Read by QxMD icon Read


Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Revista Brasileira de Anestesiologia
Alexandre Hideaki Oshiro, Denise Aya Otsuki, Marcelo Waldir M Hamaji, Kaleizu T Rosa, Keila Kazue Ida, Denise T Fantoni, José Otavio Costa Auler
OBJECTIVES: Inhalant anesthesia induces dose-dependent cardiovascular depression, but whether fluid responsiveness is differentially influenced by the inhalant agent and plasma volemia remains unknown. The aim of this study was to compare the effects of isoflurane, sevoflurane and desflurane on pulse pressure variation and stroke volume variation in pigs undergoing hemorrhage. METHODS: Twenty-five pigs were randomly anesthetized with isoflurane, sevoflurane or desflurane...
December 2015: Clinics
Maria Kałan, Agnieszka Witczak, Jerzy Mosiewicz, Helena Donica
Hart failure (HF) accounts for numerous serious problems: medical, social and financial. HF affects 2-3% adult population and its frequency increases with age. Despite advances in laboratory diagnostics of HR the use of biochemical markers remains limited. Currently, only natriuretic peptides, especially type B natriuretic peptides (BNP) and N-terminal fragment of pro-BNP (NT-proBNP) have been fully approved biomarkers employed in diagnosing HF. The concentration of those peptides fluctuates and largely depends on age, gender, renal function, day/night rhythm and volemia which reflects hemodynamic state rather than hart abnormal structure...
September 21, 2015: Postȩpy Higieny i Medycyny Doświadczalnej
Mauro Bernardi, Carmen Serena Ricci, Luca Santi
Hyponatremia is common in cirrhosis. It mostly occurs in an advanced stage of the disease and is associated with complications and increased mortality. Either hypovolemic or, more commonly, hypervolemic hyponatremia can be seen in cirrhosis. Impaired renal sodium handling due to renal hypoperfusion and increased arginine-vasopressin secretion secondary to reduced effective volemia due to peripheral arterial vasodilation represent the main mechanisms leading to dilutional hyponatremia in this setting. Patients with cirrhosis usually develop slowly progressing hyponatremia...
2014: Journal of Clinical Medicine
Daniel A Lichtenstein
This review article describes two protocols adapted from lung ultrasound: the bedside lung ultrasound in emergency (BLUE)-protocol for the immediate diagnosis of acute respiratory failure and the fluid administration limited by lung sonography (FALLS)-protocol for the management of acute circulatory failure. These applications require the mastery of 10 signs indicating normal lung surface (bat sign, lung sliding, A-lines), pleural effusions (quad and sinusoid sign), lung consolidations (fractal and tissue-like sign), interstitial syndrome (lung rockets), and pneumothorax (stratosphere sign and the lung point)...
June 2015: Chest
Avnish Bharadwaj, Mamta Khandelwal, Suresh Kumar Bhargava
Paediatric patients undergoing surgical procedures commonly require some volume of blood or blood component replacement in the perioperative period. Paediatric patients undergoing major surgery associated with substantial blood loss should be evaluated pre-operatively. Pre-operative correction of anaemia may be done considering the age, plasma volume status, clinical status and comorbidities. Maximum allowable blood loss (MABL) for surgery must be calculated, and appropriate quantity of blood and blood components should be arranged...
September 2014: Indian Journal of Anaesthesia
José Resende de Castro Júnior, Natália Fernandes, Thiago Bento de Paiva Lacet, Fábio Simplício Maia, Glauco Resende Bonato, Cristianne Nogueira, Sílvio Henrique Barberato, Rogério Baumgratz de Paula
INTRODUCTION: Hypertension is highly prevalent in patients with chronic kidney disease and hypervolemia is one of the principal causes. OBJECTIVE: To evaluate the influence of the reduction of volemia on blood pressure as well as on echocardiographic parameters in patients on continuous ambulatory peritoneal dialysis. METHODS: Twelve patients with no clinical evidence of hypervolemia were submitted to an increase in the rate of the dialysis with the purpose of reducing body weight by 5%...
October 2014: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Jerzy Kopeć
UNLABELLED: Even though significant progress has been attained in the question of dialysis therapy--experts have not addressed the aspect of when is proper moment to initiate dialysis therapy. It has not been proven that early starting of hemodialysis with higher GFRvalues has positive influence on decreasing mortality in this patients population. Steady rise in the number of elderly patients with multiple comorbidities qualified for hemodialysis results in increased mortality in this group...
2014: Przegla̧d Lekarski
Guilherme Schettino, Rezende Ederlon, Ciro Leite Mendes, Alvaro Réa-Neto, Cid Marcos David, Suzana Margareth Ajeje Lobo, Alberto Barros, Eliézer Silva, Gilberto Friedman, José Luiz Gomes do Amaral, Marcelo Park, Maristela Monachini, Mirella Cristine de Oliveira, Murillo Santucci César Assunção, Nelson Akamine, Patrícia Veiga C Mello, Renata Andréa Pietro Pereira, Rubens Costa Filho, Sebastião Araújo, Sérgio Félix Pinto, Sérgio Ferreira, Simone Mattoso Mitushima, Sydney Agareno, Yuzeth Nóbrega de Assis Brilhante
BACKGROUND AND OBJECTIVES: Cardiac output and preload as absolute data do not offer helpful information about the hemodynamic of critically ill patients. However, monitoring the response of these variables to volume challenge or inotropic drugs is a very useful tool in the critical care setting, particularly for patients with signs of tissue hypoperfusion. Although PAC remains the " gold standard" to measure cardiac output and preload, new and alternative technologies were developed to evaluate these hemodynamic variables...
March 2006: Revista Brasileira de Terapia Intensiva
Raphaël Giraud, Nils Siegenthaler, Diego Arroyo, Karim Bendjelid
BACKGROUND: Pulse pressure variations (PPVs) and stroke volume variations (SVVs) are dynamic indices for predicting fluid responsiveness in intensive care unit patients. These hemodynamic markers underscore Frank-Starling law by which volume expansion increases cardiac output (CO). The aim of the present study was to evaluate the impact of the administration of catecholamines on PPV, SVV, and inferior vena cava flow (IVCF). METHODS: In this prospective, physiologic, animal study, hemodynamic parameters were measured in deeply sedated and mechanically ventilated pigs...
October 2014: Journal of Trauma and Acute Care Surgery
Biagio Barbano, Liborio Sardo, Antonietta Gigante, Maria Ludovica Gasperini, Marta Liberatori, Gianluca Di Lazzaro Giraldi, Antonio Lacanna, Antonio Amoroso, Rosario Cianci
Advanced cirrhosis is frequently associated with renal dysfunction. Hepatorenal syndrome (HRS) is characterized by the occurrence of kidney injury in cirrhotic patients in the absence of other identifiable causes. HRS is classified in 2 different types. Type 1 is characterized by acute renal failure and rapid functional deterioration of other organs, usually related to a precipitating event. Type 2 is characterized by slowly progressive renal failure and refractory ascites. Advanced liver disease induces the progression of hemodynamic alterations such as arterial vasodilation of splanchnic circulation and impairment of cardiac function...
January 2014: Current Vascular Pharmacology
Marianne Serveaux, Michel Burnier, Sébastien Kissling
Assessment of volume status is often challenging in daily clinical practice. One of the clinician's tasks is to prevent or to treat organ systems failures that arise from a mismatch between the transport of oxygen and metabolic needs. Renal failure is a frequently encountered in-hospital diagnosis that is known to alter significantly the prognosis. In patients with acute renal failure in particular, the consequences of an inadequate volume management further increase morbidity and mortality.
February 26, 2014: Revue Médicale Suisse
Wenqing Lu, Jing Dong, Zifeng Xu, Hao Shen, Jijian Zheng
BACKGROUND: The pleth variability index (PVI) has been demonstrated to be a useful, noninvasive indicator of continuous fluid responsiveness. Whether PVI can be used to assess the changes of intravascular volume status remains to be elucidated. MATERIAL AND METHODS: Using correlation analysis and receiver operating characteristic (ROC) curves, we sought a correlation between PVI and the initial distribution volume of glucose (IDVG), evaluating PVI as an indicator of the central extracellular fluid volume after anesthesia induction in patients undergoing elective abdominal surgery...
2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Cristiana Rollino, Rosanna Balbiano, Pietro Caramello, Dario Roccatello
Vaptans, vasopressin V2 receptor antagonists, are new drugs indicated in the treatment of Inappropriate ADH Secretion Syndrome (SIADH). We report a case of SIADH in a patient affected by AIDS. During a hospitalization for an ongoing CMV meningitis she developed a severe hyponatremia (114 mEq/L), which was initially treated with restriction of free water. When the diagnosis of SIADH was done (plasma Osmolarity 240 mOsm/kg, urinary sodium >30 mEq/24 h, normal volemia, lack of hypocorticosurrenalism and hypothyroidism), tolvaptan was given at the dose of 15 mg/day...
November 2013: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Daniel A Lichtenstein
Lung ultrasound is a basic application of critical ultrasound, defined as a loop associating urgent diagnoses with immediate therapeutic decisions. It requires the mastery of ten signs: the bat sign (pleural line), lung sliding (yielding seashore sign), the A-line (horizontal artifact), the quad sign, and sinusoid sign indicating pleural effusion, the fractal, and tissue-like sign indicating lung consolidation, the B-line, and lung rockets indicating interstitial syndrome, abolished lung sliding with the stratosphere sign suggesting pneumothorax, and the lung point indicating pneumothorax...
January 9, 2014: Annals of Intensive Care
D Lichtenstein
The assessment of acute circulatory failure is a challenge in absence of solid gold standard. It is suggested that artifacts generated by lung ultrasound can be of help. The FALLS-protocol (Fluid Administration Limited by Lung Sonography) follows Weil's classification of shocks. Firstly, it searches for pericardial fluid, then right heart enlargment, lastly abolished lung sliding. In this setting, the diagnoses of pericardial tamponade, pulmonary embolism and tension pneumothorax, i.e. obstructive shock, can be schematically ruled out...
2013: Heart, Lung and Vessels
I A Checheriţă, Cristiana David, A Ciocâlteu, I Lascăr, Laura Budală
UNLABELLED: Metabolic acidosis slowly develops during renal impairment natural evolution towards ESRD and represents an important contributing factor of CKD progression. Although, several clinical and experimental trials reported the major impact of metabolic acidosis on CKD evolution, the pathophysiology mechanism remains a matter of debate. Furthermore, international guidelines do not impose a specific treatment scheme for metabolic acidosis in CKD patients, and metabolic acidosis is not fully compensated once hemodialysis starts...
2013: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Juan Carlos Garcia-Pagán, Marta Barrufet, Andres Cardenas, Angels Escorsell
According to their location, gastric varices (GV) are classified as gastroesophageal varices and isolated gastric varices. This review will mainly focus on those GV located in the fundus of the stomach (isolated gastric varices 1 and gastroesophageal varices 2). The 1-year risk of GV bleeding has been reported to be around 10%-16%. Size of GV, presence of red signs, and the degree of liver dysfunction are independent predictors of bleeding. Limited data suggest that tissue adhesives, mainly cyanoacrylate (CA), may be effective and better than propranolol in preventing bleeding from GV...
June 2014: Clinical Gastroenterology and Hepatology
G Audibert, J Hoche, A Baumann, P-M Mertes
Electrolyte disturbances are frequent after brain injuries, especially dysnatremia and dyskalemia. In neurological patients, usual clinical signs of hyponatremia are frequently confounded with clinical signs of the underlying disease. Natremia absolute value is less important than speed of onset of the trouble. Most often, hyponatremia is associated with hypotonicity and intracellular hyperhydration, which may exacerbate a cerebral edema. Distinction between inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt wasting syndrome (CSWS) may be difficult and is mainly based on assessment of patient's volemia, SIADH being associated with normal or hypervolemia and CSWS with hypovolemia...
June 2012: Annales Françaises D'anesthèsie et de Rèanimation
N Alessandri, M Petrassi, F Tufano, A Dei Giudici, S De Angelis, F Urciuoli, C Alessandri, C De Angelis, E Tomao
BACKGROUND: The cardiovascular system works to maintain homeostasis through a series of adaptive responses to physiological requirements. Different self-regulatory mechanism prevent the effects induced by hydrostatic pressure changes on oncotic pressure caused by postural changes. Gravity exerts a strong influence on the postural changes with implications on the cardiovascular system. In orbit, gravity (+Gz) is responsible of mass redistribution of circulating blood flow. The aim of this study was the evaluation of the adaptive responses of cardiovascular system to postural changes with and without the use of the Lower Body Negative Pressure (LBNP)...
March 2012: European Review for Medical and Pharmacological Sciences
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"