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Preload assessment

Ricardo Reyes, Jose Antonio Rodríguez, Josune Orbe, María Rosa Arnau, Carmen Évora, Araceli Delgado
The effect of dual delivery of bone morphogenetic protein-2 (BMP-2) and matrix metalloproteinase 10 (MMP10) on bone regeneration was investigated in a murine model of calvarial critical-size defect, hypothesizing that it would result in an enhanced bone formation. Critical-size calvarial defects (4 mm diameter) were created in mice and PLGA microspheres preloaded with either BMP-2, MMP10 or a microsphere combination of both were transplanted into defect sites at different doses. Empty microspheres were used as the negative control...
November 2018: Drug Delivery
Kjirsten Swenson, Shannon Rankin, Leticia Daconti, Tomas Villarreal, Jens Langsjoen, Darren Braude
INTRODUCTION: Bolus-dose phenylephrine (BDPE) is routinely used to treat hypotension in the operating room. BDPE's fast onset of action and ability to be administered peripherally have prompted calls for its use in the Emergency Department (ED). There are few published data on the safety of BDPE use in the ED. Primary concerns include BDPE's potential to cause dangerous hypertension or reflex bradycardia. We hypothesize that BDPE is a safe short-term vasopressor choice for hypotensive ED patients...
February 19, 2018: American Journal of Emergency Medicine
Sarah N Gartner, Fraser Aidney, Anica Klockars, Colin Prosser, Elizabeth A Carpenter, Kiriana Isgrove, Allen S Levine, Pawel K Olszewski
Human and laboratory animal studies suggest that dietary supplementation of a free essential amino acid, l-tryptophan (TRP), reduces food intake. It is unclear whether an acute gastric preload of TRP decreases consumption and whether central mechanisms underlie TRP-driven hypophagia. We examined the effect of TRP administered via intragastric gavage on energy- and palatability-induced feeding in mice. We sought to identify central mechanisms through which TRP suppresses appetite. Effects of TRP on consumption of energy-dense and energy-dilute tastants were established in mice stimulated to eat by energy deprivation or palatability...
February 19, 2018: Appetite
C Nafati, M Gardette, M Leone, L Reydellet, V Blasco, A Lannelongue, F Sayagh, S Wiramus, F Antonini, J Albanèse, L Zieleskiewicz
BACKGROUND: In critical patients, left ventricular ejection fraction and fractional shortening are used to reflect left ventricular systolic function. An emerging technique, two-dimensional-strain echocardiography, allows assessment of the left ventricle systolic longitudinal deformation (global longitudinal strain) and the speed at which this deformation occurs (systolic strain rate). This technique is of increasing use in critical patients in intensive care units and in the peri-operative period where preload constantly varies...
February 21, 2018: Annals of Intensive Care
Mohamed Mohamed Tawfik, Amany Ismail Tarbay, Ahmed Mohamed Elaidy, Karim Ali Awad, Hanaa Mohamed Ezz, Mohamed Ahmed Tolba
BACKGROUND: The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. We assessed the IVC at baseline and at subsequent time points after spinal anesthesia...
February 14, 2018: Anesthesia and Analgesia
Francesco Maria Di Matteo, Paola Saccomandi, Margareth Martino, Monica Pandolfi, Margherita Pizzicannella, Valerio Balassone, Emiliano Schena, Claudio Marcello Pacella, Sergio Silvestri, Guido Costamagna
BACKGROUND AND AIMS: Endoscopic ultrasound (EUS) has become an interventional technique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer. METHODS: Patients with a stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemo-radiotherapy...
February 13, 2018: Gastrointestinal Endoscopy
Karl-Philipp Rommel, Maximilian von Roeder, Christian Oberueck, Konrad Latuscynski, Christian Besler, Stephan Blazek, Thomas Stiermaier, Karl Fengler, Volker Adams, Marcus Sandri, Axel Linke, Gerhard Schuler, Holger Thiele, Philipp Lurz
BACKGROUND: Although systolic right ventricular (RV) dysfunction has been shown to be a potent predictor for adverse outcomes in patients with heart failure with preserved ejection fraction (HFpEF), RV functional abnormalities in the course of the syndrome are not well characterized. We, therefore, sought to assess load-independent and load-dependent systolic and diastolic characteristics of RV function in stable outpatients with HFpEF. METHODS AND RESULTS: We invasively obtained RV and left ventricular pressure-volume loops in 24 HFpEF patients and 9 patients without heart failure symptoms with a conductance catheter during basal conditions and handgrip exercise...
February 2018: Circulation. Heart Failure
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
Joseph Hernandez, Steven G Chopski, Sam Lee, William B Moskowitz, Amy L Throckmorton
Background: Limited therapeutic options are available for Fontan patients with dysfunctional or failing single ventricle physiology. This study describes the evaluation of an alternative, non-invasive, at-home therapeutic compression treatment for Fontan patients. Our hypothesis is that routinely administered, externally applied compression treatments to the lower extremities will augment systemic venous return, improve ventricular preload, and thus enhance cardiac output in Fontan patients...
January 2018: Translational Pediatrics
Tomomichi Ishizaka, Yu Yoshimatsu, Yu Maeda, Katsuyoshi Chiba, Kazuhiko Mori
Nicorandil is a representative antianginal drug that has dual properties of a nitrate and adenosine triphosphate-sensitive potassium (KATP) channel agonist; however, its effects on integrated cardiac function have not been fully understood. This study was conducted to clarify the functional, hemodynamic, and electrophysiological effects of nicorandil using ventricular pressure-volume loop analysis in isoflurane-anesthetized monkeys. Nicorandil was given intravenously at therapeutic doses of 0.2 and 2 mg/kg over 10 minutes to cynomolgus monkeys (n = 5) with a pause of 10 minutes between the 2 doses...
February 2018: Journal of Cardiovascular Pharmacology
Lowell Ling, Kai Man Chan
BACKGROUND: There is a lack of consensus on the timing of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) liberation. VA-ECMO weaning usually consists of serial decrements until an idling flow is achieved, supported by echocardiographic and haemodynamic assessments. Even with minimal idling flow, right ventricular (RV) preload is reduced and, hence, right heart function is not fully tested under adequate loading conditions. Following the use of a novel technique called Pump Controlled Retrograde Trial Off (PCRTO) in neonate VA-ECMO weaning, we report the use of this technique in seven adult patients on VA-ECMO...
February 1, 2018: Perfusion
Rachel Lord, David MacLeod, Keith George, David Oxborough, Rob Shave, Mike Stembridge
An acute non-invasive reduction in preload has been shown to augment cardiac mechanics to maintain stroke volume and cardiac output. Such interventions induce concomitant changes in heart rate (HR), whereas blood volume extraction reduces preload without HR changes. Therefore, the purpose of this study was to determine whether a preload reduction in isolation resulted in augmented stroke volume achieved via enhanced cardiac mechanics. Nine healthy volunteers (4 female, age 29 ± 11 years) underwent echocardiography for the assessment of left ventricular (LV) volumes and mechanics in a supine position at baseline and end-extraction following the controlled removal of 25% of total blood volume (1062 ± 342 ml)...
January 18, 2018: Experimental Physiology
Ani Amar, Sharon Zlochiver, Ofer Barnea
Mechano-electric feedback affects the electrophysiological and mechanical function of the heart and the cellular, tissue, and organ properties. To determine the main factors that contribute to this effect, this study investigated the changes in the action potential characteristics of the ventricle during contraction. A model of stretch-activated channels was incorporated into a three-dimensional multiscale model of the contracting ventricle to assess the effect of different preload lengths on the electrophysiological behavior...
2018: PloS One
Caroline Schneider, Lynsey Forsythe, John Somauroo, Keith George, David Oxborough
BACKGROUND: Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function; however, the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change...
March 2018: Echo Research and Practice
Atsuko Furukawa, Yukio Abe, Kazato Ito, Shingo Hosogi, Katsuhito Yamamoto, Hiroshi Ito
BACKGROUND: This study aimed to investigate the mechanisms of acute changes in functional mitral regurgitation (FMR) by preload alterations. METHODS: Twenty-two consecutive patients with left ventricular ejection fraction <40% and at least mild FMR underwent transthoracic echocardiography. Passive leg lifting and sublingual administration of nitroglycerin were performed to alter preload. Mitral regurgitant volume (MRV) was assessed using the Doppler method. RESULTS: MRV changed in parallel with preload alterations...
January 10, 2018: Journal of Cardiology
M Millicent W Peterseim, Ryan S Rhodes, Rupa N Patel, M Edward Wilson, Luke E Edmondson, Sarah A Logan, Edward W Cheeseman, Emily Shortridge, Rupal H Trivedi
PURPOSE: The GoCheck Kids smartphone photoscreening app (Gobiquity Mobile Health, Scottsdale, Arizona, USA), introduced in 2014, is marketed to pediatricians with little published validation. We wished to evaluate the GoCheck Kids Screener for accuracy in detecting amblyopia risk factors (ARF) using 2013 American Association for Pediatric Ophthalmology and Strabismus guidelines. DESIGN: Validity assessment. METHODS: Children 6 months to 6 years of age presenting from October 2016 to August 2017 were included...
March 2018: American Journal of Ophthalmology
Caroline Schneider, Lynsey Forsythe, John Somauroo, Keith George, David Oxborough
BACKGROUND: Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function however the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change...
January 3, 2018: Echo Research and Practice
Timothy Colen, Shelby Kutty, Richard B Thompson, Edythe Tham, Andrew S Mackie, Ling Li, Dongngan T Truong, Michiko Maruyama, Jeffrey F Smallhorn, Nee Scze Khoo
BACKGROUND: Tricuspid regurgitation (TR) is an important risk factor for morbidity and mortality in hypoplastic left heart syndrome (HLHS), yet the evolution of tricuspid valve (TV) dysfunction in HLHS is poorly understood. This study sought to examine changes in TV function in HLHS between the first two stages of surgical palliation and to determine the mechanism of TR at the time of stage two surgery-bidirectional cavopulmonary anastomosis (BCPA). METHODS: We prospectively investigated 44 infants at two time points-prior to Norwood-Sano (T1 - median age 5...
December 29, 2017: Journal of the American Society of Echocardiography
Angela J Murray, Ju Zhu, Joe Wood, Lynne E Macaskie
Bacteria can fabricate platinum group metal (PGM) catalysts cheaply, a key consideration of industrial processes and waste decontaminations. Biorecovery of PGMs from wastes is promising but PGM leachates made from metallic scraps are acidic. A two-step biosynthesis 'pre-seeds' metallic deposits onto bacterial cells benignly; chemical reduction of subsequent metal from acidic solution via the seeds makes bioscaffolded nanoparticles (NPs). Cells of Escherichia coli were seeded using Pd(II) or Pt(IV) and exposed to a mixed Pd(II)/Pt(IV) model solution under H2 to make bimetallic catalyst...
December 28, 2017: Microbial Biotechnology
Yohei Matsuda, Masanori Sasaki, Yuko Kataoka-Sasaki, Akio Takayanagi, Ko Kobayashi, Shinichi Oka, Masahito Nakazaki, Naoya Masumori, Jeffery D Kocsis, Osamu Honmou
INTRODUCTION: Intravenous preload (delivered before cavernous nerve [CN] injury) of bone marrow-derived mesenchymal stem cells (MSCs) can prevent or decrease postoperative erectile dysfunction (J Sex Med 2015;12:1713-1721). In the present study, the potential therapeutic effects of intravenously administered MSCs on postoperative erectile dysfunction were evaluated in a rat model of CN injury. METHODS: Male Sprague-Dawley rats were randomized into 2 groups after electric CN injury...
December 20, 2017: Sexual Medicine
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