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https://www.readbyqxmd.com/read/28803369/volume-balance-and-intradialytic-ultrafiltration-rate-in-the-hemodialysis-patient
#1
REVIEW
Jason A Chou, Kamyar Kalantar-Zadeh
PURPOSE OF REVIEW: Volume management in hemodialysis patients is often challenging. Assessing volume status and deciding how much fluid to remove during hemodialysis, the so-called ultrafiltration rate (UFR), has remained a conundrum. RECENT FINDINGS: To date there is no objective assessment tool to determine the needed UFR during each hemodialysis session. Higher volume overload or higher UFR is associated with poor outcomes including worse mortality and unfavorable clinical outcomes...
August 12, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28801076/early-development-of-right-ventricular-ischemic-lesions-in-a-novel-large-animal-model-of-acute-right-heart-failure-in-chronic-thromboembolic-pulmonary-hypertension
#2
David Boulate, Jennifer Arthur Ataam, Andrew J Connolly, Genevieve Giraldeau, Myriam Amsallem, Benoit Decante, Lilia Lamrani, Elie Fadel, Peter Dorfmuller, Frederic Perros, Francois Haddad, Olaf Mercier
BACKGROUND: Our aim was to develop a model of acute right heart failure (ARHF) in the setting of pulmonary hypertension and to characterize acute right ventricular lesions that develop early after hemodynamic restoration. METHODS AND RESULTS: We used a described piglet model of chronic pulmonary hypertension (cPH) induced by pulmonary artery occlusions. We induced ARHF in animals with cPH (ARHF-cPH group, n=9) by volume loading and iterative acute pulmonary embolisms until hemodynamic compromise followed by dobutamine infusion for hemodynamic restoration prior to sacrifice for right ventricular tissue evaluation...
August 8, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28752570/a-preliminary-comparison-of-two-dimensional-speckle-tracking-echocardiography-and-pressure-volume-loop-analysis-in-patients-with-fontan-physiology-the-role-of-ventricular-morphology
#3
David Steflik, Ryan J Butts, George H Baker, Varsha Bandisode, Andrew Savage, Andrew M Atz, Shahryar M Chowdhury
OBJECTIVE: Speckle tracking echocardiography (STE) may be a useful modality for assessing ventricular performance in patients with single ventricle physiology. However, STE's ability to accurately assess ventricular performance in this population is unknown. The objective of this study was to perform a preliminary comparison of STE measures of myocardial deformation to reference standard measures of function derived from pressure-volume loop (PVL) analysis. DESIGN: This was a secondary analysis of a prospective study investigating PVLs in patients with Fontan physiology...
July 28, 2017: Echocardiography
https://www.readbyqxmd.com/read/28743382/preoperative-echocardiographic-measures-of-left-ventricular-mechanics-are-associated-with-postoperative-vasoactive-support-in-preterm-infants-undergoing-patent-ductus-arteriosus-ligation
#4
Margaret A Gray, Eric M Graham, Andrew M Atz, Scott M Bradley, Minoo N Kavarana, Shahryar M Chowdhury
OBJECTIVE: Preoperative risk factors associated with poor outcomes after patent ductus arteriosus ligation in preterm infants have not been well defined. The aim of this study was to determine the association between preoperative echocardiographic measures of left ventricular mechanics and postoperative clinical outcomes after patent ductus arteriosus ligation. METHODS: Preterm infants less than 90 days of age with no other significant congenital anomalies who underwent patent ductus arteriosus ligation between 2007 and 2015 were considered for retrospective analysis...
July 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28741664/in-vitro-evaluation-of-an-immediate-response-starling-like-controller-for-dual-rotary-blood-pumps
#5
Andrew F Stephens, Michael C Stevens, Shaun D Gregory, Matthias Kleinheyer, Robert F Salamonsen
Rotary ventricular assist devices (VADs) are used to provide mechanical circulatory support. However, their lack of preload sensitivity in constant speed control mode (CSC) may result in ventricular suction or venous congestion. This is particularly true of biventricular support, where the native flow-balancing Starling response of both ventricles is diminished. It is possible to model the Starling response of the ventricles using cardiac output and venous return curves. With this model, we can create a Starling-like physiological controller (SLC) for VADs which can automatically balance cardiac output in the presence of perturbations to the circulation...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28711449/intrarenal-flow-alterations-during-transition-from-euvolemia-to-intravascular-volume-expansion-in-heart-failure-patients
#6
Petra Nijst, Pieter Martens, Matthias Dupont, W H Wilson Tang, Wilfried Mullens
OBJECTIVES: The goal of this study was to assess: 1) the intrarenal flow in heart failure (HF) patients during the transition from euvolemia to intravascular volume overload; and 2) the relationship between intrarenal flow and diuretic efficiency. BACKGROUND: Intrarenal blood flow alterations may help to better understand impaired volume handling in HF. METHODS: Resistance index (RI) and venous impedance index (VII) were assessed in 6 healthy subjects, 40 euvolemic HF patients with reduced ejection fraction (HFrEF) and 10 HF patients with preserved ejection fraction (HFpEF)...
July 6, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28708599/assessing-right-ventricular-function-in-pulmonary-hypertension-patients-and-the-correlation-with-the-new-york-heart-association-nyha-classification
#7
Xiaoke Shang, Shuna Xiao, Nianguo Dong, Rong Lu, Lijun Wang, Bin Wang, Yousan Chen, Liang Zhong, Mei Liu
This investigation aimed to compare the pressure-volume loop (PV loop) measurements in three less symptomatic categories (New York Heart Association classes , NYHA I, II, and III) of pulmonary hypertension (PH) patients since NYHA classification system performance is limited by the shortcomings discussed above.Thirty-six patients were enrolled in this study with PV loop measurement acquisition via micro-conductance catheters. Functional classification according to NYHA was determined with comprehensive assessing function and activity...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28699322/a-respiratory-marker-derived-from-left-vagus-nerve-signals-recorded-with-implantable-cuff-electrodes
#8
Cristian Sevcencu, Thomas N Nielsen, Benedict Kjaergaard, Johannes J Struijk
OBJECTIVE: Left vagus nerve (LVN) stimulation (LVNS) has been tested for lowering the blood pressure (BP) in patients with resistant hypertension (RH). Whereas, closed-loop LVNS (CL-LVNS) driven by a BP marker may be superior to open-loop LVNS, there are situations (e.g., exercising) when hypertension is normal. Therefore, an ideal anti-RH CL-LVNS system requires a variable to avoid stimulation in such conditions, for example, a respiratory marker ideally extracted from the LVN. As the LVN conducts respiratory signals, this study aimed to investigate if such signals can be recorded using implantable means and if a marker to monitor respiration could be derived from such recordings...
July 11, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28682837/closed-loop-and-decision-assist-guided-fluid-therapy-of-human-hemorrhage
#9
Gabriel Hundeshagen, George C Kramer, Nicole Ribeiro Marques, Michael G Salter, Aristides K Koutrouvelis, Husong Li, Daneshvari R Solanki, Alexander Indrikovs, Roger Seeton, Sheryl N Henkel, Michael P Kinsky
OBJECTIVES: We sought to evaluate the efficacy, efficiency, and physiologic consequences of automated, endpoint-directed resuscitation systems and compare them to formula-based bolus resuscitation. DESIGN: Experimental human hemorrhage and resuscitation. SETTING: Clinical Research Laboratory. SUBJECTS: Healthy volunteers. INTERVENTIONS: Subjects (n = 7) were subjected to hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based bolus resuscitation; 2) semiautonomous (decision assist) fluid administration; and 3) fully autonomous (closed loop) resuscitation...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28682025/-hypertension-in-chronic-kidney-disease
#10
Antonio De Pascalis, Alessandro Balducci
The progression of chronic kidney disease CKD is largely independent of the underlying kidney disorder once renal function has fallen below a critical level. Hypertension is an independent risk factor for disease progression in both adult and pediatric patients with kidney disorders. Optimal blood pressure control (130 /80mm Hg) represents a main goal of conservative therapy in patients with chronic kidney disease CKD but it is rarely achieved in clinical practice. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are more effective than other drugs in slowing progression of proteinuric CKD...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28679580/use-of-an-ipad-app-to-simulate-pressure-volume-loops-and-cardiovascular-physiology
#11
Staci Leisman, Daniel Burkhoff
The purpose of this laboratory exercise is to model the changes in preload, afterload, and contractility on a simulated pressure-volume loop and to correlate those findings with common measurements of clinical cardiovascular physiology. Once students have modeled these changes on a healthy heart, the students are asked to look at a simulated case of cardiogenic shock. Effects on preload, contractility, and afterload are explored, as well as the hemodynamic effects of a number of student-suggested treatment strategies...
September 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/28679200/closed-loop-ventilation-mode-in-intensive-care-unit-a-randomized-controlled-clinical-trial-comparing-the-numbers-of-manual-ventilator-setting-changes
#12
Jean-Michel Arnal, Aude Garnero, Dominik Novotni, Gaëlle Corno, Stéphane Y Donati, Didier Demory, Gabrielle Quintana, Laurent Ducros, Thomas Laubscher, Jacques Durand-Gasselin
BACKGROUND: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in intensive care unit (ICU) patients...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28655466/three-dimensional-echocardiography-derived-non-invasive-right-ventricular-pressure-volume-analysis
#13
Kuan-Chih Huang, Lian-Yu Lin, Juey-Jen Hwang, Lung-Chun Lin
In patients with pulmonary hypertension, repeated evaluations of right ventricular (RV) function are still required for clinical decision making, but the invasive nature of current pressure-volume analysis makes conducting regular follow-ups in a clinical setting infeasible. We enrolled 12 patients with pulmonary arterial hypertension (PAH) and 10 with pulmonary venous hypertension (PVH) May 2016-October 2016. All patients underwent a clinically indicated right heart catheterization (RHC), from which the yielded right ventricular pressure recordings were conjugated with RV volume by 3-D echocardiography to generate a pressure-volume loop...
June 24, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28653135/closed-loop-mechanical-ventilation-for-lung-injury-a-novel-physiological-feedback-mode-following-the-principles-of-the-open-lung-concept
#14
David Schwaiberger, Philipp A Pickerodt, Anake Pomprapa, Onno Tjarks, Felix Kork, Willehad Boemke, Roland C E Francis, Steffen Leonhardt, Burkhard Lachmann
Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). Animals were ventilated following the principles of the "open lung approach" (OLA) using a fully closed-loop physiological feedback algorithm for mechanical ventilation...
June 26, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28633398/a-novel-system-for-the-treatment-of-aortic-annular-dilation-an-ex-vivo-investigation
#15
Pallav Shah, Claudia Romagnoni, Michal Jaworek, Federico Lucherini, Monica Contino, Alan Menkis, Guido Gelpi, Gianfranco B Fiore, Carlo Antona, Riccardo Vismara
OBJECTIVES: The main reason for aortic repair failures is recurrent annular dilatation. The fibrous portion of left ventricular outflow tract dilates. A novel device was designed to tackle this problem. METHODS: The device consists of an internal ring applied at the aortic annulus plus an external flexible band at the level of the aortic root. The internal ring has a semi-rigid portion (40%, placed at ventriculo-arterial junction) and a flexible portion to allow it to conform along the curves of the non-coronary/right coronary leaflet and right coronary/left coronary leaflet commissures...
June 15, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28614115/trafficking-and-regulation-of-the-nkcc2-cotransporter-in-the-thick-ascending-limb
#16
Kerim Mutig
PURPOSE OF REVIEW: The kidney Na-K-2Cl cotransporter (NKCC2) is essential for urinary concentration and renal electrolyte handling. Loss of function mutations in the NKCC2 gene cause urinary salt and potassium wasting, whereas excessive NKCC2 function has been linked to high blood pressure. Loop diuretics, targeting the transporter, are instrumental for relieving edema or hypertension. This review focuses on intrinsic mechanisms regulating NKCC2 activity at the posttranslational level, namely its trafficking and phosphorylation...
September 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28606851/cardiorespiratory-action-of-opioid-tachykinin-agonist-peptide-hybrid-in-anaesthetized-rats-transduction-pathways
#17
Piotr Wojciechowski, Małgorzata Szereda-Przestaszewska, Andrzej Wojciech Lipkowski
AWL3106 composed of opioid (dermorphin) and tachykinin (substance P7-11) pharmacophores is a new compound with high analgesic potency and markedly reduced ability to induce tolerance and dependence. The present study aimed to determine the respiratory and cardiovascular responses evoked by this peptide in urethane-chloralose anaesthetized, spontaneously breathing rats in the presence or absence of vagal connection. Intravenous injection of AWL3106 at a dose of 0.3μmol/kg in intact rats resulted in apnoea lasting 5...
September 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28600088/invasive-hemodynamics-of-pulmonary-disease-and-the-right-ventricle
#18
REVIEW
David Silber, Justine Lachmann
Pulmonary hypertension (PH) falls into 5 groups, as defined by the World Health Organization. Swan-Ganz catheters determine precapillary versus postcapillary PH. The hemodynamic values of PH at rest and with vasodilatory challenge categorize the etiology of PH and guide treatment. RV maladaptations to increased pulmonary vascular resistance (PVR) and the chronicity of the right ventricle's (RV) response to increased PH and/or increased PVR can be understood with pressure-volume (PV) loops constructed with use of conductance catheters...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28597590/in-vitro-evaluation-of-pediatric-hollow-fiber-membrane-oxygenators-on-hemodynamic-performance-and-gaseous-microemboli-handling-an-international-multicenter-multidisciplinary-approach
#19
Shigang Wang, Luiz F Caneo, Marcelo B Jatene, Fábio B Jatene, Idagene A Cestari, Allen R Kunselman, Akif Ündar
The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model and the importance of adding an arterial filter in the circuit. The circuit consisted of a Braile Infant oxygenator or a Maquet Quadrox-I Pediatric oxygenator without integrated arterial filter (parallel arrangement), 1/4 in. ID tubing A-V loop, and a 12-Fr arterial cannula, primed with lactated Ringer's solution and packed red blood cells...
June 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28593869/a-mock-heart-engineered-with-helical-aramid-fibers-for-in-vitro-cardiovascular-device-testing
#20
So-Hyun Jansen-Park, Po-Lin Hsu, Indra Müller, Ulrich Steinseifer, Dirk Abel, Rüdiger Autschbach, Rolf Rossaint, Thomas Schmitz-Rode
Mock heart circulation loops (MHCLs) serve as in-vitro platforms to investigate the physiological interaction between circulatory systems and cardiovascular devices. A mock heart (MH) engineered with silicone walls and helical aramid fibers, to mimic the complex contraction of a natural heart, has been developed to advance the MHCL previously developed in our group. A mock aorta with an anatomical shape enables the evaluation of a cannulation method for ventricular assist devices (VADs) and investigation of the usage of clinical measurement systems like pressure-volume catheters...
April 4, 2017: Biomedizinische Technik. Biomedical Engineering
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