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Decompensated Shock

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https://www.readbyqxmd.com/read/28614145/non-human-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-poly-traumatic-hemorrhagic-shock
#1
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, R Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable non-human primate (NHP) models of severe poly-traumatic hemorrhagic shock. METHODS: NHPs were randomized into five pressure-targeted severe hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF) and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24hrs...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28600092/mechanical-circulatory-support-in-acute-decompensated-heart-failure-and-shock
#2
REVIEW
Nishtha Sodhi, John M Lasala
An array of interventional therapeutics is available in the modern era, with uses depending on acute or chronic situations. This article focuses on support in acute decompensated heart failure and cardiogenic shock, including intra-aortic balloon pumps, continuous aortic flow augmentation, and extra-corporeal membrane oxygenation.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28566471/emergency-treatment-of-decompensated-aortic-stenosis
#3
Dario Bongiovanni, Constantin Kühl, Sabine Bleiziffer, Lynne Stecher, Felix Poch, Martin Greif, Julinda Mehilli, Steffen Massberg, Norbert Frey, Rüdiger Lange, Karl-Ludwig Laugwitz, Gerhard Schymik, Derk Frank, Christian Kupatt
OBJECTIVE: The optimal treatment of patients with acute and severe decompensation of aortic stenosis is unclear due to recent advances in transcatheter interventions and supportive therapies. Our aim was to assess the early outcome of emergency transcatheter aortic valve implantation (eTAVI) versus emergency balloon aortic valvuloplasty (eBAV) followed by TAVI under elective circumstances. METHODS: Emergency conditions were defined as: cardiogenic shock with requirement of catecholamine therapy, severe acute dyspnoea (NYHA IV), cardiac resuscitation or mechanic respiratory support...
May 31, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28543399/baroreceptor-stimulation-in-a-patient-with-preexisting-subcutaneous-implantable-cardioverter-defibrillator
#4
Kay F Weipert, Jens Andrick, Ritvan Chasan, Christopher Gemein, Astrid Most, Christian W Hamm, Damir Erkapic, Joern Schmitt
BACKGROUND: Many patients with severe heart failure (HF) have an indication for baroreflex activation therapy (BAT) and an ICD. Concerns about device-device interactions were addressed in a study with small sample size that concluded combined BAT and ICD therapy is safe. There are no published data, however, concerning device-device interactions between BAT and a subcutaneous ICD (S-ICD). Since BAT frequently interferes with surface ECG recordings there are doubts about compatibility of BAT and S-ICD devices...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28538624/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#5
Michael Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene prior to decompensation is paramount to survival. Lactate is extremely sensitive to shock and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The Compensatory Reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28536660/sorafenib-associated-heart-failure-complicated-by-cardiogenic-shock-after-treatment-of-advanced-stage-hepatocellular-carcinoma-a-clinical-case-discussion
#6
Candace Wu, Kamal Shemisa
Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28471885/extracorporeal-membrane-oxygenation-for-acute-decompensated-heart-failure
#7
Laurence Dangers, Nicholas Bréchot, Matthieu Schmidt, Guillaume Lebreton, Guillaume Hékimian, Ania Nieszkowska, Sébastien Besset, Jean-Louis Trouillet, Jean Chastre, Pascal Leprince, Alain Combes, Charles-Edouard Luyt
OBJECTIVE: Long-term outcomes of patients treated with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure (i.e., cardiogenic shock complicating chronic cardiomyopathy) have not yet been reported. This study was undertaken to describe their outcomes and determine mortality-associated factors. DESIGN: Retrospective analysis of data prospectively collected. SETTING: Twenty-six-bed tertiary hospital ICU. PATIENTS: One hundred five patients implanted with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure...
May 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28463462/clinical-phenotypes-and-outcome-of-patients-hospitalized-for-acute-heart-failure-the-esc-heart-failure-long-term-registry
#8
Ovidiu Chioncel, Alexandre Mebazaa, Veli-Pekka Harjola, Andrew J Coats, Massimo Francesco Piepoli, Maria G Crespo-Leiro, Cecile Laroche, Petar M Seferovic, Stefan D Anker, Roberto Ferrari, Frank Ruschitzka, Silvia Lopez Fernandez, Daniela Miani, Gerasimos Filippatos, Aldo P Maggioni
AIMS: To identify differences in clinical epidemiology, in-hospital management and 1-year outcomes among patients hospitalized for acute heart failure (AHF) and enrolled in the European Society of Cardiology Heart Failure Long-Term (ESC-HF-LT) Registry, stratified by clinical profile at admission. METHODS AND RESULTS: The ESC-HF-LT Registry is a prospective, observational study collecting hospitalization and 1-year follow-up data from 6629 AHF patients. Among AHF patients enrolled in the registry, 13...
April 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28433485/in-hospital-mortality-in-cirrhotic-patients-at-a-tertiary-care-center
#9
R Zubieta-Rodríguez, J Gómez-Correa, R Rodríguez-Amaya, K A Ariza-Mejia, N A Toloza-Cuta
INTRODUCTION: Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. AIMS: To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28425407/persistence-of-virologic-response-after-liver-transplant-in-hepatitis-c-patients-treated-with-ledipasvir-sofosbuvir-plus-ribavirin-pretransplant
#10
Eric M Yoshida, Paul Kwo, Kosh Agarwal, Christophe Duvoux, François Durand, Markus Peck-Radosavljevic, Leslie Lilly, Bernard Willems, Hugo Vargas, Princy Kumar, Robert S Brown, Yves Horsmans, Shampa De-Oertel, Sarah Arterburn, Hadas Dvory-Sobol, Diana M Brainard, John G McHutchison, Norah Terrault, Mario Rizzetto, Beat Müllhaupt
INTRODUCTION: Recurrence of HCV infection in patients with chronic hepatitis C virus (HCV) at the time of liver transplantation is nearly universal and reduces the likelihood of graft and patient survival. MATERIALS AND METHODS: We evaluated outcomes of 17 patients (16 with HCV genotype 1 and 1 with genotype 4) who received up to 12 or 24 weeks of ledipasvir/sofosbuvir plus ribavirin prior to or up to the time of liver transplant in the SOLAR-1 and SOLAR-2 trials...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28411694/predictors-of-failure-and-complications-of-catheter-directed-interventions-for-pulmonary-embolism
#11
Efthymios D Avgerinos, Adham N Abou Ali, Nathan L Liang, Elizabeth Genovese, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis while decreasing the dose of thrombolytic required and the associated risks. This study aimed to identify factors associated with CDI failure and to describe anticipated complications. METHODS: Consecutive patients who underwent CDI for massive or submassive PE between 2009 and 2015 were identified; outcomes and complications were retrospectively collected...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#12
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28363639/increased-expression-of-cytotoxic-t-lymphocyte-associated-protein-4-by-t-cells-induced-by-b7-in-sera-reduces-adaptive-immunity-in-patients-with-acute-liver-failure
#13
Wafa Khamri, Robin D Abeles, Tie Zheng Hou, Amy E Anderson, Ahmed El-Masry, Evangelos Triantafyllou, Christine Bernsmeier, Fin S Larsen, Arjuna Singanayagam, Nobuaki Kudo, Lucia A Possamai, Fanny Lebosse, Georg Auzinger, William Bernal, Christopher Willars, Christopher J Weston, Giovanna Lombardi, Julia Wendon, Mark Thursz, Charalambos G Antoniades
BACKGROUND & AIMS: Patients with acute liver failure (ALF) have defects in innate immune responses to microbes (immune paresis) and are susceptible to sepsis. Cytotoxic T-lymphocyte-associated protein 4 (CTLA4), which interacts with the membrane receptor B7 (also called CD80 and CD86), is a negative regulator of T-cell activation. We collected T cells from patients with ALF and investigated whether inhibitory signals down-regulate adaptive immune responses in patients with ALF. METHODS: We collected peripheral blood mononuclear cells from patients with ALF and controls from September 2013 through September 2015 (45 patients with ALF, 20 patients with acute-on-chronic liver failure, 15 patients with cirrhosis with no evidence of acute decompensation, 20 patients with septic shock but no cirrhosis or liver disease, and 20 healthy individuals)...
March 28, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28350721/a-rare-case-of-cor-triatriatum-leading-to-respiratory-failure-and-shock-in-an-8-month-old
#14
Catherine Burger
An 8-month-old boy presents with 1 week of gradually worsening respiratory distress. After chest radiograph shows bilateral airspace opacities, he is treated for pneumonia with antibiotics and intravenous fluids. Shortly after this, he decompensates requiring intubation, followed by cardiopulmonary support with pressors and eventually extracorporeal membrane oxygenation. Bedside ultrasound then shows an additional congenital membrane in the left atrium obstructing pulmonary venous return and thought to have caused his original presentation and subsequent decompensation...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28346013/the-physiology-of-blood-loss-and-shock-new-insights-from-a-human-laboratory-model-of-hemorrhage
#15
REVIEW
Alicia M Schiller, Jeffrey T Howard, Victor A Convertino
The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28316844/aspergillus-pericarditis-with-tamponade-in-a-renal-transplant-patient
#16
Sylvia Biso, Rapeepat Lekkham, Antoinette Climaco
Aspergillus pericarditis is a rare and life-threatening infection in immunosuppressed patients. It has nonspecific clinical manifestations that often mimic other disease entities especially in patients who have extensive comorbidities. Diagnosis is oftentimes delayed and rarely done antemortem. A high degree of suspicion in immunocompromised patients is necessary for evaluation and timely diagnosis. This is a case of Aspergillus pericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28296034/emergency-valve-in-valve-transcatheter-aortic-valve-replacement-in-a-patient-with-degenerated-bioprosthetic-aortic-stenosis-and-cardiogenic-shock-on-veno-arterial-extracorporeal-membrane-oxygenation
#17
Matthew R Summers, Stephanie Mick, Samir R Kapadia, Amar Krishnaswamy
The use of transcatheter aortic valve replacement (TAVR) as an acute treatment in severe decompensated bioprosthetic aortic valve disease is not well documented. We describe herein a unique case in which valve-in-valve (ViV) TAVR was successfully used as both an emergency salvage therapy and a bridge to definitive fourth reoperative aortic valve replacement (AVR) in a young patient with cardiogenic shock secondary to bioprosthetic aortic valve stenosis who was dependent on veno-arterial extracorporeal membrane oxygenation (VA-ECMO)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28225875/decompensated-chagasic-heart-failure-versus-non-chagasic-heart-failure-at-a-tertiary-care-hospital-clinical-characteristics-and-outcomes
#18
Luiza Nauane Borges Azevedo Dos Santos, Mário de Seixas Rocha, Eloina Nunes de Oliveira, Carlos Antônio Gusmão de Moura, Ayslan Jorge Santos de Araujo, Ítalo Magalhães Gusmão, Gilson Soares Feitosa-Filho, Constança Margarida Sampaio Cruz
OBJECTIVE: To evaluate clinical and epidemiological characteristics and clinical outcomes in patients hospitalized with decompensated heart failure (DHF), with a comparison between Chagas and non-Chagas disease. METHOD: This is a retrospective cohort study involving 136 patients consecutively admitted with DHF between January 1 and December 31, 2011, with the following outcomes: acute renal failure, cardiogenic shock, rehospitalization, and hospital death. Individuals aged ≥ 18 years with DHF were included while those with more than 10% of missing data regarding outcomes were excluded...
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#19
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#20
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
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