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Cardiac output; hemodynamics

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https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#1
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29146614/heart-rate-reduction-improves-biventricular-function-and-interactions-in-experimental-pulmonary-hypertension
#2
Olga Gomez, Kenichi Okumura, Osami Honjo, Mei Sun, Ryo Ishii, Bart Bijens, Mark K Friedberg
OBJECTIVES: To investigate mechanisms of heart rate (HR) reduction on biventricular function and interactions in experimental pulmonary arterial hypertension (PAH). METHODS: We compared cardiac-cycle mechanics and interventricular interactions in 15 sham, 8 monocrotaline-PAH, 9 PAH+carvedilol and 8 PAH+ivabradine rats. We used echocardiography to assess biventricular function, timing of cardiac- cycle events and septal position in PAH rats; and related HR reduction effect on biventricular function measured by echocardiography and conductance catheter...
November 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29142756/usefulness-of-central-venous-saturation-as-a-predictor-of-thiamine-deficiency-in-critically-ill-patients-a-case-report
#3
Genri Numata, Satoshi Kodera, Hiroyuki Kiriyama, Atsuko Nakayama, Eisuke Amiya, Arihiro Kiyosue, Masaru Hatano, Eiki Takimoto, Masafumi Watanabe, Issei Komuro
Background: Central venous oxygen saturation (ScvO2) reflects the balance of oxygen delivery and consumption. Low ScvO2 indicates the presence of inadequate oxygen delivery, while high ScvO2 indicates reduced oxygen consumption and is sometimes associated with a high mortality rate in critically ill patients from dysoxia. Thiamine is an essential cofactor in cellular aerobic metabolism. Thiamine deficiency is more prevalent than was previously thought, and underlies severe conditions in critically ill patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#4
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29130036/accuracy-precision-and-trending-ability-of-electrical-cardiometry-cardiac-index-versus-continuous-pulmonary-artery-thermodilution-method-a-prospective-observational-study
#5
P B W Cox, A M den Ouden, M Theunissen, L J Montenij, A G H Kessels, M D Lancé, W F F A Buhre, M A E Marcus
Introduction: Evaluation of accuracy, precision, and trending ability of cardiac index (CI) measurements using the Aesculon™ bioimpedance electrical cardiometry (Aesc) compared to the continuous pulmonary artery thermodilution catheter (PAC) technique before, during, and after cardiac surgery. Methods: A prospective observational study with fifty patients with ASA 3-4. At six time points (T), measurements of CI simultaneously by continuous cardiac output pulmonary thermodilution and thoracic bioimpedance and standard hemodynamics were performed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29127237/metaboreflex-mediated-hemodynamic-abnormalities-in-individuals-with-coronary-artery-disease-without-overt-signs-or-symptoms-of-heart-failure
#6
Sara Magnani, Silvana Roberto, Gianmarco Sainas, Raffaele Milia, Girolamo Palazzolo, Lucia Cugusi, Virginia Pinna, Azzurra Doneddu, Seyed Alireza Hosseini Kakhak, Filippo Tocco, Giuseppe Mercuro, Antonio Crisafulli
This study was devised to investigate the effect of coronary artery disease (CAD) without overt signs of heart failure on the cardiovascular responses to muscle metaboreflex activation. We hypothesized that any CAD-induced pre-clinical systolic and/or diastolic dysfunction could impair hemodynamic response to the metaboreflex test. Twelve males diagnosed with CAD without any sign or symptoms of heart failure and 11 age-matched healthy controls (CTL) participated in the study. Subjects performed a post-exercise muscle ischemia (PEMI) test to activate the metaboreflex...
November 10, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29126680/anesthetic-and-perioperative-considerations-for-combined-heart-kidney-transplantation
#7
Santiago Mc Loughlin, Juan C Bianco, Ricardo G Marenchino
OBJECTIVE: To describe detailed perioperative features of combined heart and kidney transplant (HKT). DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: All consecutive HKT recipients aged 18 years and older. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After approval of the Institutional Review Board, the authors studied all consecutive adult patients who underwent HKT between January 2013 and July 2016...
September 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29120543/-right-heart-failure-important-forold-and-young-patientsa-challenge-from-the-acute-to-the-chronic
#8
Latifa Jedday, Véronique Trombert, Philippe Meyer, Georg Ehret, Jean-Luc Reny, Clémence Cuvelier
The prevalence of the right heart failure (RHF) is poorly known. However, RHF is often a consequence of left heart failure due to an interdependance between both ventricles. RHF should be indentified because of prognostic relevance. RHF is defined by the inability to maintain adequate cardiac output through the lung circulation. It can result from volume overload, pressure overload, or a disorder of systolic function. Adaptive mechanisms such as dilation or hyper-trophy will maintain adequate hemodynamics. Once these mechanisms become insufficient, congestive signs and hemodynamic consequences will appear...
November 8, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29120514/assessment-of-venous-hemodynamics-and-volume-homeostasis-during-pregnancy
#9
EDITORIAL
W Gyselaers, M Spaanderman
Venous hemodynamics and volume homeostasis are important aspects of cardiovascular physiology, however today their relevance is still very much underappreciated. Their most important role is maintenance and control of venous return and as such cardiac output. A high flow/low resistance circulation, remaining constant under physiological circumstances, is mandatory for an uncomplicated course of pregnancy. In this paper, characteristics of normal and abnormal venous and volume regulating functions are discussed with respect to normal and pathologic outcomes of pregnancy, and current (non-invasive) methods to assess these functions are summarized...
November 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29117189/cardiac-cycle-synchronized-electrical-muscle-stimulator-for-lower-limb-training-with-the-potential-to-reduce-the-heart-s-pumping-workload
#10
Ken-Ichiro Sasaki, Hiroo Matsuse, Ryuji Akimoto, Shiro Kamiya, Toshio Moritani, Motoki Sasaki, Yuta Ishizaki, Masanori Ohtsuka, Takaharu Nakayoshi, Takafumi Ueno, Naoto Shiba, Yoshihiro Fukumoto
BACKGROUND: The lower limb muscle may play an important role in decreasing the heart's pumping workload. Aging and inactivity cause atrophy and weakness of the muscle, leading to a loss of the heart-assisting role. An electrical lower limb muscle stimulator can prevent atrophy and weakness more effectively than conventional resistance training; however, it has been reported to increase the heart's pumping workload in some situations. Therefore, more effective tools should be developed...
2017: PloS One
https://www.readbyqxmd.com/read/29116689/evaluation-of-hemodynamic-performance-of-total-cavopulmonary-connection-tcpc-with-porous-inserts
#11
K Dhayananth, Arunn Narasimhan
Infants born with univentricular heart disease undergo Fontan surgery in order to establish separate systemic and pulmonary circulations. This surgery results in better blood circulation across a single ventricle that supplies oxygenated blood to the body and passively returns venous blood to the lungs through the total cavopulmonary connection (TCPC). Reducing the pressure drop across the TCPC during Fontan circulation helps in reducing the work load of univentricular heart and various designs have been proposed for this purpose...
November 8, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29112103/vasopressin-in-vasodilatory-shock-for-both-left-and-right-heart-anomalous-pediatric-patients-after-cardiac-surgery
#12
Zhongyuan Lu, Xu Wang, Juxian Yang, Shoujun Li, Jun Yan
Although the use of vasopressin has become common place in pediatric patients with vasodilatory shock after cardiac surgery, its efficacy and hemodynamic effects have not been systematically documented. Furthermore, previous studies were mainly limited patients with left heart anomalies. To date, the use of vasopressin in patients with right heart anomalies hasn't yet been reported. To clarify the hemodynamic effects of vasopressin on pediatric patients with vasodilatory shock after cardiopulmonary bypass, 70 consecutive patients, most of whom with right heart anomalies were retrospectively analyzed in Fuwai Hospital from October 2013 to September 2015...
November 3, 2017: Shock
https://www.readbyqxmd.com/read/29111423/maternal-cardiovascular-dysfunction-in-women-with-early-onset-preeclampsia-and-late-onset-preeclampsia-a-cross-sectional-study
#13
Sindhura Vaddamani, Anish Keepanasseril, Ajith Ananthakrishna Pillai, Binay Kumar
OBJECTIVES: To compare the cardiovascular changes associated with early onset (EOPE) and late onset (LOPE) subtypes of preeclampsia. METHODS: A prospective matched cross-sectional study involving 50 women each with early and late onset subtypes of preeclampsia conducted in a tertiary hospital in South India. Cardiac function and remodelling were assessed by conventional 2D, M-mode and doppler echocardiography. RESULTS: Women with EOPE had a significantly more altered left ventricular (LV) geometry, global LV diastolic dysfunction, impairment in myocardial contractility (40% vs...
October 25, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29110150/the-effect-of-an-aerobic-exercise-bout-24%C3%A2-h-prior-to-each-doxorubicin-treatment-for-breast-cancer-on-markers-of-cardiotoxicity-and-treatment-symptoms-a-rct
#14
Amy A Kirkham, Neil D Eves, Rob E Shave, Kelcey A Bland, Joshua Bovard, Karen A Gelmon, Sean A Virani, Don C McKenzie, Eric J Stöhr, Darren E R Waburton, Kristin L Campbell
PURPOSE: In rodents, a single exercise bout performed 24 h prior to a single doxorubicin treatment provides cardio-protection. This study investigated whether performing this intervention prior to every doxorubicin treatment for breast cancer reduced subclinical cardiotoxicity and treatment symptoms. METHODS: Twenty-four women with early stage breast cancer were randomly assigned to perform a 30-min, vigorous-intensity treadmill bout 24 h prior to each of four doxorubicin-containing chemotherapy treatments or to usual care...
November 6, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29105685/-cardiogenic-shock-from-pharmacological-treatment-to-mechanical-circulatory-support
#15
Ilaria Battistoni, Marco Marini, Alberto Lavorgna, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Giorgio Caretta, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Massimo Iacoviello, Renata De Maria, Alessandro Navazio, Nadia Aspromonte, Andrea Di Lenarda, Michele Massimo Gulizia, Serafina Valente
Cardiogenic shock (CS) is a state of critical end-organ hypoperfusion due to reduced cardiac output, despite adequate filling status. The development of multiorgan dysfunction is believed to be the major contributor to the high early mortality. Little evidence exists as to which vasopressor or inotrope should best be used for early treatment; however, customized pharmacological therapy, tailored on hemodynamic monitoring, is essential to achieve normal peripheral perfusion. Moreover, an increasing number of mechanical circulatory support devices are available for hemodynamic support in patients with CS but, at present, data derived from randomized clinical trials on the effectiveness, safety, differential indications for mechanical support devices, and optimal implant timing are limited...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29105684/-cardiogenic-shock-from-early-diagnosis-to-multiparameter-monitoring
#16
Marco Marini, Ilaria Battistoni, Alberto Lavorgna, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Giorgio Caretta, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Andrea Mortara, Daniela Pini, Renata De Maria, Nadia Aspromonte, Andrea Di Lenarda, Michele Massimo Gulizia, Serafina Valente
Cardiogenic shock (CS) is a life-threatening condition that occurs in response to reduced cardiac output, in the presence of adequate intravascular volume, and results in tissue hypoxia. CS can occur as a result of several etiologies but the most common is acute myocardial infarction. Despite the introduction of emergency revascularization for CS complicating acute myocardial infarction, mortality still remains exceptionally high, particularly in patients with refractory CS. The diagnosis of CS is sometimes challenging and it is based on clinical, hemodynamic, and biochemical signs...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#17
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy (HDP) is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in HDP considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVES: This study aimed to examine cardiovascular parameters in a cohort of patients affected by HDP according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of HDP...
November 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29094424/fetal-sheep-central-hemodynamics-and-cardiac-function-during-ascending-aorta-occlusion
#18
Heikki Huhta, Juulia Junno, Mervi Haapsamo, Tiina Erkinaro, Pasi Ohtonen, Lowell E Davis, A Roger Hohimer, Ganesh Acharya, Juha Rasanen
Fetal aortic isthmus (AoI) allows communication between left (LV) and right (RV) ventricular outputs and represents arterial watershed between the brachiocephalic (brain) and subdiaphragmatic (placenta) circulations. To understand the capability of AoI to maintain the balance between upper and lower body circulations, we performed a complete fetal ascending aorta occlusion in 9 chronically instrumented sheep at near term gestation. We hypothesized that the occlusion would significantly decrease LV output and concomitantly increase RV output in order to maintain adequate systemic cardiac output and perfusion pressure to the fetal brain circulation through retrograde filling of the AoI...
November 2, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29090260/assessment-of-method-agreement-between-two-minimally-invasive-hemodynamic-measurements-in-septic-shock-patients-on-high-doses-of-vasopressor-drugs-a-preliminary-study
#19
Oana Antal, Mihai Mărginean, Natalia Hagău
BACKGROUND: Minimally invasive hemodynamic monitoring is still controversial among the methods used to assess the hemodynamic profile of the septic shock patient. The aim of this study was to test the level of agreement between two different devices. METHODS: We collected 385 data entries during 12-hour intervals from four critically ill patients with septic shock and high doses of vasoactive therapy using two minimally invasive methods at the same time: Vigileo™ device which uses the pulse contour principle, and EV1000™ monitoring platform which uses the transpulmonary thermodilution principle...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29078756/effects-of-lung-protective-mechanical-ventilation-associated-with-permissive-respiratory-acidosis-on-regional-extra-pulmonary-blood-flow-in-experimental-ards
#20
Rudolf Hering, Stefan Kreyer, Christian Putensen
BACKGROUND: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS...
October 27, 2017: BMC Anesthesiology
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