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Haemodynamic monitoring

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https://www.readbyqxmd.com/read/29352349/factors-affecting-n-terminal-pro-b-type-natriuretic-peptide-levels-in-preterm-infants-and-use-in-determination-of-haemodynamic-significance-of-patent-ductus-arteriosus
#1
Sarah Louise Harris, Kiran More, Bronwyn Dixon, Richard Troughton, Chris Pemberton, John Horwood, Nicola Ellis, Nicola Austin
This study aimed to investigate factors affecting N-terminal pro-B-type natriuretic peptide (NTproBNP) in preterm infants and the ability of NTproBNP to predict haemodynamically significant patent ductus arteriosus (HsPDA). Prospective cohort study of 51 infants < 30 weeks gestation. Blood NTproBNP and heart ultrasound were performed on day of life 3, 10, 28 and 36 weeks corrected age. NTproBNP levels analysed for prediction of HsPDA. The effect of gestational age, ventilation, hypoxia, bronchopulmonary dysplasia (BPD), creatinine and haemoglobin levels on NTproBNP levels were investigated...
January 19, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29330275/case-of-chest-pain-in-a-young-man
#2
Ankit Gupta, Atul Vijay Palkar, Priya Narwal
A young man with a history of smoking presented with acute-onset chest pain after lifting weights. He also noticed a change in his voice, tightness in his neck and difficulty breathing. A chest radiograph showed soft tissue emphysema in the neck. A CT scan of the chest revealed moderate amount of pneumomediastinum tracking into the neck and down to the diaphragm. He was haemodynamically stable and had no hypoxia or dysphagia. He was monitored for 48 hours and discharged home after resolution of his symptoms...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29315095/observational-study-in-healthy-volunteers-to-define-interobserver-reliability-of-ultrasound-haemodynamic-monitoring-techniques-performed-by-trainee-doctors
#3
Benjamin M Bussmann, Shrey Sharma, David Mcgregor, William Hulme, Tim Harris
OBJECTIVES: Bedside ultrasound is increasingly being used to guide fluid management in shocked patients. Little data exist on the inter-rater reliability of techniques used, especially when performed by nonexpert trainee doctors. The primary aim of this study is to measure the inter-rater reliability of five ultrasound techniques commonly used to guide fluid management: inferior vena cava collapsibility index (IVCCI), transthoracic echocardiography (TTE)-derived stroke volumes, ultrasound cardiac output monitor (USCOM) derived stroke volume and carotid artery blood flow and corrected flow time measurements...
January 8, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29241463/-myocardial-contusion-following-trauma
#4
R T Stolmeijer, H Lameijer
BACKGROUND: Myocardial contusion is a potentially life threatening condition, which should be considered in patients with a compatible thoracic trauma. Guidelines for diagnosis and determination of management are non-existent. CASE DESCRIPTION: A 51-year-old man arrived at the accident and emergency department with thoracic trauma after being knocked down by a bus. A myocardial contusion was diagnosed based on the ECG and elevated high-sensitivity (hs) troponin levels...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29227869/reliability-of-oscillometric-central-blood-pressure-responses-to-lower-limb-resistance-exercise
#5
Simon Fryer, Keeron Stone, Tabitha Dickson, James Faulkner, Danielle Lambrick, Pablo Corres, Lauren Jerred, Lee Stoner
BACKGROUND AND AIMS: Although it is well known that resistance training (RT) is beneficial for patients suffering from a variety of cardiovascular diseases, it remains underutilized as a rehabilitation tool as there is no reliable way to monitor the additional stress placed on the central organs. The current study aimed to determine between-day reliability of central haemodynamic indices using oscillometric pulse wave analysis (PWA) during progressive sub-maximal RT. METHODS: Nineteen healthy young males were tested on 3 different mornings in a fasted state...
December 5, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29217859/efficacy-of-transdermal-buprenorphine-patch-on-post-operative-pain-relief-after-elective-spinal-instrumentation-surgery
#6
Saikat Niyogi, Pratibha Bhunia, Jisnu Nayak, Sankari Santra, Amita Acharjee, Indrani Chakraborty
Background and Aims: Transdermal buprenorphine patch (TDB) is increasingly used for chronic pain management because of non-invasive dosing, longer duration of action and minimal side effects. However its role in acute post-operative pain management for spinal instrumentation surgery is not well established. The aim of this study was to evaluate the analgesic efficacy of buprenorphine patch for postoperative pain relief in patients undergoing spinal instrumentation surgery. Methods: In this randomised, placebo-controlled, double-blinded, prospective study, 70 adult patients undergoing elective spinal instrumentation surgery were randomly allocated into two groups-TDB Group (buprenorphinepatch) and TDP Group (placebo patch)...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29217857/a-comparison-of-haemodynamic-responses-between-clinical-assessment-guided-tracheal-intubation-and-neuromuscular-block-monitoring-guided-tracheal-intubation-a-prospective-randomised-study
#7
Rudranil Nandi, Shekhar Ranjan Basu, Susanta Sarkar, Rakesh Garg
Background and Aims: Haemodynamic responses to laryngoscopy and endotracheal intubation and their hazards are well documented. The purpose of the study was to compare the effects of laryngoscopy and intubation on cardiovascular responses when the appropriate moment for intubation was directed by either clinical judgment or train-of-four assessment. Methods: A total of 68 patients, posted for laparoscopic cholecystectomy, were randomised into two groups. In Group M patients, the trachea was intubated after train of four counts became zero in adductor pollicis muscle, whereas in Group C patients, the trachea was intubated after the clinical judgment of jaw muscle relaxation...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29200974/stroke-volume-monitoring-novel-continuous-wave-doppler-parameters-algorithms-and-advanced-noninvasive-haemodynamic-concepts
#8
REVIEW
R A Phillips, B E Smith, V M Madigan
Purpose of Review: Adequate oxygen delivery is essential for life, with hypoxia resulting in dysfunction, and ultimately death, of the cells, organs and organism. Blood flow delivers the oxygen bound in the blood, while haemodynamics is the science of blood flow. Stroke volume (SV) is the fundamental unit of blood flow, and reflects the interdependent performance of the heart, the vessels and the autonomic nervous system. However, haemodynamic management remains generally poor and predominantly guided by simple blood pressure observations alone...
2017: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/29198222/epinephrine-syringe-exchange-events-in-a-paediatric-cardiovascular-icu-analysing-the-storm
#9
Barbara-Jo Achuff, Jameson C Achuff, Hwan H Park, Brady Moffett, Sebastian Acosta, Craig G Rusin, Paul A Checchia
Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015...
December 4, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#10
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29182211/assessment-of-hypovolaemia-in-the-critically-ill
#11
Jan Van der Mullen, Robert Wise, Griet Vermeulen, Pieter-Jan Moonen, Manu L N G Malbrain
Assessment of the intravascular volume status of patients is one of the most challenging tasks for the intensive care clinician. It is also one of the most important skills in intensive care management as both hypervolaemia and hypovolaemia lead to increased morbidity and mortality. The assessment of hypovolaemic patients is aided by several clinical signs, laboratory investigations, and a multitude of haemodynamic monitoring systems. This review aims to outline the definitions, pathophysiology, and various assessment techniques (both old and new) employed by intensivists on the critically ill patient...
November 28, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29168462/potential-benefit-of-optimizing-atrioventricular-interventricular-delays-in-patients-with-cardiac-resynchronization-therapy
#12
Bozena Urbanek, Krzysztof Kaczmarek, Artur Klimczak, Jan Ruta, Michal Chudzik, Katarzyna Piestrzeniewicz, Pawel Ptaszynski, Jerzy Krzysztof Wranicz
BACKGROUND & OBJECTIVES: The clinical benefit of optimization (OPT) of atrioventricular delay (AVD) and interventricular delay (VVD) in cardiac resynchronization therapy (CRT) remains debatable. This study was aimed to determine the influence of AVD and VVD OPT on selected parameters in patients early after CRT implantation and at mid-term follow up (FU). METHODS: Fifty two patients (61±10 yr, 23 males) with left bundle branch block, left ventricular ejection fraction (LVEF) ≤35 per cent and heart failure were selected for CRT implantation...
July 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29165778/cardiac-ultrasound-a-true-haemodynamic-monitor
#13
Jan Poelaert, Manu L N G Malbrain
Cardiac ultrasound has been used in the critically ill for more than thirty years. The technology has made enormous progression with respect to image quality and quantity, various Doppler techniques, as well as connectivity, the transfer of data and offline calculations. Some consider cardiac ultrasound as the stethoscope of the Twenty-first century. The potential of eye-balling moving cardiac structures gives undeniable power to this diagnostic and monitoring tool. The main shortcoming is the discontinuous mode of monitoring and the fact that optimal information acquisition can only be obtained when one is well-trained and experienced...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#14
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29155934/controlled-flow-diversion-in-hybrid-venoarterial-venous-extracorporeal-membrane-oxygenation
#15
Mehmet Cakici, Fatih Gumus, Evren Ozcinar, Cagdas Baran, Onat Bermede, Mustafa Bahadir Inan, Mustafa Serkan Durdu, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: Patients on venoarterial or venovenous extracorporeal membrane oxygenation (ECMO) support may require venoarterial-venous (VAV-ECMO) configuration during follow-up. We report 12 cases of VAV-ECMO with significant outflow steal. METHODS: Between October 2014 and November 2016, a total of 97 patients (56.6 ± 12.0 years; 59 men/38 women; body surface area 1.84 ± 0.36 m 2 ) were supported with venoarterial ECMO ( n  = 85) or venovenous ECMO ( n  = 12)...
August 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29154421/haemodynamic-monitoring-of-cardiac-status-using-heart-sounds-from-an-implanted-cardiac-device
#16
Pramodsingh H Thakur, Qi An, Lynne Swanson, Yi Zhang, Roy S Gardner
AIM: The aim of this study was to evaluate the haemodynamic correlates of heart sound (HS) parameters such as third HS (S3), first HS (S1), and HS-based systolic time intervals (HSTIs) from an implantable cardiac device. METHODS AND RESULTS: Two unique animal models (10 swine with myocardial ischaemia and 11 canines with pulmonary oedema) were used to evaluate haemodynamic correlates of S1, S3, and HSTIs, namely, HS-based pre-ejection period (HSPEP), HS-based ejection time (HSET), and the ratio HSPEP/HSET during acute haemodynamic perturbations...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153687/influence-of-non-dipping-pattern-of-blood-pressure-in-gestational-hypertension-on-maternal-cardiac-function-hemodynamics-and-intrauterine-growth-restriction
#17
A Ilic, D J Ilic, S Tadic, M Stefanovic, A Stojsic-Milosavljevic, K Pavlovic, A Redzek, L Velicki
BACKGROUND: An association between gestational hypertension (GH) and changes of maternal cardiac function was previously reported. AIM: The study assessed the effect of non-dipping pattern of blood pressure (BP) in GH on haemodynamic function and intrauterine growth restriction (IUGR). METHODS: This study included 126 women (91 with GH and 35 normotensive controls). Based on the BP values measured by ambulatory blood pressure monitoring (ABPM), all hypertensive women were classified in dipper (46 women) or in non-dipper group (45 women)...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29149433/predictive-values-of-pulse-pressure-variation-and-stroke-volume-variation-for-fluid-responsiveness-in-patients-with-pneumoperitoneum
#18
Marko Zlicar, Vesna Novak-Jankovic, Rok Blagus, Maurizio Cecconi
Animal studies suggest that dynamic predictors remain useful in patients with pneumoperitoneum, but human data is conflicting. Our aim was to determine predictive values of pulse pressure variation (PPV) and stroke volume variation (SVV) in patients with pneumoperitoneum using LiDCORapid™ haemodynamic monitor. Standardised fluid challenges of colloid were administered to patients undergoing laparoscopic procedures, one fluid challenge per patient. Intra-abdominal pressure was automatically held at 12 mmHg...
November 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29149268/mitral-valve-replacement-with-the-novel-tribio-and-an-established-stented-bioprosthesis-in-a-sheep-model
#19
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: Heart valve replacement with a bioprosthesis is one of the most frequently performed procedures in cardiac surgery and represents a highly effective therapy to relieve diseased heart valves. Nevertheless, as postoperatively elevated transvalvular gradients and prosthesis-patient mismatch are reported as shortcomings of the procedure or of the currently used devices, there is a need for novel bioprostheses with improved haemodynamics. This study presents preclinical haemodynamic results after mitral valve replacement with the novel TRIBIO bioprosthesis (TRIBIO) compared with an established bioprosthesis in a sheep model...
November 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29127739/renal-haemodynamics-and-oxygenation-during-and-after-cardiac-surgery-and-cardiopulmonary-bypass
#20
REVIEW
R G Evans, Y R Lankadeva, A D Cochrane, B Marino, N Iguchi, M Z L Zhu, S G Hood, J A Smith, R Bellomo, B S Gardiner, C-J Lee, D W Smith, C N May
Acute kidney injury (AKI) is a common complication following cardiac surgery performed on cardiopulmonary bypass (CPB) and has important implications for prognosis. The aetiology of cardiac surgery-associated AKI is complex, but renal hypoxia, particularly in the medulla, is thought to play at least some role. There is strong evidence from studies in experimental animals, clinical observations and computational models that medullary ischaemia and hypoxia occur during CPB. There are no validated methods to monitor or improve renal oxygenation during CPB, and thus possibly decrease the risk of AKI...
November 11, 2017: Acta Physiologica
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