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Echocardiography fluid assessment

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https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#1
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/28063468/computational-fluid-dynamics-and-aortic-thrombus-formation-following-thoracic-endovascular-aortic-repair
#2
Foeke J H Nauta, Kevin D Lau, Christopher J Arthurs, Kim A Eagle, David M Williams, Santi Trimarchi, Himanshu J Patel, Carlos A Figueroa
BACKGROUND: We present the possible utility of computational fluid dynamics in the assessment of thrombus formation and virtual surgical planning illustrated in a patient with aortic thrombus in a kinked ascending aortic graft following thoracic endovascular aortic repair. METHODS: A patient-specific three-dimensional model was built from computed tomography. Additionally, we modeled 3 virtual aortic interventions to assess their effect on thrombosis potential: (1) open surgical repair, (2) conformable endografting, and (3) single-branched endografting...
January 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28024925/the-evolution-of-diastolic-function-during-liver-transplantation
#3
Pauline Devauchelle, Zoé Schmitt, Aurélie Bonnet, Serge Duperret, Jean-Paul Viale, Jean-Yves Mabrut, Frédéric Aubrun, Mathieu Gazon
INTRODUCTION: The peroperative management of liver transplantation is still associated with many cardio-circulatory complications in which diastolic dysfunction may play a contributive role. Transoesophageal echocardiography is a monitoring device commonly used in liver transplantation allowing diastolic function assessment. METHODS: We prospectively analysed the peroperative transoesophageal echocardiography recordings of 40 patients undergoing liver transplantation in order to describe changes in diastolic function at different steps of the surgery...
December 23, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28008296/point-of-care-ultraportable-echocardiography-predicts-diuretic-response-in-patients-admitted-with-acute-decompensated-heart-failure
#4
Dena K Krishnan, Barbara Pawlaczyk, Peter A McCullough, Susan Enright, Arvind Kunadi, Thomas E Vanhecke
BACKGROUND: Routine management of patients with acute decompensated heart failure (ADHF) requires careful attentiveness to fluid status and diuretic treatment efficacy. New advances in ultrasound have made ultraportable echocardiography (UE) available to physicians for point-of-care use. The purpose of this study is to explore physiologic measures of intravascular fluid volume derived from UE and explore predictors of diuretic response in ADHF. METHODS: Various echocardiography imaging measurements, particularly diameter and collapse of inferior vena cava (IVC), were collected from 77 patients admitted with a primary diagnosis of ADHF...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28000133/association-of-early-hemodynamic-profile-and-the-development-of-systolic-dysfunction-following-traumatic-brain-injury
#5
Vijay Krishnamoorthy, Ali Rowhani-Rahbar, Nophanan Chaikittisilpa, Edward F Gibbons, Frederick P Rivara, Nancy R Temkin, Alex Quistberg, Monica S Vavilala
BACKGROUND: While systolic dysfunction has been observed following traumatic brain injury (TBI), the relationship between early hemodynamics and the development of systolic dysfunction has not been investigated. Our study aimed to determine the early hemodynamic profile that is associated with the development of systolic dysfunction after TBI. METHODS: We conducted a prospective cohort study among patients under 65 years old without cardiac comorbidities who sustained moderate-severe TBI...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27984249/predicting-fluid-responsiveness-in-acute-liver-failure-a-prospective-study
#6
Vinod Kumar Audimoolam, Mark J W McPhail, Chris Willars, William Bernal, Julia A Wendon, Maurizio Cecconi, Georg Auzinger
BACKGROUND: The profound hemodynamic changes seen in acute liver failure (ALF) resemble the hyperdynamic state found in the later stages of septic shock. Vasopressor support frequently is required after initial volume therapy. Markers of preload dependency have not been studied in this patient group. Dynamic maneuvers such as passive leg raising or end-expiratory hold, which have shown good predictive accuracy in a general intensive care unit population, cannot be considered safe in this cohort because of the concerns of intracranial hypertension...
December 14, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27981285/utility-of-transthoracic-echocardiography-tte-in-assessing-fluid-responsiveness-in-critically-ill-patients-a-challenge-for-the-bedside-sonographer
#7
Wojciech Mielnicki, Agnieszka Dyla, Tomasz Zawada
Transthoracic echocardiography (TTE) has become one of the most important diagnostic tools in the treatment of critically ill patients. It allows clinicians to recognise potentially reversible life-threatening situations and is also very effective in the monitoring of the fluid status of patients, slowly substituting invasive methods in the intensive care unit. Hemodynamic assessment is based on a few static and dynamic parameters. Dynamic parameters change during the respiratory cycle in mechanical ventilation and the level of this change directly corresponds to fluid responsiveness...
December 5, 2016: Medical Ultrasonography
https://www.readbyqxmd.com/read/27942784/-introduction-of-prehospital-emergency-ultrasound-into-an-emergency-medical-service-area
#8
C Weilbach, A Kobiella, N Rahe-Meyer, K Johanning
BACKGROUND: Emergency ultrasound as part of the provision of emergency medical services using mobile devices offers great benefits regarding to some important questions related to the management of critically ill and injured patients in the prehospital situation where diagnostic resources are limited. The aim of this study is to determine whether the comprehensive introduction of prehospital emergency ultrasound examinations into a German Emergency Medical Services ("rescue services") area is both feasible and beneficial for patients...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27749318/diagnostic-accuracy-of-the-inferior-vena-cava-collapsibility-to-predict-fluid-responsiveness-in-spontaneously-breathing-patients-with-sepsis-and-acute-circulatory-failure
#9
Sebastien Preau, Perrine Bortolotti, Delphine Colling, Florent Dewavrin, Vincent Colas, Benoit Voisin, Thierry Onimus, Elodie Drumez, Alain Durocher, Alban Redheuil, Fabienne Saulnier
OBJECTIVE: To investigate whether the collapsibility index of the inferior vena cava recorded during a deep standardized inspiration predicts fluid responsiveness in nonintubated patients. DESIGN: Prospective, nonrandomized study. SETTING: ICUs at a general and a university hospital. PATIENTS: Nonintubated patients without mechanical ventilation (n = 90) presenting with sepsis-induced acute circulatory failure and considered for volume expansion...
September 30, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27734218/the-importance-of-residual-renal-function-in-peritoneal-dialysis
#10
Dorota Sikorska, Krzysztof Pawlaczyk, Anna Olewicz-Gawlik, Natasza Czepulis, Bartlomiej Posnik, Ewa Baum, Maria Wanic-Kossowska, Bengt Lindholm, Andrzej Oko
BACKGROUND: Peritoneal dialysis (PD) patients with preserved residual diuresis have a lower risk of death and complications. Here we analyzed associations between residual diuresis and presence of fluid overload and biomarkers of cardiac strain and nutrition in PD patients. METHODS: Among 44 PD patients placed into three subgroups, depending on volume of residual diuresis (group A ≤ 500; group B 600-1900; and group C ≥ 2000 mL/day), we examined: overhydration (OH) assessed by bioimpedance analysis (BIA; yielding OH index OHBIA) and by clinical criteria (edema and hypertension); nutritional status (by subjective global assessment, SGA); metabolic status (electrolytes, serum lipid profile, CRP, and albumin); biomarkers of fluid overload and cardiac strain (N-terminal probrain natriuretic peptide, NT-proBNP, and troponin T, TnT); and, echocardiography and chest X-ray...
December 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27680806/e5-lung-ultrasound-and-echocardiography-for-peripartum-haemodynamic-monitoring-of-patients-with-severe-preeclampsia
#11
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27653798/comparison-of-echocardiographic-indices-used-to-predict-fluid-responsiveness-in-ventilated-patients
#12
Philippe Vignon, Xavier Repessé, Emmanuelle Bégot, Julie Léger, Christophe Jacob, Koceila Bouferrache, Michel Slama, Gwenaël Prat, Antoine Vieillard-Baron
RATIONALE: Assessment of fluid responsiveness relies on dynamic echocardiographic parameters which have not yet been compared in large cohorts. OBJECTIVES: To determine the diagnostic accuracy of dynamic parameters used to predict fluid responsiveness in ventilated patients with a circulatory failure of any cause. METHODS: In this multicenter prospective study, respiratory variations of superior vena cava diameter (∆SVC) measured using transesophageal echocardiography, of inferior vena cava diameter (∆IVC) measured using transthoracic echocardiography, of the maximal Doppler velocity in left ventricular outflow tract (∆VmaxAo) measured using either approach, and pulse pressure variations (∆PP) were recorded with the patient in the semi-recumbent position...
September 21, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27638998/fixing-the-jugular-flow-reduces-ventricle-volume-and-improves-brain-perfusion
#13
Paolo Zamboni, Erica Menegatti, Corrado Cittanti, Francesco Sisini, Sergio Gianesini, Fabrizio Salvi, Francesco Mascoli
OBJECTIVE: Increased ventricle volume and brain hypoperfusion are linked to neurodegeneration. We hypothesized that in patients with restricted jugular flow, surgical restoration may reduce brain ventricle volume, because it should improve the pressure gradient, hence promoting cerebrospinal fluid reabsorption into the venous system. METHODS: The effects of restoring the jugular flow were assessed by means of a validated echocardiography with color Doppler (ECD) protocol of flow quantification, magnetic resonance venography, and single-photon emission computed tomography combined with computed tomography (SPECT-CT)...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27592289/echocardiography-as-a-guide-for-fluid-management
#14
REVIEW
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27575931/echocardiographic-findings-in-haemodialysis-patients-according-to-their-state-of-hydration
#15
María Cristina Di Gioia, Raul Gascuena, Paloma Gallar, Gabriela Cobo, Rosa Camacho, Nuria Acosta, Zsofia Baranyi, Isabel Rodriguez, Aniana Oliet, Olimpia Ortega, Inmaculada Fernandez, Carmen Mon, Milagros Ortiz, Mari C Manzano, Juan C Herrero, José I Martinez, Joaquín Palma, Ana Vigil
BACKGROUND: Chronic fluid overload is frequent in hemodialysis patients (P) and it associates with hypertension, left ventricular hypertrophy (LVH) and higher mortality. Moreover, echocardiographic data assessing fluid overload is limited. Our aim was to evaluate the relationship between fluid overload measured by bioimpedance spectroscopy (BIS) and different echocardiographic parameters. METHODS: Cross-sectional observational study including 76 stable patients...
August 26, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27509588/correlation-between-volume-overload-chronic-inflammation-and-left-ventricular-dysfunction-in-chronic-kidney-disease-patients
#16
Muzamil Olamide Hassan, Raquel Duarte, Therese Dix-Peek, Ahmed Vachiat, Sagren Naidoo, Caroline Dickens, Sacha Grinter, Pravin Manga, Saraladevi Naicker
BACKGROUND: Fluid overload is common in chronic kidney disease (CKD) patients, potentially driving chronic inflammation and left ventricular dysfunction. We investigated the association between volume overload, chronic inflammation, and left ventricular dysfunction across subgroups of CKD patients. METHODS: The study included 160 participants, comprising peritoneal dialysis (PD), hemodialysis (HD), stage-3 CKD patients, and age- and sex-matched controls (40 in each group)...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27478966/assessment-of-adequacy-of-volume-resuscitation
#17
John H Boyd, Demetrios Sirounis
PURPOSE OF REVIEW: It has recently become evident that administration of intravenous fluids following initial resuscitation has a greater probability of producing tissue edema and hypoxemia than of increasing oxygen delivery. Therefore, it is essential to have a rational approach to assess the adequacy of volume resuscitation. Here we review passive leg raising (PLR) and respiratory variation in hemodynamics to assess fluid responsiveness. RECENT FINDINGS: The use of ultrasound enhances the clinician's ability to detect and predict fluid responsiveness, whereas enthusiasm for this modality must be tempered by recent evidence that it is only reliable in apneic patients...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27412036/echocardiography-training-for-cardiac-surgery-residents-results-of-a-canadian-needs-assessment
#18
Mazin Fatani, Kevin Lachapelle, Farhan Bhanji, Peter McLeod
BACKGROUND: In assessing an unstable patient post cardiac surgery, echocardiography can be an essential tool as part of this assessment. However, it may be under-utilized for several reasons. We conducted this study to  determine the perceived needs and training objectives for echocardiography training for cardiac surgery residents. METHODS: This study was a cross-sectional, stratified national survey of cardiac surgery residents, cardiac surgeons, cardiac surgery program directors and cardiologists, designed to acquire opinions on what type and level of objective-based training in echocardiography is required for cardiac surgery residents...
July 13, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27371776/preliminary-observations-on-the-association-between-serum-il-6-and-hydration-status-and-cardiovascular-risk-in-patients-treated-with-peritoneal-dialysis
#19
Dorota Sikorska, Krzysztof Pawlaczyk, Magdalena Roszak, Natasza Czepulis, Andrzej Oko, Marek Karczewski, Andrzej Breborowicz, Janusz Witowski
INTRODUCTION: Systemic inflammation, as defined by elevated blood IL-6, is a strong independent predictor of peritoneal dialysis (PD) patient survival. The present study has aimed to determine whether there exists a particular "phenotype" associated with high systemic IL-6 that characterizes PD patients in terms of their fluid status and cardiac parameters. METHODS: Fifty-seven prevalent PD patients were classified according to serum concentrations of IL-6. The degree of overhydration was assessed by bioimpedance analysis (BIA)...
September 2016: Cytokine
https://www.readbyqxmd.com/read/27313657/inverse-problem-for-color-doppler-ultrasound-assisted-intracardiac-blood-flow-imaging
#20
Jaeseong Jang, Chi Young Ahn, Jung-Il Choi, Jin Keun Seo
For the assessment of the left ventricle (LV), echocardiography has been widely used to visualize and quantify geometrical variations of LV. However, echocardiographic image itself is not sufficient to describe a swirling pattern which is a characteristic blood flow pattern inside LV without any treatment on the image. We propose a mathematical framework based on an inverse problem for three-dimensional (3D) LV blood flow reconstruction. The reconstruction model combines the incompressible Navier-Stokes equations with one-direction velocity component of the synthetic flow data (or color Doppler data) from the forward simulation (or measurement)...
2016: Computational and Mathematical Methods in Medicine
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