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Hemodynamic monitoring

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https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#1
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#2
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28926566/guidelines-for-the-management-of-a-brain-death-donor-in-the-rhesus-macaque-a-translational-transplant-model
#3
Tiffany J Zens, Juan S Danobeitia, Peter J Chlebeck, Laura J Zitur, Scott Odorico, Kevin Brunner, Jennifer Coonen, Saverio Capuano, Anthony M D'Alessandro, Kristina Matkowskyj, Weixiong Zhong, Jose Torrealba, Luis Fernandez
INTRODUCTION: The development of a translatable brain death animal model has significant potential to advance not only transplant research, but also the understanding of the pathophysiologic changes that occur in brain death and severe traumatic brain injury. The aim of this paper is to describe a rhesus macaque model of brain death designed to simulate the average time and medical management described in the human literature. METHODS: Following approval by the Institutional Animal Care and Use Committee, a brain death model was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28925890/the-use-of-hemodynamic-and-cerebral-monitoring-to-study-pharmacodynamics-in-neonates
#4
A Smits, L Thewissen, A Dereymaeker, E Dempsey, A Caicedo, Gunnar Naulaers
BACKGROUND: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. METHODS: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28925377/applied-upper-airway-resistance-instantly-affects-breath-components-a-unique-insight-into-pulmonary-medicine
#5
Pritam Sukul, Jochen Schubert, Svend Kamysek, Phillip Trefz, Wolfram Miekisch
Respiratory parameters such as flow or rate have complex effects onto exhalation of volatile substances and can hamper clinical interpretation of breath biomarkers. We investigated effects of progressively applied upper-airway resistances onto exhalation of volatile organic compounds (VOCs) in healthy humans. We performed real-time mass-spectrometric determination of breath volatiles in 50 subjects with parallel non-invasive hemodynamic monitoring, breath-resolved spirometry and capnometry during controlled tidal breathing (12 breaths/min)...
September 19, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28922579/evaluating-real-time-effects-of-topical-1-1000-epinephrine-in-endoscopic-sinus-and-skull-base-surgery-on-hemodynamic-parameters-through-intraoperative-arterial-line-monitoring
#6
Michael T Yim, Omar G Ahmed, Masayoshi Takashima
BACKGROUND: Administration of topical 1:1000 epinephrine is commonly used in practice to achieve vasoconstriction during endoscopic sinus surgery and skull-base surgery; however, real-time effects on cardiovascular changes from systemic absorption have not been well studied. METHODS: Twenty-six patients undergoing endoscopic transsphenoidal resection of a pituitary lesion at a single institution were included into the study. Following arterial line placement by anesthesiology, 6 cottonoid pledgets soaked in 1:1000 epinephrine were placed into the bilateral nasal passages...
September 18, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28920777/heart-rate-and-indirect-blood-pressure-responses-to-four-different-field-anesthetic-protocols-in-wild-born-captive-chimpanzees-pan-troglodytes
#7
Rebeca Atencia, Eric J Stöhr, Aimee L Drane, Mike Stembridge, Glyn Howatson, Pablo Rodriguez Lopez Del Rio, Yedra Feltrer, Babila Tafon, Sharon Redrobe, Bruce Peck, Jaclyn Eng, Steve Unwin, Carlos R Sanchez, Rob E Shave
Limited data are available on hemodynamic responses to anesthetic protocols in wild-born chimpanzees (Pan troglodytes). Accordingly, this study characterized the heart rate (HR) and blood pressure responses to four anesthetic protocols in 176 clinically healthy, wild-born chimpanzees undergoing routine health assessments. Animals were anesthetized with medetomidine-ketamine (MK) (n = 101), tiletamine-zolazepam (TZ) (n = 30), tiletamine-zolazepam-medetomidine (TZM) (n = 24), or medetomidine-ketamine (maintained with isoflurane) (MKI) (n = 21)...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28918617/right-ventricular-thrombosis-combined-with-fetal-death-and-acrocyanosis-in-pregnancy
#8
Feridoun Sabzi, Aghigh Heidari
Prepartum or postpartum right ventricular thrombosis (RVT) is an exceedingly rare and potentially lethal phenomenon in pregnancy. We here report a case of a pregnant patient with near term pregnancy admitted for dyspnea, amniotic fluids discharge and labor pain in a gynecology center that an eight-month dead fetus was diagnosed and delivered vaginally by induction. A post delivery period was complicated by aggravation of her dyspnea and pleuritic chest pain that she referred for further evaluation in our cardiac center...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28916602/validation-study-of-image-based-fractional-flow-reserve-during-coronary-angiography
#9
Mariano Pellicano, Ifat Lavi, Bernard De Bruyne, Hana Vaknin-Assa, Abid Assali, Orna Valtzer, Yonit Lotringer, Giora Weisz, Yaron Almagor, Panagiotis Xaplanteris, Ajay J Kirtane, Pablo Codner, Martin B Leon, Ran Kornowski
BACKGROUND: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFRangio) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFRangio in patients with stable coronary artery disease. METHODS AND RESULTS: FFRangio is a computational method based on rapid flow analysis for the assessment of FFR...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28916535/spinal-cord-perfusion-pressure-predicts-neurologic-recovery-in-acute-spinal-cord-injury
#10
Jordan W Squair, Lise M Bélanger, Angela Tsang, Leanna Ritchie, Jean-Marc Mac-Thiong, Stefan Parent, Sean Christie, Christopher Bailey, Sanjay Dhall, John Street, Tamir Ailon, Scott Paquette, Nicolas Dea, Charles G Fisher, Marcel F Dvorak, Christopher R West, Brian K Kwon
OBJECTIVE: To determine whether spinal cord perfusion pressure (SCPP) as measured with a lumbar intrathecal catheter is a more predictive measure of neurologic outcome than the conventionally measured mean arterial pressure (MAP). METHODS: A total of 92 individuals with acute spinal cord injury were enrolled in this multicenter prospective observational clinical trial. MAP and CSF pressure (CSFP) were monitored during the first week postinjury. Neurologic impairment was assessed at baseline and at 6 months postinjury...
September 15, 2017: Neurology
https://www.readbyqxmd.com/read/28902662/circadian-hemodynamics-in-men-and-women-with-high-blood-pressure-dipper-vs-nondipper-and-racial-differences
#11
Andrew Sherwood, LaBarron K Hill, James A Blumenthal, Alan L Hinderliter
OBJECTIVE: The 'nondipping' pattern of circadian blood pressure (BP) variation is an established independent predictor of adverse cardiovascular outcomes. Although this phenomenon has been widely studied, its underlying circadian hemodynamics of cardiac output and systemic vascular resistance (SVR) have not been well characterized. We evaluated the hypothesis that BP nondipping would be associated with a blunted night-time reduction in SVR in a biracial sample of 140 (63 African-American and 77 white) men and women with elevated clinic BP (130-159/85-99 mmHg)...
September 11, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28902381/-organ-interactions-heart-and-lung-management-of-the-acute-right-heart-failure
#12
Guido Michels, Roman Pfister
The pathophysiology and the management of patients with acute right heart failure are very complex. The bed-side focused echocardiography is the basis of differential diagnosis and acute diagnosis. Individual therapy monitoring is complex due to the strong preload dependence of the right ventricle and the limitation of non-invasive estimation of pulmonary-vascular hemodynamics, so that the indication for a pulmonary artery catheter should be liberal in acute right heart failure. The treatment goals of acute right heart failure are the treatment of the underlying disease or triggering factors in combination with individualized optimization of hemodynamic tailored to current right-ventricular function...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28900761/a-novel-multi-objective-physiological-control-system-for-rotary-left-ventricular-assist-devices
#13
Anastasios Petrou, Marcial Monn, Mirko Meboldt, Marianne Schmid Daners
Various control and monitoring algorithms have been proposed to improve the left-ventricular assist device (LVAD) therapy by reducing the still-occurring adverse events. We developed a novel multi-objective physiological control system that relies on the pump inlet pressure (PIP). Signal-processing algorithms have been implemented to extract the required features from the PIP. These features then serve for meeting various objectives: pump flow adaptation to the perfusion requirements, aortic valve opening for a predefined time, augmentation of the aortic pulse pressure, and monitoring of the LV pre- and afterload conditions as well as the cardiac rhythm...
September 12, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#14
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887695/a-nirs-death-experience-a-reduction-in-cortical-oxygenation-by-time-resolved-near-infrared-spectroscopy-preceding-cardiac-arrest
#15
C Lanks, C B Kim, H B Rossiter
Near-infrared spectroscopy (NIRS) has been used effectively post-cardiac-arrest to gauge adequacy of resuscitation and predict the likelihood of achieving a return of spontaneous circulation. However, preempting hemodynamic collapse is preferable to achieving ROSC through advanced cardiac life support. Minimizing "time down" without end-organ perfusion has always been a central pillar of ACLS. In many critically ill patients there is a prolonged phase of end-organ hypoperfusion preceding loss of palpable pulses and initiation of ACLS...
September 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28885215/hyperspectral-imaging-as-a-novel-diagnostic-tool-in-microcirculation-of-wounds
#16
Georg Daeschlein, Inga Langner, Thomas Wild, Sebastian von Podewils, Claudia Sicher, Thomas Kiefer, Michael Jünger
Monitoring of perfusion is a cornerstone in surgery, phlebology and basic science to proof wound healing by interventions. In chronic wound management it is of utmost importance to realize and parametrize wound bed perfusion to verify actual, and plan further treatment by noninvasive diagnostics. Up to now monitoring is based on visual inspection of wounds as conventionally practiced over more than decades. The main problems of visual inspection are the lack of standardization and comparability because of interindividual variations...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28880397/transcranial-doppler-a-stethoscope-for-the-brain-neurocritical-care-use
#17
REVIEW
Chiara Robba, Danilo Cardim, Mypinder Sekhon, Karol Budohoski, Marek Czosnyka
Transcranial Doppler (TCD) ultrasonography is a noninvasive bedside monitoring technique that can evaluate cerebral blood flow hemodynamics in the intracranial arterial vasculature. TCD allows assessment of linear cerebral blood flow velocity, with a high temporal resolution and is inexpensive, reproducible, and portable. The aim of this review is to provide an overview of the most commonly used TCD derived signals and measurements used commonly in neurocritical care. We describe both basic (flow velocity, pulsatility index) and advanced concepts, including critical closing pressure, wall tension, autoregulation, noninvasive intracranial pressure, brain compliance, and cerebrovascular time constant; we also describe the clinical applications of TCD to highlight their utility in the diagnosis and monitoring of cerebrovascular diseases as the "stethoscope for the brain...
September 7, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28874293/a-plea-for-an-early-ultrasound-clinical-integrated-approach-in-patients-with-acute-heart-failure-a-proactive-comment-on-the-esc-guidelines-on-heart-failure-2016
#18
G Tavazzi, A N Neskovic, A Hussain, G Volpicelli, G Via
BACKGROUND: The European Association of Cardiology (ESC) Guidelines on the diagnosis and treatment of acute heart failure (AHF) indicate prompt therapy initiation and performance of relevant investigations as paramount. Specifically, echocardiography prior to treatment is advocated only with hemodynamic instability, and the evaluation of clinical signs of peripheral perfusion and congestion is suggested as guidance for early interventions. Given the growing body of evidence on the diagnostic/monitoring capabilities of bedside ultrasound (including focused cardiac ultrasound, comprehensive echocardiography, lung ultrasound), we discuss the potential benefit of an integrated clinical/ultrasound approach at the very early stages of acute heart failure...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28868984/the-new-kidney-donor-allocation-system-and-implications-for-anesthesiologists
#19
Srikanth Sridhar, Sara Guzman-Reyes, Sam D Gumbert, Semhar J Ghebremichael, Angelina R Edwards, Mark J Hobeika, Wasim A Dar, Evan G Pivalizza
Given potential disparity and limited allocation of deceased donor kidneys for transplantation, a new federal kidney allocation system was implemented in 2014. Donor organ function and estimated recipient survival in this system has implications for perioperative management of kidney transplant recipients. Early analysis suggests that many of the anticipated goals are being attained. For anesthesiologists, implications of increased dialysis duration and burdens of end-stage renal disease include increased cardiopulmonary disease, challenging fluid, hemodynamic management, and central vein access...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28867577/biological-properties-of-cardiac-mesenchymal-stem-cells-in-rats-with-diabetic-cardiomyopathy
#20
Diógenes Rodrigo Maronezzi de Paula, Vanessa Capuano, Daniel Mendes Filho, Anna Cecília Dias Maciel Carneiro, Virgínia de Oliveira Crema, Lucas Felipe de Oliveira, Aldo Rogélis Aquiles Rodrigues, Nicola Montano, Valdo José Dias da Silva
Cardiomyopathy is a major outcome in patients with diabetes mellitus (DM) and contributes to the high morbidity/mortality observed in this disease. AIMS: To evaluate several biological properties of cardiac mesenchymal stem cells (cMSCs) in a rat model of streptozotocin-induced DM with concomitant diabetic cardiomyopathy. MAIN METHODS: After 10weeks of DM induction, diabetic and control rats were assessed using ECG and ventricular hemodynamics monitoring. Then, the hearts were excised and processed for histology and for extracting non-cardiomyocytic cells...
August 31, 2017: Life Sciences
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