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Hemodynamic monitoring

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https://www.readbyqxmd.com/read/28538623/impact-of-a-novel-pi3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#1
George E Black, Kyle K Sokol, Donald M Moe, Jon Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhalo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental PI3-kinase inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage associated molecular patterns (DAMPs) METHODS: 16 swine were studied using LY294002 (LY), a non-selective PI3-KI: Animals were assigned to Trauma only (TO, N=3); LY drug only (LYO, N=3); and Experimental (N=10), trauma + drug (LY+T) groups...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28527965/perfusion-index-an-indicator-of-success-during-endoscopic-thoracic-sympathectomy-for-hyperhidrosis
#2
Eric I-Hun Jeng, Nikolaus Gravenstein, Charles T Klodell
BACKGROUND: Endoscopic thoracic sympathectomy (ETS) is indicated for refractory hyperhidrosis. The pulse oximetry-derived perfusion index (PI) quantifies pulsatile blood flow at the oximeter. Thoracic sympathectomy increases blood flow; thus we postulate it will reliably increase PI. We evaluated the ipsilateral finger PI as a predictor of successful sympathectomy during ETS. METHODS: After institutional review board approval and informed consent, 100 adult patients undergoing bilateral ETS were studied...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527831/different-efficacy-of-inhaled-and-oral-medications-in-pulmonary-hypertension
#3
Batool J AbuHalimeh, Joseph G Parambil, Adriano R Tonelli
Pulmonary arterial hypertension (PAH) is progressive disorder characterized by elevated pulmonary vascular resistance that can lead to right heart failure and death. One of the main therapeutic options for PAH are medications targeting the prostacyclin pathway. Treprostinil is a prostacyclin analogue and selexipag is a selective IP receptor agonist. Treprostinil can be delivered by a variety of routes including oral, inhaled, subcutaneous and intravenous. Selexipag is currently approved as an oral formulation...
May 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28520687/3-nacl-adenosine-lidocaine-mg2-alm-bolus-and-4-hours-drip-infusion-reduces-noncompressible-hemorrhage-by-60-in-a-rat-model
#4
Hayley L Letson, Geoffrey P Dobson
BACKGROUND: Noncompressible torso hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine, and Mg (ALM) bolus and 0.9% NaCl/ALM "drip" on survivability and cardiac/gut/kidney function in a rat model of hepatic hemorrhage and shock. METHODS: Male Sprague-Dawley rats (428 ± 4 g) were anesthetized and randomly assigned to one of five groups (n = 16): (1) Sham, (2) No treatment, (3) Saline controls, (4) ALM therapy, and (5) Hextend...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28514289/anti-angiogenic-therapy-with-contrast-enhanced-ultrasound-in-colorectal-cancer-patients-with-liver-metastasis
#5
Zhiyong Wu, Xiaowei Yang, Li Chen, Zhikuan Wang, Yan Shi, Hui Mao, Guanghai Dai, Xiaoling Yu
The aim of the study was to evaluate the efficacy of anti-angiogenic therapy with dynamic contrast-enhanced ultrasound (DCE-US) in colorectal cancer (CRC) patients with liver metastasis.A total of 50 CRC patients with liver metastasis who received bevacizumab (BEV)-based chemotherapy (BEV + FOLFOX6 protocol) were recruited into the present study. Before the study (d0), and 3, 7, 14, and 42 days (d3, d7, d14, and d42) after chemotherapy, DCE-US was performed, and tumor perfusion was evaluated quantitatively by retention time (RT), peak enhancement (PE), and wash-in area under the curve (WiAUC) on the basis of a contrast-uptake curve determined with original linear data...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28513192/the-haemodynamic-effect-of-an-adjustable-band-in-an-arteriovenous-fistula
#6
M Sturm, H Lee, S Thomas, T Barber
A number of treatment approaches exist for excessive flowrate arteriovenous fistulae. Banding has a number of advantages, yet there is concern over its use due to reported high post-surgery thrombosis rates. A computational study is conducted of a new technique, to elucidate the hemodynamics present in the process. The key improvement involves the use of an adjustable band which can be used to optimise the flowrate during the surgery. The pressure and flowrate changes are apparent from the computational results and the computational results also demonstrate that further optimization may be possible...
May 17, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28509710/ultrasound-guided-pericardiocentesis-a-novel-parasternal-approach
#7
Adi Osman, Tan Wan Chuan, Jamalludin Ab Rahman, Gabriele Via, Guido Tavazzi
OBJECTIVE: The aim of this study was to evaluate a novel pericardiocentesis technique using an in-plane parasternal medial-to-lateral approach with the use of a high-frequency probe in patients with cardiac tamponade. BACKGROUND: Echocardiography is pivotal in the diagnosis of pericardial effusion and tamponade physiology. Ultrasound guidance for pericardiocentesis is currently considered the standard of care. Several approaches have been described recently, which differ mainly on the site of puncture (subxiphoid, apical, or parasternal)...
May 15, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28507833/does-hemodynamic-guided-heart-failure-management-reduce-hospitalization-a-systematic-review
#8
REVIEW
Abdul M Minhas, Saba Ahmed, Muhammad S Khan, Kaneez Fatima, Muhammad N Anwar, Jonathan Constantin
Heart failure (HF) is a pressing health concern as the expense of hospitalization financially burdens the health care system. Hemodynamic monitoring has the potential to detect increases in intracardiac filling pressures weeks before clinical deterioration; hence, preliminary findings of volume overload with the use of these devices may prevent the progression of disease and lead to a reduction in HF-associated hospitalizations. We extensively searched PubMed, Ovid SP, Embase, and Cochrane databases to identify all the possible studies that assess the effect of hemodynamic monitoring on hospitalizations in HF patients...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28506550/cardioprotective-efficacy-of-sevoflurane-vs-propofol-during-induction-and-or-maintenance-in-patients-undergoing-coronary-artery-revascularization-surgery-without-pump-a-randomized-trial
#9
J L Guerrero Orriach, M Galán Ortega, A Ramirez Fernandez, M Ramirez Aliaga, M I Moreno Cortes, D Ariza Villanueva, A Florez Vela, J Alcaide Torres, C Santiago Fernandez, E Matute Gonzalez, E Alsina Marcos, J J Escalona Belmonte, M Rubio Navarro, L Garrido Sanchez, J Cruz Mañas
PURPOSE: Pre and post-operative administration of sevoflurane in myocardial revascularization surgery provides enhanced cardioprotective effects exerted by pharmacologic pre- and post-conditioning, as compared to propofol. The identification of the enzymes involved in conditioning mechanisms is crucial to the understanding of the effects of sevoflurane in cardiac surgery patients. The impact of sevoflurane on another crucial target organ-the kidney-was also assessed. METHODS: Ninety patients undergoing off-pump myocardial revascularization surgery were allocated to receive either intra- and postoperative sevoflurane (SS), intraoperative sevoflurane and postoperative propofol (SP), or intra- and postoperative propofol (PP))...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28497934/cerebral-autoregulation-monitoring-in-acute-traumatic-brain-injury-what-s-the-evidence
#10
Leanne A Calviello, Joseph Donnelly, Frederick A Zeiler, Eric P Thelin, Peter Smielewski, Marek Czosnyka
Cerebral autoregulation is conceptualized as a vascular self-regulatory mechanism within the brain. Controlled by elusive relationships between various biophysical processes, it functions to protect the brain against potential damages caused by sudden changes in cerebral perfusion pressures and flow. Following events such as traumatic brain injuries (TBI), autoregulation may be compromised, potentially leading to an unfavorable outcome. In spite of its complexity, autoregulation has been able to be quantified non-invasively within the neuro-critical care setting with the aid of transcranial Doppler...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28497259/safety-and-tolerability-of-intravenous-valproic-acid-in-healthy-subjects-a-phase-i-dose-escalation-trial
#11
Patrick E Georgoff, Vahagn C Nikolian, Tess Bonham, Manjunath P Pai, Celia Tafatia, Ihab Halaweish, Kathleen To, Kuanwong Watcharotone, Aishwarya Parameswaran, Ruijuan Luo, Duxin Sun, Hasan B Alam
BACKGROUND: Valproic acid, a histone deacetylase inhibitor, has beneficial effects in the setting of cancer, neurologic diseases, and traumatic injuries. In animal models of traumatic injury, a single dose of valproic acid has been shown to reduce mortality. The purpose of this trial was to determine the maximum tolerated single dose of intravenous valproic acid in healthy humans. METHODS: A double-blinded, placebo-controlled, dose-escalation trial design was used to identify dose-limiting toxicities in healthy subjects who received a single dose of intravenous valproic acid...
May 11, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28497189/quantification-of-mitral-regurgitation-during-percutaneous-mitral-valve-repair-added-value-of-simultaneous-hemodynamic-and-3d-echocardiographic-assessment
#12
Ilonka Rohm, Tudor C Poerner, Ali Hamadanchi, Sylvia Otto, Torsten Doenst, Christian Jung, P Christian Schulze, Björn Goebel
The objective of this study was to investigate the usefulness of intraprocedural hemodynamic monitoring for MR evaluation during pMRV. Assessment of mitral regurgitation (MR) during percutaneous mitral valve repair (pMVR) procedure is challenging. 3D color Doppler allows exact quantification of MR, but is technically demanding. Sixty patients with moderate to severe MR (14 with structural and 46 functional MR) were included in the study. Intraprocedural pressure curves were continuously obtained in the left atrium (LA) and left ventricle (LV)...
May 11, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28497180/performance-of-a-capnodynamic-method-estimating-effective-pulmonary-blood-flow-during-transient-and-sustained-hypercapnia
#13
Thorir Svavar Sigmundsson, Tomas Öhman, Magnus Hallbäck, Eider Redondo, Fernando Suarez Sipmann, Mats Wallin, Anders Oldner, Caroline Hällsjö Sander, Håkan Björne
The capnodynamic method is a minimally invasive method continuously calculating effective pulmonary blood flow (COEPBF), equivalent to cardiac output when intra pulmonary shunt flow is low. The capnodynamic equation joined with a ventilator pattern containing cyclic reoccurring expiratory holds, provides breath to breath hemodynamic monitoring in the anesthetized patient. Its performance however, might be affected by changes in the mixed venous content of carbon dioxide (CvCO2). The aim of the current study was to evaluate COEPBF during rapid measurable changes in mixed venous carbon dioxide partial pressure (PvCO2) following ischemia-reperfusion and during sustained hypercapnia in a porcine model...
May 11, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28493849/effects-of-pressure-variation-and-atrial-fibrillation-on-cardiomems-%C3%A2-hf-measured-pulmonary-artery-diastolic-pressure-comparison-of-device-averaged-and-visually-inspected-waveforms
#14
Aaron M Wolfson, Omid Yousefian, Lindsay Short, Daniel O'Brien, Guy Talmor, Jessica Qiu, Andrew Yoon, Michael Fong, Leslie Saxon, Rahul Doshi, Luanda Grazette, David M Shavelle
OBJECTIVE: Heart failure (HF) management guided by implantable hemodynamic monitoring reduces hospitalization rates. Hemodynamic data from the CardioMEMS(™) HF system includes device-averaged pulmonary artery pressures (PAP) and heart rate. Agreement of device-averaged values compared to the standard method of visual inspection of pressure waveforms at end-expiration is unknown. We evaluated the agreement between device-averaged and visually inspected end-expiratory PAP. APPROACH: Twenty-one patients implanted with the CardioMEMS(™) HF system were evaluated...
May 11, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28493634/an-experimental-study-of-the-recovery-of-injured-porcine-lungs-with-prolonged-normothermic-cellular-ex-vivo-lung-perfusion-following-donation-after-circulatory-death
#15
John R Spratt, Lars M Mattison, Paul A Iaizzo, Roland Z Brown, Haylie Helms, Tinen L Iles, Brian Howard, Angela Panoskaltsis-Mortari, Gabriel Loor
INTRODUCTION: Donation after circulatory death (DCD) is an underused source of donor lungs. Normothermic cellular ex vivo lung perfusion (EVLP) is effective in preserving standard donor lungs but may also be useful in the preservation and assessment of DCD lungs. METHODS: Using a model of DCD and prolonged EVLP, the effects of donor warm ischemia and postmortem ventilation on graft recovery were evaluated. Adult male swine underwent general anesthesia and heparinization...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28493526/real-time-mri-guidance-of-cardiac-interventions
#16
Adrienne E Campbell-Washburn, Mohammad A Tavallaei, Mihaela Pop, Elena K Grant, Henry Chubb, Kawal Rhode, Graham A Wright
Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages...
May 11, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28490233/update-on-finger-application-type-noninvasive-continuous-hemodynamic-monitors-cnap-and-ccnexfin-physical-principles-validation-and-clinical-use
#17
Eugene P Raggi, Tetsuro Sakai
The CNAP HD Monitor (CNSystems, Graz, Austria) and the ccNexfin (The ClearSight System: Edwards Lifesciences Corporation, Irvine, CA) are continuous, noninvasive blood pressure monitors using a finger-application device. These devices show a promising ability to allow for rapid detection of hemodynamic derangement when compared with oscillometry. The accuracy and precision of these devices as blood pressure monitors has been evaluated when compared with intra-arterial catheters. Additionally, they can be used to measure beat-to-beat cardiac output (CO)...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28486234/low-plasma-protein-levels-at-birth-are-associated-with-poor-cardiovascular-adaptation-and-serious-adverse-outcome-in-infants-with-gestational-age-32-weeks-the-proh%C3%A3-mie-study
#18
Francesco Bonsante, Duksha Ramful, Sylvain Samperiz, Sandrine Daniel, Anais Godeluck, Pierre-Yves Robillard, Karim Jamal-Bey, Jean-Bernard Gouyon, Christine Binquet, Silvia Iacobelli
BACKGROUND: Retrospective studies suggest that early hypoproteinemia has prognostic value for adverse outcome in preemies, but the underlying pathophysiology is unknown. We hypothesized that the prognostic relevance of hypoproteinemia could be related to its association with impaired cardiovascular function and organ perfusion during transition. OBJECTIVES: To describe the plasma protein status and the measures of cardiovascular function according to the outcome in infants <32 weeks' gestation...
May 10, 2017: Neonatology
https://www.readbyqxmd.com/read/28485326/clarifications-on-continuous-renal-replacement-therapy-and-hemodynamics
#19
REVIEW
Xiao-Ting Wang, Cui Wang, Hong-Min Zhang, Da-Wei Liu
OBJECTIVE: Continuous renal replacement therapy (CRRT) is a continuous process of bedside blood purification which is widely used in the treatment of acute kidney injury (AKI) and for fluid management. However, since AKI and fluid overload are often found to be associated with hemodynamic abnormalities, determining the relationship between CRRT and hemodynamics remains a challenge in the treatment of critically ill patients. The aim of this review was to summarize key points in the relationship between CRRT and hemodynamics and to understand and monitor renal hemodynamics in critically ill patients, especially those with AKI...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28485324/a-novel-porcine-model-of-septic-shock-induced-by-acute-respiratory-distress-syndrome-due-to-methicillin-resistant-staphylococcus-aureus
#20
Shuo Wang, Jun-Yu Wang, Tao Wang, Chen-Chen Hang, Rui Shao, Chun-Sheng Li
BACKGROUND: Sepsis is one of the main causes of mortality in critically ill patients following progression to septic shock. To investigate the pathophysiologic changes of sepsis, we developed a novel porcine model of septic shock induced by acute respiratory distress syndrome (ARDS) due to methicillin-resistant Staphylococcus aureus(MRSA) pneumonia. METHODS: Twenty-six male Landraces (Lvyuanweiye, Beijing, China) weighing 30 ± 2 kg were divided into four groups: sham group (SH; n = 5); cotton smoke inhalation group (SM; n = 6); MRSA pneumonia group (MR; n = 6); and septic shock group with cotton smoke inhalation + MRSA pneumonia (SS; n = 9)...
May 20, 2017: Chinese Medical Journal
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