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Shock, cardiac output, sepsis

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https://www.readbyqxmd.com/read/28160954/management-of-sepsis-in-patients-with-pulmonary-arterial-hypertension-in-the-intensive-care-unit
#1
REVIEW
Todd M Tartavoulle
Pulmonary arterial hypertension is a lethal condition, and the management of sepsis in patients with pulmonary arterial hypertension is challenging. As the disease progresses, the right ventricle is susceptible to failure due to a high pulmonary vascular resistance. The limited ability of the right ventricle to increase cardiac output in septic shock makes it difficult to deliver oxygen to the organ and tissues. Intravascular volume replacement and vasoactive drugs should only be considered after a thorough assessment...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27956337/-postsurgical-morbidity-in-pediatric-patients-undergoing-surgery-for-congenital-heart-disease-in-umae-from-yucatan
#2
Addy Castillo-Espínola, Ana Velázquez-Ibarra, Aurea Zetina-Solórzano, Patricia Bolado-García, Gonzalo Gamboa-López
OBJECTIVE: To describe the clinical course of pediatric patients undergoing surgery for congenital heart disease in UMAE from Yucatan. METHODS: Descriptive survey records of pediatric patients congenital heart undergoing surgery for congenital heart disease from November, 1st 2011 to November, 30st 2013. RESULTS: The most frequent heart diseases were the persistence ductus arteriosus (37.6%) and transposition of great vessels. The intensive care stay was 3days (median)...
December 9, 2016: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/27931645/haemodynamic-coherence%C3%A2-%C3%A2-the-relevance-of-fluid-therapy
#3
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
https://www.readbyqxmd.com/read/27931643/microvascular-monitoring-do-global-markers-help
#4
REVIEW
Jean-Louis Vincent, Fabio Silvio Taccone
The microcirculation is altered in sepsis, and the degree and persistence of these alterations are associated with outcome. When there are significant alterations of the systemic circulation, as in shock, the microcirculation is always altered. However, sometimes global variables can be restored to normal while the microcirculation remains altered. Monitoring the microcirculation has, therefore, been proposed as a more precise means of assessing the effects of therapy. In this review, we will discuss the limitations of global haemodynamic variables such as mean arterial pressure, cardiac output and mixed venous oxygen saturation as markers of microcirculatory abnormalities...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#5
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27753856/hw-01-4-cardioankle-vascular-index-cavi-in-hypertension
#6
Kohji Shirai
BACKGROUND: The cardio-ankle vascular index (CAVI) is a new arterial stiffness index of the arterial tree from the origin of the aorta to the ankle, and was essentially derived from the stiffness parameterβtheory proposed by Hayashi. The conspicuous feature of CAVI is independency from blood pressure at the time of measurement. AIM: The purpose is to clarify the meaning of CAVI as a surrogate marker of arteriosclerosis, and also the role of CAVI in the blood pressure control system...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27713891/vasoactive-agents-for-the-treatment-of-sepsis
#7
REVIEW
Zhongheng Zhang, Kun Chen
The article describes some commonly used vasoactive agents in patients with septic shock. Depending on their distinct pharmacological properties, their effects on vascular bed and cardiac function are different. For example, dopamine has equivalent effect on heart and vasculature, which can result in increases in cardiac output, mean arterial pressure and heart rate. Dobutamine is considered as inodilator because it has potent effect on cardiac systole and vasculature. Patients with sepsis and septic shock sometimes have coexisting cardiac dysfunction that justifies the use of dobutamine...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27643093/hw-01-4-cardioankle-vascular-index-cavi-in-hypertension
#8
Kohji Shirai
BACKGROUND: The cardio-ankle vascular index (CAVI) is a new arterial stiffness index of the arterial tree from the origin of the aorta to the ankle, and was essentially derived from the stiffness parameterβtheory proposed by Hayashi. The conspicuous feature of CAVI is independency from blood pressure at the time of measurement. AIM: The purpose is to clarify the meaning of CAVI as a surrogate marker of arteriosclerosis, and also the role of CAVI in the blood pressure control system...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27434562/-measurement-of-brachial-artery-velocity-variation-and-inferior-vena-cava-variability-to-estimate-fluid-responsiveness
#9
Weihua Zhu, Linjun Wan, Xiaohong Wan, Gang Wang, Meixian Su, Gengjin Liao, Qingqing Huang
OBJECTIVE: To investigate the accuracy and feasibility of brachial artery peak velocity variation (ΔVpeakbrach) and inferior vena cava variability (VIVC) as indicators of fluid responsiveness in critically ill patients. METHODS: A single-center prospective observation was conducted. The patients on mechanical ventilation with spontaneously breathing admitted to Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University from June 2013 to August 2015 were enrolled...
August 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/27411452/efficacy-and-safety-of-esmolol-in-treatment-of-patients-with-septic-shock
#10
Wei Du, Xiao-Ting Wang, Yun Long, Da-Wei Liu
BACKGROUND: Previous studies have suggested that β1-receptor blockers benefit septic shock patients. This study aimed to determine whether β1-receptor blockers benefit tissue perfusion in sepsis and to identify parameters to reduce the risk of this drug in sepsis. METHODS: Consecutive septic shock patients were recruited from the Intensive Care Unit of Peking Union Medical College Hospital within 48 h of diagnosis. All patients were hemodynamically stable and satisfactorily sedated with a heart rate (HR) ≥100 beats/min...
July 20, 2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27378201/the-effects-of-direct-hemoperfusion-using-a-polymyxin-b-immobilized-column-in-a-pig-model-of-severe-pseudomonas-aeruginosa-pneumonia
#11
Gianluigi Li Bassi, Joan Daniel Marti, Eli Aguilera Xiol, Talitha Comaru, Francesca De Rosa, Montserrat Rigol, Silvia Terraneo, Mariano Rinaudo, Laia Fernandez, Miguel Ferrer, Antoni Torres
BACKGROUND: Hemoperfusion through a column containing polymyxin B-immobilized fiber (PMX-HP) is beneficial in abdominal sepsis. We assessed the effects of PMX-HP in a model of severe Pseudomonas aeruginosa pneumonia. METHODS: Eighteen pigs with severe P. aeruginosa pneumonia were mechanically ventilated for 76 h. Pigs were randomized to receive standard treatment with fluids and vasoactive drugs, or standard treatment with two 3-h PMX-HP sessions. Antibiotics against P...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27238916/high-serum-strem-1-correlates-with-myocardial-dysfunction-and-predicts-prognosis-in-septic-patients
#12
Zhenyu Li, Enyuan Zhang, Yipeng Hu, Yi Liu, Bing Chen
OBJECTIVE: This study aimed to evaluate the predictive and prognostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in patients with myocardial dysfunction induced by severe sepsis and septic shock. MATERIALS AND METHODS: A total of 84 patients with severe sepsis and septic shock were enrolled between May 2013 and December 2014.The patients were monitored by pulse indicator continuous cardiac output system and divided into myocardial depression group (cardiac function index [CFI] < 4...
June 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27177587/speckle-tracking-echocardiography-in-patients-with-septic-shock-a-case-control-study-speckss
#13
Pauline Yeung Ng, Wai Ching Sin, Andrew Kei-Yan Ng, Wai Ming Chan
BACKGROUND: Sepsis-induced myocardial dysfunction is a well-recognized condition and confers worse outcomes in septic patients. Echocardiographic assessment by conventional parameters such as left ventricular ejection fraction (LVEF) is often affected by ongoing changes in preload and afterload conditions. Novel echocardiographic technologies such as speckle tracking echocardiography (STE) have evolved for direct assessment of the myocardial function. We investigate the measurement of myocardial strain by speckle tracking echocardiography for the diagnosis of sepsis-induced myocardial dysfunction...
May 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27138843/initiation-or-maintenance-of-beta-blocker-therapy-in-patients-hospitalized-for-acute-heart-failure
#14
Luiz Carlos Passos, Márcio Galvão Oliveira, Andre Rodrigues Duraes, Thiago Moreira Trindade, Andréa Cristina Costa Barbosa
Background Beta-blockers have been recommended for patients with heart failure and reduced ejection fraction for their long-term benefits. However, the tolerance to betablockers in patients hospitalized with acute heart failure should be evaluated. Objective To estimate the proportion of patients hospitalized with acute heart failure who can tolerate these agents in clinical practice and compare the clinical outcomes of patients who can and cannot tolerate treatment with beta-blockers. Setting Two reference hospitals in cardiology...
August 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27073445/application-strategy-of-picco-in-septic-shock-patients
#15
Xiaoyun Liu, Wenli Ji, Jifeng Wang, Tao Pan
Septic shock, also known as infectious or toxic shock, is a medical condition caused by severe infection and sepsis. Early identification, timely diagnosis and effective treatments are imperative to prevent this medical condition. The aim of the present study was to examine the application of pulse index continuous cardiac output (PiCCO) technique in the treatment of septic shock patients. Fifty septic shock patients were randomly divided into the conventional detection group (group C, n=25) and the PiCCO detection group (group P, n=25)...
April 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27038480/experts-opinion-on-management-of-hemodynamics-in-ards-patients-focus-on-the-effects-of-mechanical-ventilation
#16
REVIEW
A Vieillard-Baron, M Matthay, J L Teboul, T Bein, M Schultz, S Magder, J J Marini
RATIONALE: Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. Hemodynamic effects of ventilation are due to changes in pleural pressure (Ppl) and changes in transpulmonary pressure (TP). TP affects RV afterload, whereas changes in Ppl affect venous return...
May 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27030453/impella-assisted-transcatheter-closure-of-an-acute-postinfarction-ventricular-septal-defect
#17
Uzoma Nwachukwu Ibebuogu, Oluwaseyi Bolorunduro, Inyong Hwang
This case report describes a 72-year-old woman who developed an acute postmyocardial infarction ventricular septal defect (VSD) with consequent cardiogenic shock. Intra-aortic balloon pump (IABP) counter-pulsation was urgently initiated in the cardiac catheterisation laboratory, with neither clinical nor haemodynamic improvement, prompting immediate removal of the IABP and the insertion of an Impella 2.5 heart pump (AbioMed Inc; Danvers, Massachusetts, USA), a temporary ventricular assist device. Thereafter, the patient improved clinically and was admitted to the cardiovascular intensive care unit (ICU)...
March 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26958745/4-phenylbutyric-acid-reveals-good-beneficial-effects-on-vital-organ-function-via-anti-endoplasmic-reticulum-stress-in-septic-rats
#18
Liangming Liu, Huiling Wu, JiaTao Zang, Guangming Yang, Yu Zhu, Yue Wu, Xiangyun Chen, Dan Lan, Tao Li
OBJECTIVES: Sepsis and septic shock are the common complications in ICUs. Vital organ function disorder contributes a critical role in high mortality after severe sepsis or septic shock, in which endoplasmic reticulum stress plays an important role. Whether anti-endoplasmic reticulum stress with 4-phenylbutyric acid is beneficial to sepsis and the underlying mechanisms are not known. DESIGN: Laboratory investigation. SETTING: State Key Laboratory of Trauma, Burns and Combined Injury...
August 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26925867/cardiac-output-monitoring-managing-intravenous-therapy-commit-to-treat-emergency-department-patients-with-sepsis
#19
Peter C Hou, Michael R Filbin, Anthony Napoli, Joseph Feldman, Peter S Pang, Jeffrey Sankoff, Bruce M Lo, Howard Dickey-White, Robert H Birkhahn, Nathan I Shapiro
OBJECTIVE: Fluid responsiveness is proposed as a physiology-based method to titrate fluid therapy based on preload dependence. The objectives of this study were to determine if a fluid responsiveness protocol would decrease progression of organ dysfunction, and a fluid responsiveness protocol would facilitate a more aggressive resuscitation. METHODS: Prospective, 10-center, randomized interventional trial. INCLUSION CRITERIA: suspected sepsis and lactate 2...
August 2016: Shock
https://www.readbyqxmd.com/read/26911946/-the-hemodynamic-characteristics-of-septic-shock-and-relationship-with-syndrome-types-of-traditional-chinese-medicine
#20
Jianzhuo He, Lei Wang, Xin Yin, Liheng Guo, Minzhou Zhang
OBJECTIVE: To observe hemodynamic characteristics and the correlation with syndrome types of traditional Chinese medicine (TCM) in patients with septic shock, so as to direct the treatment based on syndrome differentiation. METHODS: A prospective observation was conducted. Sixty-eight patients with septic shock admitted to the Department of Critical Care Medicine of Dade Road General Hospital of Guangdong Hospital of TCM from January 2013 to July 2015 were enrolled...
February 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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