH. Postcapillary PH is generally associated with a diastolic pulmonary pressure gradient (diastolic PAP minus mean PAWP) <7 mm Hg, a transpulmonary pressure gradient (mean PAP minus mean PAWP) <12 mm Hg, and pulmonary vascular resistance ≤3 Wood units (WU)...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28904482/mathematics-of-ventilator-induced-lung-injury
#18
REVIEW
Ubaidur Rahaman
Ventilator-induced lung injury (VILI) results from mechanical disruption of blood-gas barrier and consequent edema and releases of inflammatory mediators. A transpulmonary pressure (PL) of 17 cmH2O increases baby lung volume to its anatomical limit, predisposing to VILI. Viscoelastic property of lung makes pulmonary mechanics time dependent so that stress (PL) increases with respiratory rate. Alveolar inhomogeneity in acute respiratory distress syndrome acts as a stress riser, multiplying global stress at regional level experienced by baby lung...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#19
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28895301/early-leaflet-thrombosis-complicating-transcatheter-implantation-of-a-sapien-3-valve-in-a-native-right-ventricular-outflow-tract
#20
Mounir Riahi, Philipp Blanke, John Webb, Ronald G Carere
A 59-year-old female with Tetralogy of Fallot had a previous complete repair with RVOT patch enlargement. She developed subsequent severe symptomatic (NYHA III) pulmonary regurgitation with severe RV dilatation. She had a concomitant interstitial lung disease secondary to hypersensitivity pneumonitis that precluded her from cardiac surgery. After preprocedural assessment using computed tomography, echocardiography and invasive angiography we decided to implant a 29 mm Edwards Sapien 3 valve without pre-stenting...
September 12, 2017: Catheterization and Cardiovascular Interventions
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