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vasopressor use

Tiago R Velho, Hugo Duarte Ferreira, Catarina Carvalheiro, André Sena, Nádia Juqueira, Nuno Guerra, Javier Gallego, Ângelo Nobre
BACKGROUND: Aortic valve disease is the most common valvular heart disease. Surgical aortic valve replacement remains the gold-standard of treatment. Recently, minimally invasive approaches have been developed to reduce surgical trauma and to compete with percutaneous treatment of valvular heart disease. Minimally invasive approaches are associated with reduced perioperative morbidity and mortality. METHODS: Single-center retrospective study comparing clinical data of patients submitted to surgical treatment of aortic stenosis by limited sternotomy versus conventional sternotomy between January 2014 and August 2016...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Yusuke Yagihashi, Shuichi Shimabukuro, Tomotune Toyosato, Yoshitaka Arakaki
PURPOSE: Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi. METHODS: We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute. We analyzed 132 patients who underwent excretory phase CT...
October 13, 2018: International Urology and Nephrology
J M Nieves Alonso, E Alday Muñoz, A Planas Roca
BACKGROUND AND OBJECTIVE: Although pulse pressure variation (PPV) is an effective dynamic parameter widely used to predict the increase in cardiac output after the administration of fluids in abdominal surgery, its use in thoracic surgery is controversial. A study was designed to describe the behaviour of PPV during lung resection surgery. PATIENTS AND METHODS: A prospective observational study was conducted on adult patients scheduled for lung resection surgery...
October 9, 2018: Revista Española de Anestesiología y Reanimación
A Reshad Garan, Waqas A Malick, Marlena Habal, Veli K Topkara, Justin Fried, Amirali Masoumi, Aws K Hasan, Dimitri Karmpaliotis, Ajay Kirtane, Melana Yuzefpolskaya, Maryjane Farr, Yoshifumi Naka, Dan Burkhoff, Paolo C Colombo, Paul Kurlansky, Hiroo Takayama, Koji Takeda
Chronic systolic heart failure (HF) with acute decompensation can result in cardiogenic shock (CS) requiring short-term mechanical circulatory support. We sought to identify predictors of survival for acute decompensated HF (ADHF) patients requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Patients >18 years old treated at our institution with VA-ECMO from 2009 to 2018 for ADHF with CS were studied. Demographic, hemodynamic, and echocardiographic data were collected. The primary outcome was survival to discharge...
October 9, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Min-Shan Tsai, Po-Ya Chuang, Chien-Hua Huang, Chao-Hsiun Tang, Ping-Hsun Yu, Wei-Tien Chang, Wen-Jone Chen
OBJECTIVES: To evaluate the ramifications of steroid use during postarrest care. DESIGN: Retrospective observational population-based study enrolled patients during years 2004-2011 with 1-year follow-up. SETTING: Taiwan National Health Insurance Research Database. PATIENTS: Adult nontraumatic cardiac arrest patients in the emergency department, who survived to admission. INTERVENTIONS: These patients were classified into the steroid and nonsteroid groups based on whether steroid was used or not during hospitalization...
October 10, 2018: Critical Care Medicine
Emmanuel Canet, Rinaldo Bellomo
PURPOSE OF REVIEW: The present article reviews the recent literature on the main aspects of perioperative acute kidney injury (AKI). RECENT FINDINGS: AKI occurs in 1 in every 10 surgical patients, with cardiac, orthopedic, and major abdominal surgeries being the procedures associated with the highest risk. Overall, complex operations, bleeding, and hemodynamic instability are the most consistent procedure-related risk factors for AKI. AKI increases hospital stay, mortality, and chronic kidney disease, gradually with severity...
October 10, 2018: Current Opinion in Critical Care
Wagner L Nedel, Tatiana H Rech, Rodrigo A Ribeiro, José Augusto S Pellegrini, Rafael B Moraes
OBJECTIVES: To systematically review the literature and synthesize evidence concerning the effects of vasopressin and its analogs compared with other vasopressors in distributive shock, focusing on renal outcomes. DATA SOURCES: We performed a systematic review in MEDLINE, Embase, Cochrane Central, and databases. STUDY SELECTION: Randomized clinical trials that compared vasopressin and its analogs with other vasopressors and reported renal outcomes in adult patients with distributive shock...
October 9, 2018: Critical Care Medicine
Sanah Mohtar, Theresa W C Hui, Michael G Irwin
BACKGROUND: Video-assisted thoracoscopic surgery has dramatically increased over the last decade because of both medical and cosmetic benefits. Anesthesia for video-assisted thoracoscopic surgery in small children is more challenging compared to adults due to the considerable problems posed by small airway dimensions and ventilation. The optimal technique for one-lung ventilation has yet to be established and the use of remifentanil infusion in this setting is not well described. AIMS: This study investigated the use of extraluminal bronchial blocker placement for one-lung ventilation and the effect of infusion of remifentanil in infants and small children undergoing video-assisted thoracoscopic surgery...
October 3, 2018: Paediatric Anaesthesia
Shungo Imai, Takehiro Yamada, Kumiko Kasashi, Yusuke Niinuma, Masaki Kobayashi, Ken Iseki
OBJECTIVES: In our previous study, we built a risk prediction model of vancomycin (VCM)-associated nephrotoxicity using decision tree (DT) analysis. However, this has several limitations in clinical applications. Our objective here was to construct a clinically applicable risk prediction model to be used at the time of initial therapeutic drug monitoring (TDM), in patients with uncomplicated infections. METHOD: A retrospective study was conducted at Hokkaido University Hospital...
October 2, 2018: Journal of Evaluation in Clinical Practice
Galinos Barmparas, Navpreet K Dhillon, James M Tatum, Kavita Patel, Gretchen M Thomsen, Russell Mason, Daniel R Margulies, Eric J Ley
BACKGROUND: Neuromuscular blockade (NMB) is often utilized in the treatment of acute respiratory distress syndrome (ARDS). Its use for a period of 48 h has been shown to improve mortality in randomized control trials. We aimed to characterize outcomes associated with a prolonged NMB. We hypothesized that the duration of NMB would not be associated with increased mortality. MATERIALS AND METHODS: This was a retrospective review from June 2014 to October 2016 of patients admitted to the surgical intensive care unit and receiving cisatracurium for ARDS...
November 2018: Journal of Surgical Research
Valiollah Hassani, Gholamreza Movaseghi, Reza Safaeeyan, Sahar Masghati, Batool Ghorbani Yekta, Reza Farahmand Rad
Background: Hypotension is a common problem in general anesthesia. Maintaining the mean arterial pressure by choosing a vasopressor with minimal complications is still discussed in various surgeries. Objectives: The aim of this study is comparison of ephedrine versus norepinephrine in treating anesthesia-induced hypotension in hypertensive patients in spinal surgery in a randomized double-blinded study. Methods: This randomized, double-blinded study was approved by Iran University of Medical Sciences, operating room of medical center...
August 2018: Anesthesiology and Pain Medicine
R Thomas Collins, Robert E Lyle, Mallikarjuna Rettiganti, Jeffrey M Gossett, James M Robbins, Patrick H Casey
OBJECTIVE: To evaluate whether the presence of patent ductus arteriosus (PDA) in preterm infants worsens long-term neurodevelopmental outcomes. STUDY DESIGN: This was a secondary observational analysis of data from 1090 preterm low-birthweight infants in the Infant Health and Development Program (IHDP), a multicenter longitudinal cohort study of outcomes assessed from 3 to 18 years of age. Multivariable analysis was adjusted for IHDP treatment group (intervention or follow-up), birth weight, maternal race, maternal education, infant sex, maternal preconception weight, Home Observation Measurement of the Environment (HOME) total score at 12 months, neonatal health index, and gestational age...
September 26, 2018: Journal of Pediatrics
Raghavan Murugan, Vikram Balakumar, Samantha J Kerti, Priyanka Priyanka, Chung-Chou H Chang, Gilles Clermont, Rinaldo Bellomo, Paul M Palevsky, John A Kellum
BACKGROUND: Although net ultrafiltration (UFNET ) is frequently used for treatment of fluid overload in critically ill patients with acute kidney injury, the optimal intensity of UFNET is unclear. Among critically ill patients with fluid overload receiving renal replacement therapy (RRT), we examined the association between UFNET intensity and risk-adjusted 1-year mortality. METHODS: We selected patients with fluid overload ≥ 5% of body weight prior to initiation of RRT from a large academic medical center ICU dataset...
September 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
Michael D Wood, David M Maslove, John Muscedere, Stephen H Scott, J Gordon Boyd
PURPOSE: To assess the feasibility of using an integrated multimodal data collection strategy to characterize the post-intensive care syndrome (PICS). MATERIALS AND METHODS: Adult patients admitted to the ICU requiring invasive mechanical ventilation for >24 h and/or requiring vasopressor support were eligible for enrollment. We assessed cognitive and sensorimotor function at 3- and 12-months after ICU discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and with the KINARM robot...
September 12, 2018: Journal of Critical Care
JoAn R Laes, Stephen Hendriksen, Jon B Cole
Introduction: Hyperbaric oxygen (HBO2 ) therapy is infrequently reported as a treatment for poison-induced retinal damage. We describe a case in which HBO2 therapy was used to treat suspected retinal toxicity induced by quinine. Case report: We present a case in which HBO2 was used to treat visual disturbances thought to be caused by quinine-induced retinal damage. The patient intentionally ingested undisclosed amounts of citalopram and quinine. Following a complicated hospital course, including profound shock requiring treatment with four vasopressors and a peripheral left-ventricular assist device, the patient, once extubated, reported visual abnormalities consistent with those described from quinine-induced retinal toxicity...
July 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
A Claire Watkins, Nathan L Maassel, Mehrdad Ghoreishi, Murtaza Y Dawood, Si M Pham, Zachary N Kon, Bradley S Taylor, Bartley P Griffith, James S Gammie
BACKGROUND: Cardiac surgery for structural heart disease has poor outcomes in the presence of cardiogenic shock or advanced heart failure. We applied venoarterial extracorporeal membrane oxygenation (ECMO) to restore end-organ function and resuscitate patients before high-risk cardiac operation. METHODS: Twelve patients with cardiogenic shock and end-organ failure were evaluated for cardiac surgery. The average Society of Thoracic Surgeons (STS) mortality risk was 24% (±13)...
September 17, 2018: Annals of Thoracic Surgery
Marcelli Cristine Vocci, Cassiana Mendes Bertoncello Fontes, Luciana Patricia Fernandes Abbade
OBJECTIVE: To identify the risk and incidence of pressure injuries in bedridden pediatric patients to determine the most prevalent risk factors and preventive measures and to define the sociodemographic, clinical, and therapeutic profiles in this group. METHODS: Prospective cohort study performed between March 2015 and March 2016 in the intensive care unit and the pediatric ward of a public teaching hospital. The study included 85 pediatric patients (45 intensive care unit and 40 pediatric ward patients)...
October 2018: Advances in Skin & Wound Care
Jason L Kass, Sameer Lakha, Matthew A Levin, Thomas Joseph, Hung-Mo Lin, Eric M Genden, Marita S Teng, Brett A Miles, Samuel DeMaria
BACKGROUND: In free flap head and neck reconstructions, hemodynamic management is complicated by the deleterious effects of excessive crystalloid administration. Patients may undergo periods of hypotension or excess fluid administration. The purpose of this study was to present our examination of the hypotheses that intraoperative hypotension and blood pressure lability are associated with increased fluid administration and flap failure. METHODS: We reviewed the records of 445 patients undergoing head and neck surgery involving free tissue transfer...
September 19, 2018: Head & Neck
Johannes Menger, Arabella Fischer, Mohamed Mouhieddine, Mathias Seidel, Maximilian Edlinger-Stanger, Michele Bevilacqua, Michael Hiesmayr, Martin Dworschak
BACKGROUND: Active decision support systems implementing goal directed therapy may be an approach to reduce disparities in outcome between different health care providers. We assessed feasibility of and adherence to an active decision support system (ADSS) comprising fluids, vasopressors, and dobutamine to optimize hemodynamics during high-risk vascular surgery. METHODS: In this prospective observational trial a closed-loop goal-directed therapy protocol, employing the minimally-invasive LiDCOrapid device, was used to actively provide advice to the anesthesiologist during surgery...
September 18, 2018: Minerva Anestesiologica
Julien Demiselle, Martin Wepler, Clair Hartmann, Peter Radermacher, Frédérique Schortgen, Ferhat Meziani, Mervyn Singer, Valérie Seegers, Pierre Asfar
BACKGROUND: Criteria for the Sepsis-3 definition of septic shock include vasopressor treatment to maintain a mean arterial pressure > 65 mmHg and a lactate concentration > 2 mmol/L. The impact of hyperoxia in patients with septic shock using these criteria is unknown. METHODS: A post hoc analysis was performed of the HYPER2S trial assessing hyperoxia versus normoxia in septic patients requiring vasopressor therapy, in whom a plasma lactate value was available at study inclusion...
September 17, 2018: Annals of Intensive Care
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