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Preload assessment

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https://www.readbyqxmd.com/read/28213737/associations-among-left-ventricular-systolic-function-tachycardia-and-cardiac-preload-in-septic-patients
#1
Michael J Lanspa, Sajid Shahul, Andrew Hersh, Emily L Wilson, Troy D Olsen, Eliotte L Hirshberg, Colin K Grissom, Samuel M Brown
BACKGROUND: In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy. We sought to determine whether tachycardia was associated with left ventricular longitudinal strain, a measure of cardiac dysfunction. We hypothesized an association would primarily exist in patients with high preload. METHODS: We prospectively observed septic patients admitted to three study ICUs, who underwent early transthoracic echocardiography...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28212401/preload-based-starling-like-control-of-rotary-blood-pumps-an-in-vitro-evaluation
#2
Mahdi Mansouri, Shaun D Gregory, Robert F Salamonsen, Nigel H Lovell, Michael C Stevens, Jo P Pauls, Rini Akmeliawati, Einly Lim
Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs) are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC) used in conventional LVADs, we developed a preload-based Starling-like controller (SLC). The SLC emulates the Starling law of the heart to maintain mean pump flow ([Formula: see text]) with respect to mean left ventricular end diastolic pressure (PLVEDm) as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm) and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC)...
2017: PloS One
https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#3
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28202132/comparison-of-platelet-reactivity-in-black-versus-white-patients-with-acute-coronary-syndromes-after-treatment-with-ticagrelor
#4
Michael A Gaglia, Michael J Lipinski, Thibault Lhermusier, Arie Steinvil, Sarkis Kiramijyan, Shreejana Pokharel, Rebecca Torguson, Dominick J Angiolillo, Lars Wallentin, Robert F Storey, Ron Waksman
Ticagrelor, a potent platelet inhibitor, has primarily been studied in white patients. Platelet reactivity among black patients with acute coronary syndrome (ACS) on ticagrelor, however, is unknown. Our objective was to compare platelet reactivity in black versus white patients with ACS treated with ticagrelor. We conducted a prospective, pharmacodynamic study of 29 black patients with ACS treated with ticagrelor. Platelet reactivity was assessed at 1, 4, and 8 hours after a loading dose of ticagrelor 180 mg and at 30 days on a maintenance dose of ticagrelor 90 mg twice daily...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28195341/left-ventricular-systolic-function-is-associated-to-sympathetic-nervous-activity-and-markers-of-inflammation-in-cirrhosis
#5
Raquel Yotti, Cristina Ripoll, Yolanda Benito, Maria Vega Catalina, Jaime Elízaga, Diego Rincón, Francisco Fernández-Avilés, Javier Bermejo, Rafael Bañares
: An accurate evaluation of cardiac function in patients with cirrhosis remains a challenge. We used robust echocardiographic indices to characterize LV systolic function and its relationship to activation of the sympathetic nervous system (SNS) and inflammation in 59 patients cirrhosis and 59 age-matched controls. Aditionally, in eleven patients we withdrew betablockers and diuretics and used phenylephrine and albumin infusion to evaluate the response to acute afterload and preload changes (interventional substudy)...
February 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#6
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28171797/efficacy-of-repair-techniques-of-the-achilles-tendon-a-meta-analysis-of-human-cadaveric-biomechanical-studies
#7
REVIEW
Kaissar Yammine, Chahine Assi
PURPOSE: Achilles injuries are very common, mainly among young athletes. When indicated, the surgical treatment aims for strong repairs that can resist distraction and consequently ruptures. The majority of the published clinical meta-analyses reported comparisons between broad treatment modalities such as conservative treatment, open, and minimally invasive surgery. METHODS: A meta-analysis has been conducted to assess further clinical and biomechanical variables on human cadavers related to the efficacy of Achilles repair...
January 28, 2017: Foot
https://www.readbyqxmd.com/read/28165145/left-ventricular-diastolic-dysfunction-in-patients-with-chronic-obstructive-pulmonary-disease-impact-of-methods-of-assessment
#8
Heba Farouk, Maged Albasmi, Karim El Chilali, Kareem Mahmoud, Abdo Nasr, Hussein Heshmat, Samah Abdel-Moneim, Essam Baligh
BACKGROUND: The prevalence of left ventricular (LV) diastolic dysfunction in patients with chronic obstructive pulmonary disease (COPD), using different echocardiographic parameters, varies widely in the literature. The highest prevalence of LV diastolic dysfunction was detected using the mitral inflow indexes that are commonly altered in these patients due to the associated tachycardia, reduced preload, and ventricular septal shift. In this study, we aimed at evaluating the impact of the used echocardiographic method of assessment on the prevalence of LV diastolic dysfunction in patients with COPD and normal LV systolic function...
February 6, 2017: Echocardiography
https://www.readbyqxmd.com/read/28160954/management-of-sepsis-in-patients-with-pulmonary-arterial-hypertension-in-the-intensive-care-unit
#9
REVIEW
Todd M Tartavoulle
Pulmonary arterial hypertension is a lethal condition, and the management of sepsis in patients with pulmonary arterial hypertension is challenging. As the disease progresses, the right ventricle is susceptible to failure due to a high pulmonary vascular resistance. The limited ability of the right ventricle to increase cardiac output in septic shock makes it difficult to deliver oxygen to the organ and tissues. Intravascular volume replacement and vasoactive drugs should only be considered after a thorough assessment...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28146440/sudden-collapse-of-a-preschool-aged-child-on-the-playground
#10
RoseAnn L Scheller, Laurie H Johnson, Michelle C Caruso, Angela Lorts
PURPOSE: Primary cardiac events are rare in children. There is little information in the literature regarding the most appropriate emergency department (ED) management of this type of pediatric patient, especially with regard to medication use. SUMMARY: This case highlights the pediatric ED evaluation and treatment of sudden collapse in a child with an ultimate diagnosis of hypertrophic cardiomyopathy. Cardiac disorders represent 2% to 6% of cases of pediatric syncope presenting to EDs, particularly if there are previous prodromal symptoms and/or a history of exertion...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28129302/evaluation-and-quality-assessment-of-prestripped-preloaded-descemet-membrane-endothelial-keratoplasty-grafts
#11
Khoa D Tran, Philip K Dye, Kelly Odell, Joshua Galloway, Christopher G Stoeger, Michael D Straiko, Mark A Terry
PURPOSE: To determine graft quality and feasibility of Descemet membrane endothelial keratoplasty (DMEK) grafts that are prestripped and preloaded into injectors by eye bank technicians before shipping to surgeons. METHODS: DMEK grafts (n = 31) were prepared from donor corneas and preloaded into Straiko Modified Jones tubes and set inside viewing chambers filled with 20 mL of Optisol-GS. Preloaded grafts were evaluated using specular microscopy and slit-lamp biomicroscopy...
January 26, 2017: Cornea
https://www.readbyqxmd.com/read/28121458/effects-of-practice-variability-on-spinal-manipulation-learning
#12
Andrée-Anne Marchand, Laura Mendoza, Claude Dugas, Martin Descarreaux, Isabelle Pagé
OBJECTIVE: To evaluate the effects of practice variability on chiropractic students' capacity to deliver spinal manipulations (SMs) of a targeted peak force. METHODS: Forty students participated in an experimental session including either a variable or a constant practice protocol of 45 SMs. SMs were delivered on a computer-connected device that recorded force-time profiles. Ten SMs with a target peak force of 350-N were performed before practice, immediately following practice, and 2 days later...
January 25, 2017: Journal of Chiropractic Education
https://www.readbyqxmd.com/read/28107308/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#13
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. Inhaled nitric oxide (iNO) lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure...
2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28097243/range-of-motion-sacral-screw-and-rod-strain-in-long-posterior-spinal-constructs-a-biomechanical-comparison-between-s2-alar-iliac-screws-with-traditional-fixation-strategies
#14
Chester E Sutterlin, Antony Field, Lisa A Ferrara, Andrew L Freeman, Kevin Phan
BACKGROUND: S1 screw failure and L5/S1 non-union are issues with long fusions to S1. Improved construct stiffness and S1 screw offloading can help avoid this. S2AI screws have shown to provide similar stiffness to iliac screws when added to L3-S1 constructs. We sought to examine and compare the biomechanical effects on an L2-S1 pedicle screw construct of adding S2AI screws, AxiaLIF, L5-S1 interbody support via transforaminal lumbar interbody fusion (TLIF), and to examine the effect of the addition of cross connectors to each of these constructs...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28095449/does-antiplatelet-therapy-during-bridging-thrombolysis-increase-rates-of-intracerebral-hemorrhage-in-stroke-patients
#15
Anne Broeg-Morvay, Pasquale Mordasini, Agnieszka Slezak, Kai Liesirova, Julia Meisterernst, Gerhard Schroth, Marcel Arnold, Simon Jung, Heinrich P Mattle, Jan Gralla, Urs Fischer
BACKGROUND: Symptomatic intracerebral hemorrhage (sICH) after bridging thrombolysis for acute ischemic stroke is a devastating complication. We aimed to assess whether the additional administration of aspirin during endovascular intervention increases bleeding rates. METHODS: We retrospectively compared bleeding complications and outcome in stroke patients who received bridging thrombolysis with (tPA+ASA) and without (tPA-ASA) aspirin during endovascular intervention between November 2008 and March 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28095176/a-flexible-workflow-for-automated-bioluminescent-kinase-selectivity-profiling
#16
Tracy Worzella, Matt Butzler, Jacquelyn Hennek, Seth Hanson, Laura Simdon, Said Goueli, Cris Cowan, Hicham Zegzouti
Kinase profiling during drug discovery is a necessary process to confirm inhibitor selectivity and assess off-target activities. However, cost and logistical limitations prevent profiling activities from being performed in-house. We describe the development of an automated and flexible kinase profiling workflow that combines ready-to-use kinase enzymes and substrates in convenient eight-tube strips, a bench-top liquid handling device, ADP-Glo Kinase Assay (Promega, Madison, WI) technology to quantify enzyme activity, and a multimode detection instrument...
November 1, 2016: Journal of Laboratory Automation
https://www.readbyqxmd.com/read/28091885/assessing-the-impact-of-preload-on-pyrite-rich-sediment-and-groundwater-quality
#17
Ohene Karikari-Yeboah, Jonas Addai-Mensah
Pyrite-rich sediments would, invariably, undergo redox reactions which would lead to acidic aqueous environment containing solubilized toxic metal species. When such sediments are subjected to preload, a technique employed by geotechnical engineers to improve the load-bearing capacity of highly compressible formation, transient flow of pore water, accompanied by acidity transfer, would occur as a response. Despite the concomitant environmental and socio-economic significance, to date, there has been limited interdisciplinary research on the underpinning geotechnical engineering and geo-environmental science issues for pyrite-rich sediments under preload...
February 2017: Environmental Monitoring and Assessment
https://www.readbyqxmd.com/read/28079557/dobutamine-aggravates-haemodynamic-deterioration-induced-by-pleural-effusion-a-randomised-controlled-porcine-study
#18
Kristian B Wemmelund, Anders H Sørensen, Viktor K Ringgård, Erik Sloth, Peter Juhl-Olsen
BACKGROUND: Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. OBJECTIVE: We hypothesised that dobutamine would affect the physiological determinants preload, afterload, contractility and changes of inferior vena cava characteristics during experimental pleural effusion. DESIGN: A randomised, controlled laboratory study. SETTING: Animal laboratory, conducted from March 2013 to May 2013...
January 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#19
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28043781/the-application-of-physiological-loading-using-a-dynamic-multi-axis-spine-simulator
#20
Timothy Patrick Holsgrove, Anthony W Miles, Sabina Gheduzzi
In-vitro testing protocols used for spine studies should replicate the in-vivo load environment as closely as possible. Unconstrained moments are regularly employed to test spinal specimens in-vitro, but applying such loads dynamically using an active six-axis testing system remains a challenge. The aim of this study was to assess the capability of a custom-developed spine simulator to apply dynamic unconstrained moments with an axial preload. Flexion-extension, lateral bending, and axial rotation were applied to an L5/L6 porcine specimen at 0...
December 30, 2016: Medical Engineering & Physics
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