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https://www.readbyqxmd.com/read/29921225/effects-of-acute-ethanol-intoxication-in-an-ovine-peritonitis-model
#1
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model. METHODS: Anesthetized, mechanically ventilated female sheep were randomized to an ethanol group (n = 7), which received 1 g/kg ethanol diluted in intravenous (i.v.) saline infusion or a control group (n = 7), which received the same volume of i...
June 19, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29916133/three-dimensional-indices-of-renal-perfusion-in-normal-pregnancy-and-pre-eclampsia
#2
Amanda Ali, Susan Addley, Stephen Ong
INTRODUCTION: We compared renal perfusion in normal pregnant women and women with pre-eclampsia using three-dimensional (3D) ultrasound. We measured the flow index (FI), vascular index (VI) and vascularisation flow index (VFI) which are believed to reflect vascularity and flow intensity. METHODS: Fourteen patients with normal pregnancy and 16 patients with pre-eclampsia were recruited. Imaging was conducted using a Voluson E8 machine and a 6-MHz trans-abdominal probe...
June 18, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29909939/renal-artery-embolization-in-a-child-with-delayed-hemodynamic-instability-from-penetrating-knife-wound
#3
M Barras, E Pearson, I Cousin, C Le Rouzic, M Thepaut, J-C Gentric, J-M Roue, S Yevich, P de Vries
Penetrating laceration injury in the pediatric population may present as an acute or delayed life-threatening injury. Although emergent intra-arterial embolization is commonly utilized in adults, few cases have been reported for children. Surgical treatment for severe renal laceration injuries may require complete nephrectomy; an unfortunate outcome for a pediatric patient if a renal-preserving alternative is feasible. We present a case of penetrating renal laceration in a 10-year-old boy treated with intra-arterial embolization of the lacerated dominant renal artery and subsequent renal perfusion by an uninjured accessory renal artery allowing for renal preservation...
June 14, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29908046/sepsis-induced-acute-kidney-injury-a-disease-of-the-microcirculation
#4
Shuai Ma, Roger G Evans, Naoya Iguchi, Marianne Tare, Helena C Parkington, Rinaldo Bellomo, Clive N May, Yugeesh R Lankadeva
Acute kidney injury (AKI) is a common complication of sepsis and is significantly associated with mortality. Sepsis accounts for more than 50% of the cases of AKI, with a mortality rate of up to 40%. The pathogenesis of septic AKI is complex, but there is emerging evidence that, at least in the first 48 hours, the defects may be functional rather than structural in nature. For example, septic AKI is associated with an absence of histopathological changes, but with microvascular abnormalities and tubular stress...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29907130/acute-kidney-injury-is-associated-with-a-decrease-in-cortical-renal-perfusion-during-septic-shock
#5
Anatole Harrois, Nicolas Grillot, Samy Figueiredo, Jacques Duranteau
BACKGROUND: Renal perfusion status remains poorly studied at the bedside during septic shock. We sought to measure cortical renal perfusion in patients with septic shock during their first 3 days of care using renal contrast enhanced ultrasound (CEUS). METHODS: We prospectively included 20 ICU patients with septic shock and 10 control patients (CL) without septic shock admitted to a surgical ICU. Cortical renal perfusion was evaluated with CEUS during continuous infusion of Sonovue (Milan, Italy) within the first 24 h (day 0), between 24 and 48 h (day 1) and after 72 h (day 3) of care...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29897282/divergent-effects-of-aki-to-ckd-models-on-inflammation-and-fibrosis
#6
Laurence Black, Jeremie M Lever, Amie M Traylor, Bo Chen, Zhengqin Yang, Stephanie Esman, Yanlin Jiang, Gary Cutter, Ravindra Boddu, James George, Anupam Agarwal
Chronic kidney disease (CKD) is a condition with significant morbidity and mortality that affects 15% of adults in the United States. One cause of CKD is acute kidney injury (AKI), which commonly occurs secondary to sepsis, ischemic events, and drug-induced nephrotoxicity. Unilateral ischemia-reperfusion injury (UIRI) without contralateral nephrectomy (CLN) and repeated low dose cisplatin (RLDC) models of AKI to CKD demonstrate responses characteristic of the transition; however, previous studies have not effectively compared the pathogenesis...
June 13, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29897275/editor-s-choice-diuretic-resistance-in-acute-heart-failure
#7
Frederik H Verbrugge
Diuretic resistance is a powerful predictor of adverse outcome in acute heart failure (AHF), irrespectively of underlying glomerular filtration rate. Metrics of diuretic efficacy such as natriuresis, urine output, weight loss, net fluid balance, or fractional sodium excretion, differ in their risk for measurement error, convenience, and biological plausibility, which should be taken into account when interpreting their results. Loop diuretic resistance in AHF has multiple causes including altered drug pharmacokinetics, impaired renal perfusion and effective circulatory volume, neurohumoral activation, post-diuretic sodium retention, the braking phenomenon and functional as well as structural adaptations in the nephron...
June 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29897100/controlled-hypotension-versus-normotensive-resuscitation-strategy-for-people-with-ruptured-abdominal-aortic-aneurysm
#8
REVIEW
Daniel H Moreno, Daniel G Cacione, Jose Cc Baptista-Silva
BACKGROUND: An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair...
June 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29896798/renal-effects-of-norepinephrine-induced-variations-in-mean-arterial-pressure-after-liver-transplantation-a-randomized-cross-over-trial
#9
J Skytte Larsson, G Bragadottir, B Redfors, S-E Ricksten
BACKGROUND: Acute kidney injury is commonly seen after liver transplantation. The optimal perioperative target mean arterial pressure (MAP) for renal filtration, perfusion and oxygenation in liver recipients is not known. The effects of norepinephrine-induced changes in MAP on renal blood flow (RBF), oxygen delivery (RDO2 ), glomerular filtration rate (GFR) and renal oxygenation (=renal oxygen extraction, RO2 Ex) were therefore studied early after liver transplantation. METHODS: Ten patients with an intra- and post-operative vasopressor-dependent systemic vasodilation were studied early after liver transplantation during sedation and mechanical ventilation...
June 12, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29893677/prospective-randomized-un-blinded-three-arm-controlled-study-in-coronary-artery-revascularization-with-minimal-invasive-extracorporeal-circulation-systems-miecc-surrogate-parameter-analysis-of-biocompatibility
#10
Arndt H Kiessling, Harald Keller, Anton Moritz
OBJECTIVES: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused by, the reduced priming volume and hemodilution, or the avoidance of blood-air contact and dispersion of mediastinal debris into the systemic circulation. The aim of the trial was the comparison of MiECC to an open ECC setup (openECC) or a system with reduced blood air and debris interaction (closeECC)...
May 16, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29892792/the-renal-blood-flow-reserve-in-healthy-humans-and-patients-with-atherosclerotic-renovascular-disease-measured-by-positron-emission-tomography-using-15-o-h-2-o
#11
Johanna Päivärinta, Niina Koivuviita, Vesa Oikonen, Hidehiro Iida, Kaisa Liukko, Ilkka Manner, Eliisa Löyttyniemi, Pirjo Nuutila, Kaj Metsärinne
BACKGROUND: Microvascular function plays an important role in ARVD (atherosclerotic renovascular disease). RFR (renal flow reserve), the capacity of renal vasculature to dilate, is known to reflect renal microvascular function. In this pilot study, we assessed PET (positron emission tomography)-based RFR values of healthy persons and renal artery stenosis patients. Seventeen patients with ARVD and eight healthy subjects were included in the study. Intravenous enalapril 1 mg was used as a vasodilatant, and the maximum response (blood pressure and RFR) to it was measured at 40 min...
June 11, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29891225/acute-kidney-injury-after-pediatric-cardiac-surgery
#12
REVIEW
Shi-Min Yuan
Acute kidney injury (AKI) is a common complication of pediatric cardiac surgery and is associated with increased morbidity and mortality. Literature of AKI after pediatric cardiac surgery is comprehensively reviewed in terms of incidence, risk factors, biomarkers, treatment and prognosis. The novel RIFLE (pediatric RIFLE for pediatrics), Acute Kidney Injury Network (AKIN) and Kidney Disease Improving Global Outcomes (KDIGO) criteria have brought about unified diagnostic standards and comparable results for AKI after cardiac surgery...
March 30, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29887980/a-case-of-chronic-ulcer-due-to-subcutaneous-arteriolosclerosis-in-an-obese-patient-mimicking-pyoderma-gangrenosum
#13
Sezin Fıçıcıoğlu, Nuray Can, Busem Tutuğ
The differential diagnosis of chronic ulcers covers a wide range of diseases and poses a diagnostic challenge. Subcutaneous ischemic arteriolosclerosis can lead to local ischaemia and ulceration as a result of arteriolar narrowing and reduction of tissue perfusion. This pathophysiological feature can be seen in eutrophication (nonuremic calciphylaxis) in morbid obesity, hypertensive ischemic leg ulcer (Martorell ulcer) and calciphylaxis in chronic renal insufficiency. All of the ulcers happened in this way can be wrongly diagnosed as pyoderma gangrenosum because of clinical similarity and inadequate biopsies...
April 23, 2018: Dermatology Reports
https://www.readbyqxmd.com/read/29886155/multi-organ-assessment-of-compensated-cirrhosis-patients-using-quantitative-magnetic-resonance-imaging
#14
Christopher R Bradley, Eleanor F Cox, Robert A Scott, Martin W James, Phillip Kaye, Guruprasad P Aithal, Susan T Francis, Indra Neil Guha
BACKGROUND AND AIMS: Advancing liver disease results in deleterious changes in a number of critical organs. The ability to measure structure, blood flow and tissue perfusion within multiple organs in a single scan has implications for determining the balance of benefit versus harm for therapies. Our aim was to establish the feasibility of Magnetic Resonance Imaging to assess changes in compensated cirrhosis (CC), and relate this to disease severity and future liver related outcomes (LROs)...
June 7, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29883813/comparative-analysis-of-two-porcine-kidney-decellularization-methods-for-maintenance-of-functional-vascular-architectures
#15
Joao Paulo Zambon, In Kap Ko, Mehran Abolbashari, Jennifer Huling, Cara Clouse, Tae Hyoung Kim, Charesa Smith, Anthony Atala, James J Yoo
Kidney transplantation is currently the only definitive solution for the treatment of end-stage renal disease (ESRD), however transplantation is severely limited by the shortage of available donor kidneys. Recent progress in whole organ engineering based on decellularization/recellularization techniques has enabled pre-clinical in vivo studies using small animal models; however, these in vivo studies have been limited to short-term assessments. We previously developed a decellularization system that effectively removes cellular components from porcine kidneys...
June 5, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29882159/prognostic-value-of-myocardial-perfusion-imaging-performed-pre-renal-transplantation-post-transplantation-follow-up-and-outcomes
#16
Christopher W Ives, Wael A AlJaroudi, Vineeta Kumar, Ayman Farag, Dana V Rizk, Suzanne Oparil, Ami E Iskandrian, Fadi G Hage
PURPOSE: Noninvasive stress testing is commonly performed as part of pre-renal transplantation (RT) evaluation. We evaluated the prognostic value of myocardial perfusion imaging (MPI)-myocardial perfusion, left ventricular ejection fraction (LVEF) and heart rate response (HRR)-post-RT. METHODS: Consecutive RT recipients were identified at our institution. MPI was considered abnormal when there was a perfusion defect or reduced ejection fraction. HRR to vasodilator stress was calculated as percentage change from baseline...
June 7, 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29878499/the-future-of-marginal-kidney-repair-in-the-context-of-normothermic-machine-perfusion
#17
Jenna R DiRito, Sarah A Hosgood, Gregory T Tietjen, Michael L Nicholson
Normothermic machine perfusion (NMP) is a technique that utilizes extra-corporeal membrane oxygenation to recondition and repair kidneys at near body temperature prior to transplantation. The application of this new technology has been fuelled by a significant increase in the use of the kidneys donated after circulatory death (DCD), which are more susceptible to ischaemic injury. Preliminary results indicate that normothermic machine perfusion itself may be able to repair marginal organs prior to transplantation...
June 7, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29877961/endovascular-perfusion-augmentation-for-critical-care-partial-aortic-occlusion-for-treatment-of-severe-ischemia-reperfusion-shock
#18
M Austin Johnson, Emily M Tibbits, Guillaume L Hoareau, Meryl A Simon, Anders J Davidson, Erik S DeSoucy, E Robert Faulconer, J Kevin Grayson, Lucas P Neff, Timothy K Williams
BACKGROUND: The resuscitation of patients in shock is materially intensive and many patients are refractory to maximal therapy. We hypothesized that partial inflation of an intra-aortic balloon, termed Endovascular Perfusion Augmentation for Critical Care (EPACC), would minimize material requirements while improving physiologic metrics. METHODS: Swine underwent a 25% controlled bleed and 45 minutes of complete aortic occlusion to create a severe ischemia-reperfusion shock state...
June 5, 2018: Shock
https://www.readbyqxmd.com/read/29872089/ccl2-deficiency-protects-against-chronic-renal-injury-in-murine-renovascular-hypertension
#19
Sonu Kashyap, Mazen Osman, Christopher M Ferguson, Meryl C Nath, Bhaskar Roy, Karen R Lien, Karl A Nath, Vesna D Garovic, Lilach O Lerman, Joseph P Grande
Inflammation plays an important role in the pathogenesis of renal and cardiovascular disease in renovascular hypertension (RVH). Ccl2 is an important mediator of inflammation, and is induced within 24 hours following surgery to establish RVH in the murine 2 kidney 1 clip model, a time prior to onset of interstitial inflammation, fibrosis, or tubular atrophy. We tested the hypothesis that Ccl2 deficiency protects the stenotic kidney (STK) from development of chronic renal damage in mice with renovascular hypertension due to renal artery stenosis (RAS)...
June 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29870992/assessment-of-renal-pathological-changes-in-lupus-nephritis-using-diffusion-weighted-imaging-a-multiple-correspondence-analysis
#20
Zhenfeng Zheng, Tiekun Yan, Junya Jia, Dong Li, Li Wei, Wenya Shang, Zhenfeng Zheng
BACKGROUND/AIMS: Renal pathological changes affect the motion of water molecules, which can be detected using diffusion-weighted imaging (DWI). The current study was performed to explore the correlation between renal tissue pathological injuries and DWI iconographical parameters in lupus nephritis (LN). METHODS: Twenty adult patients with LN and 11 healthy volunteers were recruited. Patients with LN received renal biopsies and renal DWI-MRI inspections. The renal biopsy tissues were characterized based on the ISN/RPS 2003 classification...
May 30, 2018: Kidney & Blood Pressure Research
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