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Low cardiac output syndrome

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https://www.readbyqxmd.com/read/28637179/is-delayed-surgical-revascularization-in-acute-myocardial-infarction-useful-or-dangerous-new-insights-into-an-old-problem
#1
Philippe Grieshaber, Peter Roth, Lukas Oster, Tobias M Schneider, Gerold Görlach, Bernd Nieman, Andreas Böning
OBJECTIVES: Haemodynamically stable patients admitted for coronary artery bypass grafting in acute myocardial infarction often undergo delayed surgery in order to avoid the risks of emergency surgery. However, initially stable patients undergoing delayed surgery may develop low cardiac output syndrome (LCOS) during the waiting period, which might be a major drawback of this strategy. We aim to define risk factors and clinical consequences of LCOS during the waiting period. METHODS: A total of 530 consecutive patients with acute myocardial infarction (33% non-ST-segment elevation myocardial infarction and 67% ST-segment-elevation myocardial infarction) underwent isolated coronary artery bypass grafting between 2008 and 2013...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#2
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28616803/amitriptyline-may-have-possibility-to-induce-brugada-syndrome-rather-than-long-qt-syndrome
#3
Nur Jaharat Lubna, Takeshi Wada, Yuji Nakamura, Koki Chiba, Xin Cao, Hiroko Izumi-Nakaseko, Kentaro Ando, Atsuhiko T Naito, Yoshioki Satoh, Atsushi Sugiyama
Amitriptyline has been reported to induce long QT syndrome in addition to Brugada syndrome. We qualitatively and quantitatively analyzed the potential of amitriptyline to induce these lethal syndromes by using the halothane-anesthetized dogs (n = 6). Amitriptyline was intravenously administered in doses of 0.1, 1 and 10 mg/kg over 10 min every 20 min, which would provide approximately 1, 10 and 100 times higher plasma concentrations than a therapeutic one, respectively. The low dose hardly altered any of the cardiovascular variables...
June 14, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28600090/hemodynamics-of-cardiogenic-shock
#4
REVIEW
Ariel Furer, Jeffrey Wessler, Daniel Burkhoff
Cardiogenic shock (CS) represents an advanced state of morbidity along the pathophysiologic pathway of end-organ hypoperfusion caused by reduced cardiac output and blood pressure. Acute coronary syndromes remain the most common cause of CS. The spectrum of hypoperfusion states caused by low cardiac output ranges from pre-CS to refractory CS and can be characterized by an array of hemodynamic parameters. This review provides the foundation for a hemodynamic understanding of CS including the use of hemodynamic monitoring for diagnosis and treatment, the cardiac and vascular determinants of CS, and a hemodynamic approach to risk stratification and management of CS...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#5
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28538112/levosimendan-for-the-low-cardiac-output-syndrome-after-cardiac-surgery
#6
EDITORIAL
Akshay S Desai, John A Jarcho
New England Journal of Medicine, Volume 376, Issue 21, Page 2076-2078, May 2017.
May 25, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28538105/linezolid-induced-lactic-acidosis-the-thin-line-between-bacterial-and-mitochondrial-ribosomes
#7
Alessandro Santini, Dario Ronchi, Manuela Garbellini, Daniela Piga, Alessandro Protti
Linezolid inhibits bacterial growth by targeting bacterial ribosomes and by interfering with bacterial protein synthesis. Lactic acidosis is a rare, but potentially lethal, side effect of linezolid. Areas covered: The pathogenesis of linezolid-induced lactic acidosis is reviewed with special emphasis on aspects relevant to the recognition, prevention and treatment of the syndrome. Expert opinion: Linezolid-induced lactic acidosis reflects the untoward interaction between the drug and mitochondrial ribosomes...
June 1, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28536187/question-2-is-levosimendan-better-than-milrinone-in-preventing-post-operative-low-cardiac-output-syndrome-and-improving-cardiac-function-in-children-with-congenital-heart-disease
#8
https://www.readbyqxmd.com/read/28511716/retraction-note-to-inotropic-therapy-for-cardiac-low-output-syndrome-comparison-of-hemodynamic-effects-of-dopamine-dobutamine-versus-dopamine-dopexamine
#9
EDITORIAL
N E El Mokhtari, A Arlt, A Meissner, M Lins
No abstract text is available yet for this article.
May 16, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28488096/improving-risk-assessment-for-post-surgical-low-cardiac-output-syndrome-in-patients-without-severely-reduced-ejection-fraction-undergoing-open-aortic-valve-replacement-the-role-of-global-longitudinal-strain-and-right-ventricular-free-wall-strain
#10
K Balderas-Muñoz, H Rodríguez-Zanella, J F Fritche-Salazar, N Ávila-Vanzzini, L E Juárez Orozco, J A Arias-Godínez, O Calvillo-Argüelles, S Rivera-Peralta, J C Sauza-Sosa, M E Ruiz-Esparza, E Bucio-Reta, A Rómero, N Espinola-Zavaleta, B Domínguez-Mendez, M Gaxiola-Macias, M A Martínez-Ríos
Low cardiac output syndrome (LCOS) after surgical aortic valve replacement (SAVR) is related to increased mortality and treatment related costs. We aimed to evaluate whether echocardiography-derived left ventricular global longitudinal strain (LV-GLS) relates to the occurrence of postoperative LCOS in patients undergoing SAVR. We prospectively enrolled 75 patients with symptomatic severe aortic stenosis, left ventricular ejection fraction (LVEF) >40%, NYHA Class <IV, without other significant valve disease...
May 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28469689/refractory-vasoplegic-syndrome-in-an-adult-patient-with-infective-endocarditis-a-case-report-and-literature-review
#11
Seyed Mohsen Mirhosseini, Ali Sanjari Moghaddam, Paritash Tahmaseb Pour, Ali Dabbagh
Postoperative vasoplegic syndrome (VS) is characterized by low systemic vascular resistance, normal or elevated cardiac output, and poor response to volume expansion. The incidence of VS after cardiac surgery requiring cardiopulmonary bypass is about 20%. Sometimes, VS becomes refractory and initial treatments do not work, rendering treatment a great challenge. In this study, we describe a young male patient with endocarditis undergoing tricuspid valve replacement. When being weaned off cardiopulmonary bypass, the patient experienced VS...
January 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28459760/an-international-survey-of-corticosteroid-use-for-the-management-of-low-cardiac-output-syndrome
#12
Saul Flores, Michael R FitzGerald, Ilias Iliopoulos, Joshua A Daily, Marco Rodriguez, David P Nelson, Hector R Wong, Kusum Menon, David S Cooper
OBJECTIVE: Limited evidence exists on use of corticosteroids in low cardiac output syndrome following cardiac surgery. We sought to determine physicians' practices and beliefs with regard to corticosteroids therapy for low cardiac output syndrome. DESIGN: Multinational internet-based survey. SETTING: Pediatric Cardiac Intensive Care Society member database. SUBJECTS: Pediatric cardiac intensive care physicians. INTERVENTIONS: None...
April 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28455084/recipient-umbilical-artery-elongation-redundancy-in-twin-twin-transfusion-syndrome
#13
Roopali Donepudi, Lovepreet K Mann, Christoph Wohlmuth, Anthony Johnson, Michael W Bebbington, Kenneth J Moise, David S Boudreaux, Helena Gardiner, Ramesha Papanna
BACKGROUND: Chronic hypertension in adults causes arterial lengthening in major arteries, but the effects of early fetal hypertension on the twin-twin transfusion syndrome recipient's vascular architecture remains unknown. OBJECTIVE: We hypothesize that arterial cord redundancy is related to recipient hypertension and subsequent heart failure. Our objectives were to: (1) establish a 3-dimensional color Doppler ultrasound method of measuring umbilical arterial length relative to its corresponding venous segment in the umbilical cord using artery vein angle; (2) compare recipient artery vein angle to gestational age-matched controls; and (3) test the association of artery vein angle with recipient heart failure...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28434547/stress-dose-corticosteroid-versus-placebo-in-neonatal-cardiac-operations-a-randomized-controlled-trial
#14
Pertti K Suominen, Juho Keski-Nisula, Tiina Ojala, Paula Rautiainen, Timo Jahnukainen, Johanna Hästbacka, Pertti J Neuvonen, Olli Pitkänen, Jussi Niemelä, Anu Kaskinen, Jukka Salminen, Risto Lapatto
BACKGROUND: Corticosteroids can improve the hemodynamic status of neonates with postoperative low cardiac output syndrome after cardiac operations. This study compared a prophylactically administered stress-dose corticosteroid (SDC) regimen against placebo on inflammation, adrenocortical function, and hemodynamic outcome. METHODS: Forty neonates undergoing elective open heart operations were randomized into two groups. The SDC group received perioperatively 2 mg/kg methylprednisolone, and 6 hours after the operation, a hydrocortisone infusion (0...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28424078/interleukin-6-displays-lung-anti-inflammatory-properties-and-exerts-protective-hemodynamic-effects-in-a-double-hit-murine-acute-lung-injury
#15
Guillaume Voiriot, Keyvan Razazi, Valérie Amsellem, Jeanne Tran Van Nhieu, Shariq Abid, Serge Adnot, Armand Mekontso Dessap, Bernard Maitre
BACKGROUND: Interleukin 6 (IL-6) is a predictive factor of poor prognosis in patients with acute respiratory distress syndrome (ARDS). However, its acute pulmonary hemodynamic effects and role in lung injury have not been investigated in a clinically relevant murine model of ARDS. METHODS: We used adult C57Bl6 wild-type (WT) and IL-6 knock-out (IL-6KO) mice. The animals received intravenous recombinant human IL-6 (rHuIL-6) or vehicle followed by intratracheal lipopolysaccharide (LPS) or saline before undergoing low tidal volume mechanical ventilation (MV) for 5 h...
April 19, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28407819/-association-between-fluid-overload-and-acute-renal-injury-after-congenital-heart-disease-surgery-in-infants
#16
De-Qiang Luo, Zi-Li Chen, Wei Dai, Feng Chen
OBJECTIVE: To study the association between fluid overload and acute kidney injury (AKI) after congenital heart disease surgery in infants. METHODS: A retrospective analysis was performed on 88 infants aged less than 6 months who underwent a radical surgery for congenital heart disease. The treatment outcomes were compared between the infants with AKI after surgery and those without. The effect of cumulative fluid overload on treatment outcomes 2 days after surgery was analyzed...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28407126/mitral-valve-replacement-in-severely-calcified-mitral-valve-annulus-a-10-year-experience
#17
Kareem Salhiyyah, Hassan Kattach, Ahmed Ashoub, Diana Patrick, Szabolcs Miskolczi, Geoffrey Tsang, Sunil K Ohri, Clifford W Barlow, Theodore Velissaris, Steve Livesey
OBJECTIVES: Severe calcification in the mitral valve annulus is a challenging problem during mitral valve surgery. We describe our experience with mitral valve replacement in severely calcified mitral valve without decalcification of the annulus. METHODS: Between April 2001 and July 2011, 61 patients underwent mitral valve replacement with severe mitral annulus calcification without decalcification of the annulus. This retrospective study was performed to assess the surgical and the long-term postoperative outcomes in this group...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28393776/serial-semi-invasive-hemodynamic-assessment-following-pericardiectomy-for-chronic-constrictive-pericarditis
#18
Ujjwal Kumar Chowdhury, Poonam Malhotra Kapoor, Adil Rizvi, Vishwas Malik, Sandeep Seth, Rajiv Narang, Mani Kalaivani, Sarvesh Pal Singh, Sathiya Selvam
OBJECTIVES: This study was designed to prospectively investigate the effects of pericardiectomy via median sternotomy on intra- and postoperative hemodynamics by a new semi-invasive device (Flotrac/VigileoTM monitor) using arterial pressure waveform analysis. PATIENTS AND METHODS: Thirty consecutive patients aged 15 to 55 years (mean+SD, 31.73 + 13.53 years), who had undergone total pericardiectomy via median sternotomy underwent serial hemodynamic evaluation. FlotracTM Sensor - derived stroke volume, stroke volume variation, systemic vascular resistance index (SVRI), cardiac index and right atrial pressure were measured just before and after pericardiectomy, at 12 hours, 24 hours, 48 hours, 72 hours and at discharge postoperatively...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28384188/baroreflex-sensitivity-and-outcomes-following-coronary-surgery
#19
Marco Ranucci, Alberto Porta, Vlasta Bari, Valeria Pistuddi, Maria Teresa La Rovere
Postoperative atrial fibrillation, acute kidney dysfunction and low cardiac output following coronary surgery are associated with morbidity and mortality. The purpose of this study is to determine if the preoperative autonomic control is a determinant of these postoperative complications. This is a prospective cohort study on 150 adult patients undergoing surgical coronary revascularization with cardiopulmonary bypass. The patients received an autonomic control assessment after the induction of anesthesia. Baroreflex sensitivity was computed by spectral analysis and expressed as BRSαHF and BRSαLF for measure respectively in the high and low frequency domains...
2017: PloS One
https://www.readbyqxmd.com/read/28369431/elective-surgery-for-ascending-aortic-aneurysm-in-the-elderly-should-there-be-an-age-cut-off
#20
Sven Peterss, Ahmed M Mansour, Mohammad A Zafar, Kabir Thombre, John A Rizzo, Bulat A Ziganshin, Umer M Darr, John A Elefteriades
OBJECTIVES: The objective of this study is to retrospectively analyse surgical outcomes in patients aged 75-79, and 80 and above. METHODS: Between 2000 and 2015, 108 patients aged 75-79 (G 75 , mean age 76.9 ± 1.5years) and 72 patients aged 80 and above (G 80 , mean age 82.2 ± 2.1years) underwent elective aneurysm repair. Operative outcome and survival was compared with 727 contemporary younger counterparts aged <75 years (G Ctrl , mean age 56.6 ± 11...
May 1, 2017: European Journal of Cardio-thoracic Surgery
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