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Haemodynamic monitoring

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https://www.readbyqxmd.com/read/27908913/comfrey-herbal-remedy-causing-second-degree-heart-block-do-not-be-outfoxed-by-digitalis
#1
Mathew Kurian Vithayathil, Matthew Edwards
A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves...
December 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27908301/utility-of-b-type-natriuretic-peptides-in-the-assessment-of-patients-with-systemic-sclerosis-associated-pulmonary-hypertension-in-the-pharos-registry
#2
Lorinda Chung, Robert M Fairchild, Daniel E Furst, Shufeng Li, Firas Alkassab, Marcy B Bolster, Mary Ellen Csuka, Chris T Derk, Robyn T Domsic, Aryeh Fischer, Tracy Frech, Mardi Gomberg-Maitland, Jessica K Gordon, Monique Hinchcliff, Vivien Hsu, Laura K Hummers, Dinesh Khanna, Thomas A Jr Medsger, Jerry A Molitor, Ivana R Preston, Elena Schiopu, Lee Shapiro, Faye Hant, Richard Silver, Robert Simms, John Varga, Virginia D Steen, Roham T Zamanian
OBJECTIVES: To assess the utility of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) in detecting and monitoring pulmonary hypertension (PH) in systemic sclerosis (SSc). METHODS: PHAROS is a multicenter prospective cohort of SSc patients at high risk for developing pulmonary arterial hypertension (SSc-AR-PAH) or with a definitive diagnosis of SSc-PH. We evaluated 1) the sensitivity and specificity of BNP≥64 and NT-proBNP≥210 pg/mL for the detection of SSc-PAH and/ or SSc-PH in the SSc-AR-PAH population; 2) baseline and longitudinal BNP and NT-proBNP levels as predictors of progression to SSc-PAH and/or SSc-PH; 3) baseline BNP≥180, NT-proBNP≥553 pg/mL, and longitudinal changes in BNP and NT-proBNP as predictors of mortality in SSc-PH diagnosed patients...
November 10, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#3
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27900165/evaluation-of-cardiovascular-risk-lowering-health-benefits-accruing-from-laboratory-based-community-based-and-exercise-referral-exercise-programmes
#4
R Webb, J E S Thompson, J-S Ruffino, N A Davies, L Watkeys, S Hooper, P M Jones, G Walters, D Clayton, A W Thomas, K Morris, D H Llewellyn, M Ward, J Wyatt-Williams, B J McDonnell
BACKGROUND: To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). METHODS: Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27891584/an-observational-study-of-the-macro-and-micro-haemodynamic-implications-of-epidural-anaesthesia-in-children
#5
L Triffterer, P Marhofer, G Lechner, T C Marksz, O Kimberger, W Schmid, D Marhofer
The haemodynamic implications of epidural anaesthesia in children are poorly documented. We report macro- and micro-haemodynamic data from an observational study of 25 children ranging from neonates to six-years old, who underwent surgery conducted with a specific combination of monitoring systems. We analysed 90 min of study-related monitoring after epidural catheterisation, with skin incision taking place after around 30 min. We recorded macrohaemodynamic parameters (monitored using LiDCOrapid) including heart rate, mean arterial pressure, cardiac output, stroke volume, systemic vascular resistance and stroke volume variation...
November 28, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27882094/the-protective-and-hemodynamic-effects-of-dexmedetomidine-on-hypertensive-cerebral-hemorrhage-patients-in-the-perioperative-period
#6
Junhui Zhao, Chuixian Zhou
The aim of the present study was to analyze the protective and hemodynamic effects of dexmedetomidine in hypertensive cerebral hemorrhage (HCH) patients during perioperative period. In total, 50 HCH patients were selected and randomly divided into two groups, one group was administered with dexmedetomidine and the other groups with midazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were monitored in the two groups of patients before and during the operation. The MAP, HR, SpO2 and PETCO2 recorded 5 min after admission into the operation room was considered T1, the same parameters recorded 10 min after drug administration were considered T2, just after starting the operation were considered T3 and 30 min after start of operation were considered T4...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27878925/left-ventricular-deformation-at-rest-predicts-exercise-induced-elevation-in-pulmonary-artery-wedge-pressure-in-patients-with-unexplained-dyspnoea
#7
Tor Biering-Sørensen, Mário Santos, Jose Rivero, Shane D McCullough, Erin West, Alexander R Opotowsky, Aaron B Waxman, David M Systrom, Amil M Shah
AIMS: Impaired left ventricular (LV) deformation despite preserved LV ejection fraction (LVEF) is common and predicts outcomes in heart failure with preserved LVEF. We hypothesized that impaired LV deformation at rest is a marker of impaired cardiac systolic and diastolic reserve, and aimed to determine whether resting longitudinal (LS) and circumferential strain (CS) are associated with invasively measured haemodynamic response to exercise in patients with dyspnoea and a normal LVEF...
November 22, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27866432/maternal-cardiac-haemodynamics-in-severe-pre-eclampsia-complicated-by-acute-pulmonary-oedema-a-review
#8
I Bhorat, D P Naidoo, J Moodley
AIM: To establish alterations in maternal cardiac haemodynamics and function using electrocardiography and echocardiography in severe pre-eclampsia complicated by acute pulmonary oedema. METHODS: An extensive literature search including any research articles, randomised control trials, observational study, case report or expert or consensus statement pertaining to severe pre-eclampsia, eclampsia, hypertensive crises of pregnancy, pulmonary oedema, maternal cardiac haemodynamics, Holter monitoring and maternal echocardiography was done...
November 21, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27864774/comparison-of-an-automatic-analysis-and-a-manual-analysis-of-conjunctival-microcirculation-in-a-sheep-model-of-haemorrhagic-shock
#9
Philip-Helge Arnemann, Michael Hessler, Tim Kampmeier, Andrea Morelli, Hugo Karel Van Aken, Martin Westphal, Sebastian Rehberg, Christian Ertmer
BACKGROUND: Life-threatening diseases of critically ill patients are known to derange microcirculation. Automatic analysis of microcirculation would provide a bedside diagnostic tool for microcirculatory disorders and allow immediate therapeutic decisions based upon microcirculation analysis. METHODS: After induction of general anaesthesia and instrumentation for haemodynamic monitoring, haemorrhagic shock was induced in ten female sheep by stepwise blood withdrawal of 3 × 10 mL per kilogram body weight...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27855238/adrenal-crisis-secondary-to-bilateral-adrenal-haemorrhage-after-hemicolectomy
#10
Anthony Logaraj, Venessa H M Tsang, Shahrir Kabir, Julian C Y Ip
: Adrenal haemorrhage is a rare cause of adrenal crisis, which requires rapid diagnosis, prompt initiation of parenteral hydrocortisone and haemodynamic monitoring to avoid hypotensive crises. We herein describe a case of bilateral adrenal haemorrhage after hemicolectomy in a 93-year-old female with high-grade colonic adenocarcinoma. This patient's post-operative recovery was complicated by an acute hypotensive episode, hypoglycaemia and syncope, and subsequent computed tomography (CT) scan of the abdomen revealed bilateral adrenal haemorrhage...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27854379/longitudinal-maternal-haemodynamics-in-fetal-growth-restriction-in-pregnancies-at-high-risk-for-placental-insufficiency
#11
Daniel Stott, Papastefanou I, Daniela Paraschiv, Katherine Clark, Nikos A Kametas
OBJECTIVE: Fetal growth restriction is a powerful determinant of poor perinatal outcomes. Our previous work in pregnancies at high risk for the development of hypertension found that early in pregnancy maternal haemodynamics show impaired cardiovascular adaptation in gestations destined to deliver growth-restricted infants. In this study, we serially monitored maternal haemodynamics from the first through to the third trimester in a similar high-risk cohort, in order to determine if, in pregnancies complicated by growth-restriction, these distinct haemodynamic profiles found at presentation persisted throughout pregnancy...
October 31, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27826705/feasibility-and-accuracy-of-cardiac-right-to-left-shunt-detection-in-children-by-new-transpulmonary-ultrasound-dilution-method
#12
Martin Boehne, Mathias Baustert, Verena Paetzel, Dietmar Boethig, Harald Köditz, Nils Dennhardt, Philipp Beerbaum, Harald Bertram
Transpulmonary ultrasound dilution (TPUD) method, a novel indicator dilution (ID) technique for cardiac output measurement, detects and quantifies shunts, both in children and adults. However, its accuracy and reproducibility in cardiac right-to-left-shunt (RLS) detection have not been investigated. In a prospective observational study, we assessed the validity of TPUD algorithm for RLS detection in children with congenital heart disease (CHD) and proven RLS in comparison with controls without shunts between February 2010 and October 2011...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27818371/ictal-spect-is-useful-in-localizing-the-epileptogenic-zone-in-infants-with-cortical-dysplasia
#13
Martin Kudr, Pavel Krsek, Bruno Maton, Stephen Malone, Alena Jahodova, Vladimir Komarek, Prasanna Jayakar, Michael Duchowny
AIMS: To assess the localizing value of ictal SPECT in very young epilepsy surgery candidates when cerebral haemodynamic responses are known to be immature. METHODS: We retrospectively studied 13 infants with intractable focal epilepsy caused by focal cortical dysplasia (FCD). Completeness of resection of the (1) ictal SPECT hyperperfusion zone and (2) cerebral cortex with prominent ictal and interictal abnormalities on intracranial EEG (ECoG or long-term invasive monitoring) and the MRI lesion, when present, were correlated with postoperative seizure outcome...
November 4, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27807964/analgesia-nociception-monitoring-for-opioid-guidance-meta-analysis-of-randomized-clinical-trials
#14
Matthias Gruenewald, Astrid Dempfle
BACKGROUND: The adequate suppression of nociception is, besides induction of unconsciousness and immobility, the main objective during anaesthesia. Analgesics, most commonly opioids, are usually titrated by established clinical surrogates of nociception. Recently, monitoring techniques became available to evaluate analgesia/nociception during anaesthesia and provide better measures then clinical evaluation alone. They are primarily derived from autonomic response on physiologic standard measures...
November 3, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27805787/cerebral-haemodynamic-response-to-somatosensory-stimulation-in-near-term-fetal-sheep
#15
S Nakamura, D W Walker, F Y Wong
Functional hyperaemia induced by a localised increase in neuronal activity has been suggested to occur in the fetal brain from positive blood oxygen level-dependent (BOLD) signal recorded by functional magnetic resonance imaging (fMRI) following acoustic stimulation. To study the effect of somatosensory input on local cerebral perfusion we used Near-infrared spectroscopy (NIRS) in anaesthetized, partially exteriorized fetal sheep where the median nerve was stimulated with trains of pulses (2 ms, 3.3 Hz) for durations of 1...
November 2, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27800645/serial-haemodynamic-monitoring-to-guide-treatment-of-maternal-hypertension-leads-to-a-reduction-in-severe-hypertension-rates
#16
Daniel Stott, Ioannis Papastefanou, Daniela Paraschiv, Katherine Clark, Nikos A Kametas
OBJECTIVE: Firstly, to examine if treatment for hypertension in pregnancy guided by the serial assessment of maternal central haemodynamics leads to a reduction in the rates of severe hypertension, defined as blood pressure greater than or equal to 160/110mmHg. Secondly, to assess the distinct longitudinal haemodynamic profiles associated with either beta-blocker monotherapy, vasodilator monotherapy, or dual agent therapy, and their relationship with outcomes including fetal growth restriction...
October 31, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27798767/practical-management-of-anaesthesia-in-the-elderly
#17
Camilla Strøm, Lars Simon Rasmussen, Jacob Steinmetz
The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient...
October 31, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27790555/efficacy-and-safety-of-clonidine-as-an-adjuvant-to-bupivacaine-for-caudal-analgesia-in-paediatric-infra-umbilical-surgeries
#18
Samita Priolkar, Shirley Ann D'Souza
INTRODUCTION: Caudal analgesia, has gained popularity in paediatric intraoperative and postoperative pain management, more so with the use of adjuvants to prolong its duration, each of them having various results. Clonidine, an alpha2-adrenergic agonist is being used for its analgesic effects in various doses with 0.25% Bupivacaine. AIM: The study was conducted to compare the analgesic efficacy, haemodynamic safety and side effects of 1 μg/kg Clonidine added to 1 ml/kg of 0...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27764869/-hemodynamic-monitoring-basic-monitoring
#19
Torsten Schröder
Basic haemodynamic monitoring is an essential part of the anaesthesia work place. This includes Monitoring of ECG, blood pressure and pulse oximetry. For early assessement of perioperative complications every patient should have a basic haemodynamic monitoring, independant of current health status or the type of anaesthesia applied. Knowledge of function, principles and limitations ais necessary for proper interpretation of the measured values. Here, we describe the function and application of ECG, non - invasive intermittent blood pressure and pulse oximetry in the perioperative setting...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27756065/reduction-in-cerebral-oxygenation-due-to-patent-ductus-arteriosus-is-pronounced-in-small-for-gestational-age-neonates
#20
Emily Cohen, Laura Dix, Willem Baerts, Thomas Alderliesten, Petra Lemmers, Frank van Bel
BACKGROUND: A haemodynamically significant patent ductus arteriosus (hsPDA) reduces cerebral oxygenation in appropriate-for-gestational-age (AGA) preterm neonates. Reduced cerebral oxygenation has been associated with brain injury. Preterm small-for-gestational-age (SGA) neonates show higher cerebral oxygenation than AGA peers throughout the first postnatal days. To date, no studies have investigated the effect of hsPDA on cerebral oxygenation in preterm SGA neonates. OBJECTIVE: We aimed to assess the effect of hsPDA on cerebral oxygenation in preterm SGA neonates compared to AGA peers...
October 19, 2016: Neonatology
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