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https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#1
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#2
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28050480/comparison-of-dexmedetomidine-propofol-versus-fentanyl-propofol-on-insertion-conditions-of-proseal-laryngeal-mask-airway
#3
Shalaka Sandeep Nellore, Abhijeet Dattatray Waychal, Preeti Sachin Rustagi
INTRODUCTION: Proseal Laryngeal Mask Airway (PLMA) is a newer supraglottic airway device that requires adequate depth of anaesthesia and suppression of upper airway reflexes thereby providing optimal insertion conditions. AIM: To compare dexmedetomidine and fentanyl for co-induction with propofol with respect to PLMA insertion conditions, haemodynamic variation and the total dose requirement of propofol. MATERIALS AND METHODS: This was a prospective randomized double-blinded study conducted in 60 cases of American Society of Anaesthesiologists (ASA) class I/II undergoing elective surgery under general anaesthesia...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28050479/dexmedetomidine-in-attenuation-of-haemodynamic-response-and-dose-sparing-effect-on-opioid-and-anaesthetic-agents-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-study
#4
Nandlal Bhagat, Md Yunus, Habib Md Reazaul Karim, Ranendra Hajong, Prithwis Bhattacharyya, Manorama Singh
INTRODUCTION: Perioperative procedures are stressful and lead to haemodynamic instability with potentially devastating consequences. Dexmedetomidine is found to have many of the desired characteristics that are required in perioperative period. AIM: To evaluate the ability of pre and intraoperative dexmedetomidine to attenuate stress induced haemodynamic responses, quantifying the anaesthetic agents sparing as well as its cost-effectiveness in patients undergoing laparoscopic cholecystectomy...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28044333/haemodynamic-monitoring-in-the-peri-operative-period-the-past-the-present-and-the-future
#5
REVIEW
X Watson, M Cecconi
Over recent years there has been an increase in the implementation of goal-directed therapy using minimally invasive haemodynamic monitoring techniques to guide peri-operative care. Since the introduction of the pulmonary artery flotation catheter in the 1980s, various haemodynamic monitors have been developed, each associated with their own benefits and limitations. Goal-directed therapy has been well-established as a standard of care in the peri-operative period and has largely been associated with a reduction in morbidity and mortality...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28025312/performance-of-the-labcor-dokimos-plus-pericardial-aortic-prosthesis-a-single-centre-experience
#6
Rashad Zayat, Jessica Arias-Pinilla, Ali Aljalloud, Giulia Musetti, Andreas Goetzenich, Rüdiger Autschbach, Thomas van Gemmeren, Andreas Niedeggen, Nima Hatam
OBJECTIVES: In patients with a small aortic annulus, aortic valve replacement (AVR) is frequently associated with high residual pressure gradients. Supra-annular pericardial aortic prostheses are gaining popularity due to the increased effective orifice areas (EOA) and resulting lower gradients. This study reports the clinical and echocardiographic results following implantation of the new supra-annular pericardial aortic prosthesis Dokimos Plus (Labcor, Belo Horizonte, Brazil). METHODS: Between October 2013 and July 2015, 137 patients (41% women, mean age: 74 years) underwent supra-annular AVR with or without concomitant procedures using the Dokimos Plus prosthesis in our department...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28011801/impact-of-haemodynamic-sonr-sensor-on-monitoring-of-left-ventricular-function-in-patients-undergoing-cardiac-resynchronization-therapy
#7
Stefania Sacchi, Paolo Pieragnoli, Giuseppe Ricciardi, Gino Grifoni, Luigi Padeletti
AIMS: The haemodynamic SonR sensor is able to measure myocardial contractility. The isometric effort is useful in quantifying left ventricular (LV) performance. We investigated the amplitude changes in SonR signal over time and during static exercise according to the recovery of the left ventricle. METHODS AND RESULTS: Twenty five patients [18 male, 70 ± 8 years, LV ejection fraction (LVEF) 29 ± 5%, in sinus rhythm] underwent biventricular SonR implantable cardioverter defibrillator implant...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28007877/mechanical-reperfusion-with-leucocyte-filtered-blood-does-not-prevent-injury-following-global-cerebral-ischaemia
#8
Rickard P F Lindblom, Thomas Tovedal, Bo Norlin, Lars Hillered, Svetlana N Popova, Irina Alafuzoff, Stefan Thelin
OBJECTIVES: Prolonged global cerebral ischaemia leads to irreversible injury, often with lethal outcome. Brain injuries are partly caused by the uncontrolled reperfusion that occurs once the circulation is re-established. Recent animal experiments suggest that controlled reperfusion following lengthy ischaemia might prevent severe brain injury. This study aimed at further exploring cerebral alterations and outcome following prolonged global cerebral ischaemia and mechanically manipulated reperfusion...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28002069/assessment-of-a-smartphone-app-capstesia-for-measuring-pulse-pressure-variation-agreement-between-two-methods-a-cross-sectional-study
#9
Borja Barrachina, Raquel Cobos, Noemi Mardones, Angel Castañeda, Cristina Vinuesa
BACKGROUND: Less invasive and noninvasive methods are emerging for haemodynamic monitoring. Among them is Capstesia, a smartphone app that, from photographs of a patient monitor showing invasive arterial pressure, estimates advanced haemodynamic variables after digitising and analysing the pressure curves. OBJECTIVE: The aim of this study was to compare the level of agreement between the analysis of the signals obtained from the patient monitor and a photograph of the same images using the Capstesia app...
February 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27999663/implementation-of-goal-directed-fluid-therapy-during-hip-revision-arthroplasty-a-matched-cohort-study
#10
Marit Habicher, Felix Balzer, Viktor Mezger, Jennifer Niclas, Michael Müller, Carsten Perka, Michael Krämer, Michael Sander
BACKGROUND: Several randomized controlled trials (RCTs) have demonstrated that intraoperative goal-directed fluid therapy (GDFT) can decrease postsurgical complications in patients undergoing major abdominal surgery. However, very few studies have demonstrated the value of goal-directed therapy (GDT) in patients undergoing orthopaedic surgery and confirmed it is as useful in real-life conditions. Therefore, we initiated a GDFT implementation programme in patients undergoing hip revision arthroplasty in order to assess its effects on postoperative complications (e...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27998626/cardiac-biomarkers-and-haemodynamically-significant-patent-ductus-arteriosus-in-preterm-infants
#11
Dany E Weisz, Patrick J McNamara, Afif El-Khuffash
Accurately defining haemodynamically significant patent ductus arteriosus (PDA) in preterm infants who are at risk of PDA related morbidities are active areas of neonatal research. Natriuretic peptides are cardiac hormones that respond to volume and pressure loading, with elevated plasma levels found in infants with PDA. In the preterm neonatal setting, studies to date have predominantly investigated the ability of these biomarkers to discriminate between infants with and without a PDA at various postnatal ages...
December 17, 2016: Early Human Development
https://www.readbyqxmd.com/read/27987218/the-effects-of-tracheal-tube-cuffs-filled-with-air-saline-or-alkalinised-lidocaine-on-haemodynamic-changes-and-laryngotracheal-morbidity-in-children-a-randomised-controlled-trial
#12
S M F Soares, V M Arantes, M P Módolo, V J B Dos Santos, L A Vane, L H Navarro E Lima, L G Braz, P do Nascimento, N S P Módolo
We studied the effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes during tracheal extubation and postoperative laryngotracheal morbidity in children. We randomly allocated 164 children aged 3-13 years undergoing general anaesthesia to one of four groups; tracheal tube cuffs filled with air (n = 41); saline (n = 41); alkalinised lidocaine 0.5% (n = 41); or alkalinised lidocaine 1% (n = 41). Intracuff pressure was monitored and maintained below 20 cmH2 O. The mean (SD) increases in systolic blood pressure after tracheal extubation compared with before extubation were 10...
December 17, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27984414/noninvasive-assessment-of-haemodynamics-in-resistant-hypertension-the-role-of-the-renal-resistive-index
#13
Konstantinos Kintis, Costas Tsioufis, Alexandros Kasiakogias, Kyriakos Dimitriadis, Dimitris Konstantinidis, Eirini Andrikou, Ioannis Andrikou, Sotirios Patsilinakos, Dimitris Petras, Demetrios Vlahakos, Dimitris Tousoulis
OBJECTIVE: The association of resistant hypertension (RHTN) with renal haemodynamics is unclear. Our aim was to evaluate differences in haemodynamic characteristics of patients with RHTN compared with patients with controlled hypertension (HTN) at the level of the heart, kidney and aorta. METHODS: We studied 50 patients with RHTN confirmed by ambulatory blood pressure monitoring and 50 controlled hypertensive patients matched for age and sex. All participants underwent renal Doppler ultrasound to determine the renal resistive index (RRI), a complete echocardiographic study including measurements of diastolic function and evaluation of augmentation index...
December 14, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27942061/anaesthetic-challenges-in-conjoined-twins-separation-surgery
#14
Suvarna Kaniyil, Priyanka Pavithran, K K Mubarak, Taznim Mohamed
Conjoined twins are a rare congenital anomaly of unknown aetiology. We report the successful anaesthetic management of separation of ischiopagus tetrapus conjoined twins. The importance of a multidisciplinary approach, thorough pre-operative evaluation and planning, vigilant monitoring and anticipation of complications such as massive blood and fluid loss, haemodynamic instability, hypothermia and intensive, post-operative care are emphasised.
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27940452/perioperative-goal-directed-haemodynamic-therapy-based-on-flow-parameters-a-concept-in-evolution
#15
L Meng, P M Heerdt
Haemodynamic management incorporating direct or surrogate stroke volume monitoring has experienced a rapid evolution, because of emergence of the "goal-directed therapy" concept and technological developments aimed at providing a parameter leading to the goal. Nonetheless, consensus on both definitions of the ideal "goal" and strategies for achieving it remain elusive. For this review, we first consider basic physiological and patient monitoring factors relevant to the concept of "fluid responsiveness", and then focus upon randomized controlled trials and meta-analyses involving goal-directed haemodynamic therapy based on various flow parameters...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27938936/perioperative-medicine-and-the-role-of-haemodynamic-monitoring
#16
S C Ng, M Mythen
No abstract text is available yet for this article.
December 8, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27931651/effects-of-vasodilators-on-haemodynamic-coherence
#17
REVIEW
Christian Fuchs, Christian Ertmer, Sebastian Rehberg
Vasodilators are a potential therapeutic option for patients with persisting microcirculatory disorders despite adequate cardiac output and mean arterial pressure due to conventional haemodynamic stabilization. Venous vasodilation may decrease post-capillary venular pressure and thus increase capillary flow resulting in reduced extravasation and oedema formation. Arteriolar vasodilation may increase microvascular flow by 'opening' the microcirculation. In particular, inodilators that combine vasodilation with positive inotropy may be promising...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931648/haemodynamic-coherence-in-perioperative-setting
#18
REVIEW
Andrea Carsetti, Ximena Watson, Maurizio Cecconi
Over the last decade, there has been an increased interest in the use of goal-directed therapy (GDT) in patients undergoing high-risk surgery, and various haemodynamic monitoring tools have been developed to guide perioperative care. Both the complexity of the patient and surgical procedure need to be considered when deciding whether GDT will be beneficial. Ensuring optimum tissue perfusion is paramount in the perioperative period and relies on the coherence between both macrovascular and microvascular circulations...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931646/haemodynamic-coherence-in-haemorrhagic-shock
#19
REVIEW
Nicolas Libert, Anatole Harrois, Jacques Duranteau
In case of haemorrhage, a combination of low volume fluid resuscitation and permissive hypotension is used to avoid the adverse effects of early aggressive fluid resuscitation. During this phase, occult microvascular hypoperfusion can possibly develop over time. After controlling the bleeding, it is expected that optimization of macrocirculation will result in an improvement in microcirculation. However, this is the case only without alterations in microcirculation regulation. Haemodynamic coherence must be maintained to expect the restoration of microcirculation through systemic haemodynamic-driven resuscitation...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931645/haemodynamic-coherence%C3%A2-%C3%A2-the-relevance-of-fluid-therapy
#20
REVIEW
Philip Arnemann, Laura Seidel, Christian Ertmer
The ultimate goal of fluid therapy is to improve the oxygenation of cells by improving the cardiac output, thus improving microcirculation by optimizing macrocirculation. This haemodynamic coherence is often altered in patients with haemorrhagic shock and sepsis. The loss of haemodynamic coherence is associated with adverse outcomes. It may be influenced by the mechanisms of the underlying disease and properties of different fluids used for resuscitation in these critically ill patients. Monitoring microcirculation and haemodynamic coherence may be an additional tool to predict the response to fluid administration...
December 2016: Best Practice & Research. Clinical Anaesthesiology
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