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https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#1
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27903511/cardiac-remodeling-and-increased-central-venous-pressure-underlie-elevated-stroke-volume-and-cardiac-output-of-seawater-acclimated-rainbow-trout
#2
Jeroen Brijs, Erik Sandblom, Esmée Dekens, Joacim Näslund, Andreas Ekström, Michael Axelsson
Substantial increases in cardiac output (CO), stroke volume (SV) and gastrointestinal blood flow are essential for euryhaline rainbow trout (Oncorhyncus mykiss) osmoregulating in seawater. However, the underlying hemodynamic mechanisms responsible for these changes are unknown. By examining a range of circulatory and cardiac morphological variables of seawater- and freshwater-acclimated rainbow trout, the present study revealed a significantly higher central venous pressure (CVP) in seawater-acclimated trout (~0...
November 30, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27896794/efficacy-and-safety-of-ultrasound-guided-placement-of-central-venous-port-systems-via-the-right-internal-jugular-vein-in-elderly-oncologic-patients-our-single-center-experience-and-protocol
#3
Alfonso Canfora, Claudio Mauriello, Antonio Ferronetti, Gianpaolo Marte, Vittorio Di Maio, Guido Ciorra, Maria Grazia Esposito, Maria Elena Giuliano, Giovanni Fregola, Luigi Barra, Salvatore Cuzzovaglia, Vincenzo Bottino, Pietro Maida
BACKGROUND: Ultrasound-guidance has become the routine method for internal jugular vein (IJV) catheterization reducing dramatically failure and complication rates for central venous port (CVP) placement. AIMS: The aim of this study was to determine the safety and efficacy of ultrasound-guided IJV CVP placement in elderly oncologic patients. METHODS: Between January 2013 and December 2015, 101 elderly oncological patients underwent right IJV CVP placement under ultrasound-guidance...
November 28, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27892791/cardiovascular-profile-score-as-a-predictor-of-acute-intrapartum-non-reassuring-fetal-status-in-infants-with-congenital-heart-defects
#4
Takekazu Miyoshi, Shinji Katsuragi, Reiko Neki, Ken-Ichi Kurosaki, Isao Shiraishi, Michikazu Nakai, Kunihiro Nishimura, Jun Yoshimatsu, Tomoaki Ikeda
OBJECTIVES: To investigate the predictive factors of urgent cesarean delivery (CD) due to acute intrapartum non-reassuring fetal status (NRFS) in infants with congenital heart defects (CHDs). STUDY DESIGN: This was a retrospective review of 199 singletons prenatally diagnosed with a CHD and for whom vaginal delivery was attempted in our institution between 2007 and 2014. A cardiovascular profile (CVP) score was used to assess fetal heart failure. RESULTS: The number of urgent CDs due to NRFS was 37 (18...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27882024/outcomes-of-first-line-chemotherapy-in-patients-with-chronic-lymphocytic-leukemia
#5
Adil Nazir, Fawad, Sheeraz Ali, Farhana Badar, Neelam Siddique, Abdul Hameed
OBJECTIVE: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease in terms of survival with and without treatment. Many chemo and immunotherapeutic agents are available to treat this indolent disease. Aim of this study was to determine the outcomes of patients with chronic lymphocytic leukemia treated with different available chemotherapeutic regimens. METHODS: All patients with diagnosis of CLL from 2008 to 2013 were included. Data were collected from hospital information system...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27882019/plasma-bnp-level-combined-with-surgical-apgar-score-to-predict-operative-major-cardiac-adverse-events-in-malignant-obstructive-jaundice-patients
#6
Wei Yu, Changshan Huang, Qian Wang, Erjiang Zhao, Yuechao Ding, Tao Huang, Chao Ma, Bo Meng
OBJECTIVE: To investigate the predictive effect of major adverse cardiac events (MACE) in malignant obstructive jaundice (OJ) patients using plasma brain natriuretic peptide (BNP) level and surgical Apgar scoring (SAS) system. METHODS: Forty one malignant OJ patients undergoing surgical treatments were studied at a single center. Pre-and postoperative plasma BNP level, total bilirubin (TBil) and data of cardiac function (HR, CVP, CI, LVEF%) were detected, the SAS was calculated during the surgery, the relationship of both plasma BNP level and SAS with MACE after surgery was analyzed...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27878445/can-non-invasive-ventilation-modify-central-venous-pressure-comparison-between-invasive-measurement-and-ultrasonographic-evaluation
#7
Maurizio Zanobetti, Alessio Prota, Alessandro Coppa, Laura Giordano, Sofia Bigiarini, Peiman Nazerian, Francesca Innocenti, Alberto Conti, Federica Trausi, Simone Vanni, Giuseppe Pepe, Riccardo Pini
Central venous pressure (CVP) is primarily measured to assess intravascular volume status and heart preload. In clinical practice, the measuring device most commonly used in emergency departments and intensive care units, is an electronic transducer that interconnects a central venous catheter (CVC) with a monitoring system. Non-invasive ventilation (NIV) consists in a breathing support that supplies a positive pressure in airways through a mask or a cask though not using an endotracheal prosthesis. In emergency settings, non-invasive ultrasonography evaluation of CVP, and hence of intravascular volume status entail the measurement by a subxiphoid approach of inferior vena cava diameter and its variations in relation to respiratory activity...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27873292/icu-management-based-on-picco-parameters-reduces-duration-of-mechanical-ventilation-and-icu-length-of-stay-in-patients-with-severe-thoracic-trauma-and-acute-respiratory-distress-syndrome
#8
Zhong Yuanbo, Wang Jin, Shi Fei, Long Liangong, Liu Xunfa, Xu Shihai, Shan Aijun
BACKGROUND: This study aimed to assess whether a management algorithm using data obtained with a PiCCO system can improve clinical outcomes in critically ill patients with acute respiratory distress syndrome (ARDS). RESULTS: The PaO2/FiO2 ratio increased over time in both groups, with a sharper increase in the PiCCO group. There was no difference in 28-day mortality (3.2 vs. 3.6%, P = 0.841). Days on mechanical ventilation (3 vs. 5 days, P = 0.002) and ICU length of stay (6 vs...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27872408/active-expiration-and-the-measurement-of-central-venous-pressure
#9
Sheldon Magder, Karim Serri, Sara Verscheure, Renée Chauvin, Peter Goldberg
PURPOSE: To obtain a point prevalence estimate of alterations in central venous pressure (CVP) produced by active expiration in a consecutive series of intensive care patients. METHODS: We evaluated CVP tracings taken by the nurses at their morning shift change in a consecutive series of 60 cardiac surgery and 59 noncardiac surgery patients. We also assessed change in values due to the change in transducer level. Three physicians and a nurse instructor independently reviewed the tracings and determined whether there was evidence of forced expiration and whether it was type A, defined by decreasing CVP during expiration, or type B, defined by increasing CVP during expiration...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27850585/947-comparison-of-pes-derived-and-cvp-derived-transpulmonary-pressure-in-immobilized-hypoxemic-children
#10
Miyako Kyogoku, Muneyuki Takeuchi, Yoshiyuki Shimizu, Takeshi Hatachi, Kazue Moon, Kazuya Tachibana
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27819002/diagnosis-accuracy-of-mean-arterial-pressure-variation-during-a-lung-recruitment-maneuver-to-predict-fluid-responsiveness-in-thoracic-surgery-with-one-lung-ventilation
#11
Woon-Seok Kang, Chung-Sik Oh, Chulmin Park, Bo Mi Shin, Tae-Gyoon Yoon, Ka-Young Rhee, Nam-Sik Woo, Seong-Hyop Kim
: Background. Lung recruitment maneuver (LRM) during thoracic surgery can reduce systemic venous return and resulting drop in systemic blood pressure depends on the patient's fluid status. We hypothesized that changes in systemic blood pressure during the transition in LRM from one-lung ventilation (OLV) to two-lung ventilation (TLV) may provide an index to predict fluid responsiveness. Methods. Hemodynamic parameters were measured before LRM (T0); after LRM at the time of the lowest mean arterial blood pressure (MAP) (T1) and at 3 minutes (T2); before fluid administration (T3); and 5 minutes after ending it (T4)...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27815151/right-atrial-pressure-in-the-critically-ill-how-to-measure-what-is-the-value-what-are-the-limitations
#12
REVIEW
Sheldon Magder
Right atrial pressure (Pra) is determined by the interaction of the function of the heart as a pump, called cardiac function, and the factors that determine the return of blood to heart, called return function. Thus, monitoring Pra or its surrogate, central venous pressure (CVP), can give important insights into mechanisms behind changes in hemodynamic status, responses to interventions, and the likelihood of diagnoses. Examination of the components of the Pra tracing, especially during the ventilator cycle, also can give information about right heart diastolic function, status of the tricuspid valve, volume responsiveness and the cardiac rhythm...
November 1, 2016: Chest
https://www.readbyqxmd.com/read/27788791/intraoperative-pleth-variability-index-is-linked-to-delayed-graft-function-after-kidney-transplantation
#13
O Collange, L Jazaerli, A Lejay, C Biermann, S Caillard, B Moulin, N Chakfe, F Severac, M Schaeffer, P-M Mertes, A Steib
BACKGROUND: Delayed graft function (DGF) is an early postoperative complication of kidney transplantation (KT) predisposing to acute rejection and lower graft survival. Intraoperative arterial hypotension and hypovolemia are associated with DGF. Central venous pressure (CVP) is used to estimate volemia but its reliability has been criticized. Pleth variability index (PVI) is a hemodynamic parameter predicting fluid responsiveness. The aim of this study was to examine the relationship between intraoperative PVI and CVP values and the occurrence of DGF...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27777780/initial-central-venous-pressure-could-be-a-prognostic-marker-for-hemodynamic-improvement-of-polymyxin-b-direct-hemoperfusion-a-retrospective-cohort-study
#14
Hiroyuki Yamada, Tatsuo Tsukamoto, Hiromichi Narumiya, Kazumasa Oda, Satoshi Higaki, Ryoji Iizuka, Motoko Yanagita, Masako Deguchi
BACKGROUND: Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) could improve the hemodynamic status of septic shock patients. As PMX-DHP is an invasive and costly procedure, it is desirable to estimate the therapeutic effect before performing the therapy. However, it is still unclear when this therapy should be started and what type of sepsis it should be employed for. In this study, we retrospectively examined the clinical effect of patients treated with PMX-DHP by using central venous pressure (CVP)...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27773651/micro-scale-variability-enhances-trophic-transfer-and-potentially-sustains-biodiversity-in-plankton-ecosystems
#15
Anupam Priyadarshi, Sandip Mandal, S Lan Smith, Hidekatsu Yamazaki
We develop moment closure approximations to represent micro-scale spatial variability in the concentrations of nutrients (N), phytoplankton (P) and zooplankton (Z) in an NPZ model, which we apply to examine the impact of different levels of micro-scale variability on both ecosystem dynamics and trophic transfer. Accounting explicitly for both the mean-field and fluctuating components of each prognostic variable in the NPZ model yields different dynamics for the mean-field concentrations, as well as lower phytoplankton biomass and greater zooplankton biomass, compared to the conventional NPZ model without micro-scale variability...
October 20, 2016: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/27773456/clinical-hemodynamic-evaluation-of-patients-implanted-with-a-fully-magnetically-levitated-left-ventricular-assist-device-heartmate-3
#16
Nir Uriel, Sirtaz Adatya, Jiří Malý, Eric Kruse, Daniel Rodgers, Gerald Heatley, Aleš Herman, Poornima Sood, Dominik Berliner, Johann Bauersachs, Axel Haverich, Michael Želízko, Jan D Schmitto, Ivan Netuka
BACKGROUND: The HeartMate 3 (HM3) is a Conformiteé Européenne (CE) mark-approved left ventricular assist device (LVAD) with a fully magnetically levitated rotor with features consisting of a wide range of operational speeds, wide flow paths and an artificial pulse. We performed a hemodynamic and echocardiographic evaluation of patients implanted with the HM3 LVAD to assess the speed range for optimal hemodynamic support. METHODS: Sixteen HM3 patients underwent pump speed ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP] and blood pressure [BP]) and 3-dimensional echocardiography (3DE)...
July 17, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27765101/-nasopharyngeal-changes-in-8-13-years-old-healthy-children-in-china-a-longitudinal-study
#17
S S Liu, J R Deng, D S Wang, X Gong, Y H Zhou, X M Gao
Objective: Nasopharynx is an important compartment of the upper airway. It is closely associated with the characteristic craniofacial skeletal pattern related to sleep breathing. The present study aimed to investigate the growth pattern of the nasopharynx during rapid puberty growth period. Methods: Thirty non-snoring children (aged 8 to 11 years old) were selected by means of questionnaires and clinical examination. Periodic yearly follow up using MRI, lateral cephalogram, and polysomnograph (PSG) was done in these children...
October 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/27762259/inferior-vena-cava-collapsibility-index-is-a-valuable-and-non-invasive-index-for-elevated-general-heart-end-diastolic-volume-index-estimation-in-septic-shock-patients
#18
Jie Zhao, Guolin Wang
BACKGROUND This study aimed to investigate the relationship between the inferior vena cava respirophasic variation (IVC collapsibility index [IVCCI]) and the general heart end-diastolic volume index (GEDVI). By determining the above relationship, we could evaluate the utility of IVCCI as an indicator. MATERIAL AND METHODS Forty-two septic patients were finally enrolled in this study. The inferior vena cava's diameter was measured with the largest at the end of expiration (IVC3) and with the smallest at the end of inspiration (IVCi) on the ultrasound (IVCCI=[(IVCD e - IVCD i)/IVCD e] ×100%)...
October 20, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27756543/analytical-and-biological-variability-in-biomarker-measurement-in-the-hispanic-community-health-study-study-of-latinos
#19
Bharat Thyagarajan, Annie Green Howard, Ramon Durazo-Arvizu, John H Eckfeldt, Marc D Gellman, Ryung S Kim, Kiang Liu, Armando J Mendez, Frank J Penedo, Gregory A Talavera, Marston E Youngblood, Lihui Zhao, Daniela Sotres-Alvarez
BACKGROUND: Biomarker variability, which includes within-individual variability (CVI), between-individual variability (CVG) and methodological variability (CVP+A) is an important determinant of our ability to detect biomarker-disease associations. Estimates of CVI and CVG may be population specific and little data exists on biomarker variability in diverse Hispanic populations. Hence, we evaluated all 3 components of biomarker variability in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) using repeat blood collections (n=58) and duplicate blood measurements (n=761-929 depending on the biomarker)...
October 15, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27737348/noradrenaline-and-dobutamine-effects-on-the-volume-expansion-with-normal-saline-in-rabbits-subjected-to-hemorrhage
#20
Gualter Lisboa Ramalho, Matheus Fachini Vane, Luciana Cavalcanti Lima, Lucas Fachini Vane, Rosa Beatriz Amorim, Maria Aparecida Domingues, José Mariano Soares de Moraes, Lídia Raquel de Carvalho, Pedro Paulo Tanaka, Luiz Antonio Vane
PURPOSE: To evaluate the effects of dobutamine (DB), noradrenaline (NA), and their combination (NADB), on volume retention in rabbits submitted to hemorrhage. METHODS: Thirty six rabbits were randomly divided into 6 groups: SHAM, Control, Saline, DB, NA, DB+NA. All the animals, except for SHAM, were subjected to hemorrhage of 25% of the calculated blood volume. Control animals were replaced with their own blood. The other groups received NSS 3 times the volume withdrawn...
September 2016: Acta Cirúrgica Brasileira
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