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Haemodynamic monitoring

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https://www.readbyqxmd.com/read/28733534/low-dose-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-cesarean-surgery-provides-better-intraoperative-somato-visceral-sensory-block-characteristcs-and-postoperative-analgesia
#1
Yong-Hong Bi, Xiao-Guang Cui, Rui-Qin Zhang, Chun-Yu Song, Yan-Zhuo Zhang
OBJECT: In this study, we aimed to investigate the beneficial effects of dexmedetomidine on somato-visceral sensory block characteristcs, postoperative analgesia and stress response of intrathecal bupivacaine administration in women undergoing cesarean section, and to find out which dose is better. METHODS: Sixty parturients with the American Society of Anesthesiologists (ASA) physical status I or II were anesthetized with intrathecal bupivacaine(10mg) alone or in combination with dexmedetomidine (3 μg and 5 μg) to undergo cesarean section...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28719470/diurnal-variation-and-repeatability-of-arterial-stiffness-and-cardiac-output-measurements-in-the-third-trimester-of-uncomplicated-pregnancy
#2
Mohamed W Osman, Francesca Leone, Mintu Nath, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
AIM: To investigate same day repeated measures and diurnal variation of arterial stiffness, cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) during the third trimester of normal pregnancy. METHODOLOGY: Pulse wave velocity (PWV) and augmentation index (AIx) were recorded using the Arteriograph, while CO, SV and TPR were recorded using noninvasive cardiac output monitoring. The measurements were obtained in the third trimester of pregnancy from 21 healthy pregnant women at four time points (morning, afternoon, evening and midnight) over a 24-h period...
July 14, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28705939/changes-in-pulmonary-exercise-haemodynamics-in-scleroderma-a-4-year-prospective-study
#3
Gabor Kovacs, Alexander Avian, Nora Wutte, Franz Hafner, Florentine Moazedi-Fürst, Sonja Kielhauser, Elisabeth Aberer, Marianne Brodmann, Winfried Graninger, Vasile Foris, Andrea Olschewski, Horst Olschewski
Pulmonary arterial hypertension (PAH) is a feared complication of systemic sclerosis. In this prospective cohort study, we monitored the changes in resting and exercise pulmonary haemodynamics of scleroderma patients without initial PAH over a mean follow-up period of ∼4 years.All patients underwent exercise echocardiography and cardiopulmonary exercise testing at baseline and follow-up. A subgroup underwent exercise right heart catheter (RHC) investigations. The primary end-point was the echocardiographic systolic pulmonary arterial pressure at 50 W exercise (sPAP50)...
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28698881/assessment-of-haemodynamic-response-to-nonselective-beta-blockers-in-portal-hypertension-by-phase-contrast-magnetic-resonance-angiography
#4
Natasha McDonald, David M L Lilburn, Neil J Lachlan, Gillian Macnaught, Dilip Patel, Arjun N A Jayaswal, Peter C Hayes, Scott I Semple, Jonathan A Fallowfield
A significant unmet need exists for accurate, reproducible, noninvasive diagnostic tools to assess and monitor portal hypertension (PHT). We report the first use of quantitative MRI markers for the haemodynamic assessment of nonselective beta-blockers (NSBB) in PHT. In a randomized parallel feasibility study in 22 adult patients with PHT and a clinical indication for NSBB, we acquired haemodynamic data at baseline and after 4 weeks of NSBB (propranolol or carvedilol) using phase-contrast MR angiography (PC-MRA) in selected intra-abdominal vessels...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28693594/the-impact-of-phosphate-balanced-crystalloid-infusion-on-acid-base-homeostasis-palance-study-study-protocol-for-a-randomized-controlled-trial
#5
Judith-Irina Pagel, Nikolai Hulde, Tobias Kammerer, Michaela Schwarz, Daniel Chappell, Alexander Burges, Klaus Hofmann-Kiefer, Markus Rehm
BACKGROUND: This study aims to investigate the effects of a modified, balanced crystalloid including phosphate in a perioperative setting in order to maintain a stable electrolyte and acid-base homeostasis in the patient. METHODS/DESIGN: This is a single-centre, open-label, randomized controlled trial involving two parallel groups of female patients comparing a perioperative infusion regime with sodium glycerophosphate and Jonosteril® (treatment group) or Jonosteril® (comparator) alone...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28685438/functional-nirs-measurement-of-cytochrome-c-oxidase-demonstrates-a-more-brain-specific-marker-of-frontal-lobe-activation-compared-to-the-haemoglobins
#6
Isabel de Roever, Gemma Bale, Robert J Cooper, Ilias Tachtsidis
Functional near-infrared spectroscopy (fNIRS) is an increasingly common neuromonitoring technique used to observe evoked haemodynamic changes in the brain in response to a stimulus. The measurement is typically in terms of concentration changes of oxy- (∆HbO2) and deoxy- (∆HHb) haemoglobin. However, noise from systemic fluctuations in the concentration of these chromophores can contaminate stimulus-evoked haemodynamic responses, leading to misinterpretation of results. Short-separation channels can be used to regress out extracerebral haemodynamics to better reveal cerebral changes, significantly improving the reliability of fNIRS...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28655186/catheter-related-right-internal-jugular-vein-thrombosis-after-chest-surgery
#7
P-T Chen, K-C Chang, K-L Hu, C-K Ting, K-H Chan, W-K Chang
Background: Central venous catheters (CVCs) are frequently used for monitoring haemodynamic status and rapidly delivering fluid therapy during the peri- and postoperative periods. Indwelling CVCs are typically used 7-14 days postoperatively for additional monitoring and treatment, but patients may develop asymptomatic catheter-related thrombosis, leading to life-threatening pulmonary embolism and death. Early detection helps to avoid such complications. Methods: This prospective observational study investigated the risk factors associated with catheter-related right internal jugular vein thrombosis in patients undergoing chest surgery...
June 26, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28633375/final-5-year-clinical-and-echocardiographic-results-for-treatment-of-severe-aortic-stenosis-with-a-self-expanding-bioprosthesis-from-the-advance-study
#8
Ulrich Gerckens, Corrado Tamburino, Sabine Bleiziffer, Johan Bosmans, Peter Wenaweser, Stephen Brecker, Jia Guo, Axel Linke
Aims: The ADVANCE study was designed to evaluate the safety and effectiveness of transcatheter aortic valve implantation (TAVI) with a self-expanding bioprosthesis in real-world patients with symptomatic, severe aortic stenosis at high surgical risk for valve replacement. Methods and results: Study participants were enrolled from 44 experienced centres in 12 countries. Patient eligibility, treatment approach, and choice of anaesthesia were determined by the local Heart Team...
June 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28625300/preeclampsia-in-2017-obstetric-and-anaesthesia-management
#9
REVIEW
Ross Hofmeyr, Mushi Matjila, Robert Dyer
In many centres, anaesthesia now incorporates perioperative medicine. Preeclampsia is a perioperative medical challenge requiring a multi-disciplinary team. New definitions stress the rapid progression of the disease and highlight the importance of early detection. Anaesthesiologists should understand the pathophysiology of the disease and develop the ultrasound skills required to assist in the assessment of disease severity. This facilitates the choice of anaesthesia method and perioperative management in complicated cases...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#10
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28605474/digital-innovations-and-emerging-technologies-for-enhanced-recovery-programmes
#11
F Michard, T J Gan, H Kehlet
Enhanced recovery programmes (ERPs) are increasingly used to improve post-surgical recovery. However, compliance to various components of ERPs-a key determinant of success-remains sub-optimal. Emerging technologies have the potential to help patients and caregivers to improve compliance with ERPs.Preoperative physical condition, a major determinant of postoperative outcome, could be optimized with the use of text messages (SMS) or digital applications (Apps) designed to facilitate smoking cessation, modify physical activity, and better manage hypertension and diabetes...
June 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28605430/intravenous-retro-uterine-echographic-surveillance-of-the-foetus-during-surgical-thrombectomy-for-life-threatening-pulmonary-thromboembolism
#12
Shin Yajima, Shunsuke Saito, Koichi Toda, Yoshiki Sawa
Pulmonary thromboembolism is a life-threatening disease, particularly during pregnancy. We report a case of successful cardiopulmonary resuscitation followed by surgical thrombectomy in a 35-year-old woman at 28 weeks of gestation. Intracardiac echocardiography was percutaneously located behind the uterus, and greatly assisted monitoring of the foetal condition and haemodynamic status.
June 12, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28599199/the-haemodynamic-effects-of-bolus-versus-slower-infusion-of-intravenous-crystalloid-in-healthy-volunteers
#13
Ida F Ukor, Andrew K Hilton, Michael J Bailey, Rinaldo Bellomo
PURPOSE: This pilot study aimed to characterise the haemodynamic effect of 1L of IV normal saline (NS) administered as a rapid versus slow infusion on cardiac output (CO), heart rate (HR), systemic blood pressures, and carotid blood flow in six healthy volunteers. MATERIALS AND METHODS: Six healthy male volunteers aged 18-65years were randomized to receive 1L NS given over 30min or 120min. On a subsequent study session the alternate fluid regimen was administered...
May 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28586614/frequency-indications-and-complications-of-pulmonary-artery-catheter-insertion-in-adult-open-heart-surgery-patients-of-a-tertiary-care-hospital
#14
Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal
BACKGROUND: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28577077/-pain-therapy-during-labour
#15
REVIEW
Stefan Jochberger, Clemens Ortner, Klaus Ulrich Klein
To date the gold standard of treating labour pain is regional analgesia by application of epidural analgesia. When offering epidural analgesia, the programmed intermittent epidural bolus (PIEB) is more effective in terms of pain reduction, less motor blocks and higher satisfaction of the parturient compared to continuous application via perfusor pump. An upcoming alternative to epidural analgesia is remifentanil, a short acting and potent opioid. Remifentanil, however, requires haemodynamic monitoring as cardiac and respiratory impairment has been described...
June 2, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28575331/oesophageal-doppler-guided-goal-directed-haemodynamic-therapy-in-thoracic-surgery-a-single-centre-randomized-parallel-arm-trial
#16
K B Kaufmann, L Stein, L Bogatyreva, F Ulbrich, J T Kaifi, D Hauschke, T Loop, U Goebel
Background: Postoperative pulmonary and renal complications are frequent in patients undergoing lung surgery. Hyper- and hypovolaemia may contribute to these complications. We hypothesized that goal-directed haemodynamic management based on oesophageal Doppler monitoring would reduce postoperative pulmonary complications in a randomized clinical parallel-arm trial. Methods: One hundred patients scheduled for thoracic surgery were randomly assigned to either standard haemodynamic management (control group) or goal-directed therapy (GDT group) guided by an oesophageal Doppler monitoring-based algorithm...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28572613/mesenchymal-stem-cells-correct-haemodynamic-dysfunction-associated-with-liver-injury-after-extended-resection-in-a-pig-model
#17
Hans-Michael Tautenhahn, Sandra Brückner, Christiane Uder, Silvio Erler, Madlen Hempel, Martin von Bergen, Janine Brach, Sandra Winkler, Franziska Pankow, Claudia Gittel, Manja Baunack, Undine Lange, Johannes Broschewitz, Matthias Dollinger, Michael Bartels, Uta Pietsch, Kerstin Amann, Bruno Christ
In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. MSCs were infused through a central venous catheter and haemodynamic parameters as well as markers of acute kidney damage were monitored under intensive care conditions for 24 h post-surgery...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28556524/effects-of-comorbidity-and-medication-use-on-the-haemodynamic-status-during-office-based-laryngeal-procedures-a-prospective-cohort-study
#18
C T Wang, L J Liao, W C Lo, T W Huang, P W Cheng
OBJECTIVE: Office-based laryngeal procedures are emerging as effective alternative modalities for vocal disorders. This study systematically investigates the haemodynamic status of patients, specifically focusing on the potential effects of underlying comorbidity and medication use. DESIGN: Prospective cohort study. SETTING: Tertiary referral center. PARTICIPANTS: We prospectively recruited 214 consecutive patients who received office-based laryngeal procedures during January-December 2015...
May 29, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28543041/the-added-value-of-cardiac-index-and-pulse-pressure-variation-monitoring-to-mean-arterial-pressure-guided-volume-therapy-in-moderate-risk-abdominal-surgery-coguide-a-pragmatic-multicentre-randomised-controlled-trial
#19
J Stens, J-P Hering, C W P van der Hoeven, A Boom, H S Traast, L E Garmers, S A Loer, C Boer
There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre...
May 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28540781/haemodynamic-changes-during-hyperthermic-intra-thoracic-chemotherapy-for-pseudomyxoma-peritonei
#20
Nina Ashraf-Kashani, John Bell
PURPOSE: Hyperthermic intra-thoracic chemotherapy (HITOC) combined with cytoreductive surgery (CRS) is a novel approach in the management of pseuodmyxoma peritonei with thoracic extension. The haemodynamic effects of hyperthermic chemotherapy present an anaesthetic challenge. Here, we describe the haemodynamic changes seen during HITOC. MATERIALS AND METHODS: A retrospective case note review of adult patients undergoing CRS with HITOC from 2009 to 2016. Intra-operative haemodynamics were measured using the LIDCOrapid(TM) brand of invasive cardiac output (CO) monitor...
March 19, 2017: International Journal of Hyperthermia
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