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Hemodynamic review

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https://www.readbyqxmd.com/read/28822629/acute-intrapartum-rupture-of-the-pubic-symphysis-requiring-resuscitation-and-surgical-intervention-a-case-report
#1
Marie Buitendyk, Barbara Brennan, Parag Vora, Patricia Smith, Stephanie Winsor
BACKGROUND: Pubic symphysis rupture significant enough to cause serious complications or require surgical intervention is exceedingly rare. Here we review the literature and examine the details of a unique presentation. CASE: A 27-year-old woman presented in labour at 34+6 weeks gestation after an uncomplicated monochorionic-diamniotic twin pregnancy. After vaginal delivery, she developed a substantial labial hematoma. Hours later, she became hemodynamically unstable...
August 16, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28822391/the-impact-of-hemodynamic-transesophageal-echocardiography-on-the-use-of-continuous-renal-replacement-therapy-in-trauma
#2
Madison Griffin, Brett Howard, Sam Devictor, Josh Ferenczy, Frances Cobb, D Benjamin Christie
Post-traumatic fluid management is a widely debated topic. No best-practice consensus exists. Adverse outcomes such as acute kidney injury or volume overload are common. Continuous renal replacement therapy (CRRT) is an adjunct therapy for severe acute renal failure and volume overload, but is costly and not without risk. Hemodynamic transesophageal echocardiography (hTEE) is widely accepted as a reliable way to monitor volume status of intensive care unit (ICU) patients. Although data exist evaluating hTEE and CRRT independently, there is a lack of research mutually inclusive of the two...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820798/how-to-better-identify-patients-at-high-risk-of-postoperative-complications
#3
Daniel Talmor, Barry Kelly
PURPOSE OF REVIEW: Preoperative risk assessment and perioperative factors may help identify patients at increased risk of postoperative complications and allow postoperative management strategies that improve patient outcomes. This review summarizes historical and more recent scoring systems for predicting patients with increased morbidity and mortality in the postoperative period. RECENT FINDINGS: Most prediction scores predict postoperative mortality with, at best, moderate accuracy...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28817458/noninvasive-derivation-of-fractional-flow-reserve-from-coronary-computed-tomographic-angiography-a-review
#4
Stewart M Benton, Christian Tesche, Carlo N De Cecco, Taylor M Duguay, U Joseph Schoepf, Richard R Bayer
Coronary computed tomographic angiography (CCTA) has evolved as a rapid and highly sensitive method for the exclusion of obstructive coronary artery disease. Unfortunately, as it pertains to moderate and severe lesions, the ability to discriminate between those that are hemodynamically significant and those that are nonobstructive is lacking. Consequently, this deficiency can result in a significant number of unnecessary referrals for invasive angiography that yields nonobstructive results. Fractional flow reserve (FFR), which assesses the hemodynamic significance of a specific lesion, when performed during invasive angiography, results in improved patient outcomes compared with visual stenosis assessment alone...
August 16, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#5
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28807477/echocardiographic-features-and-clinical-outcomes-of-flail-mitral-leaflet-without-severe-mitral-regurgitation
#6
Devin W Kehl, Florian Rader, Robert J Siegel
BACKGROUND: Flail mitral leaflet is a common complication of degenerative mitral regurgitation (MR) and is generally equated with severe MR. However, a flail mitral leaflet is not always associated with severe MR. The hemodynamic and clinical significance of a flail leaflet in the absence of severe MR has not been characterized. The authors identified cases of flail mitral leaflet associated with only mild or moderate MR and evaluated their echocardiographic features and clinical outcomes...
August 11, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28805343/rest-and-exercise-hemodynamic-and-metabolic-findings-in-active-duty-soldiers-referred-for-cardiac-catheterization-to-exclude-heart-disease-insights-from-past-invasive-cardiopulmonary-exercise-testing-using-multisensor-high-fidelity-catheters
#7
James A Watts, Faith R Kelly, Terry D Bauch, Joseph P Murgo, Bernard J Rubal
OBJECTIVE: This study describes results of iCPET from the past, which used submaximal stress and multisensor high-fidelity catheters to exclude heart disease in a unique population of young adults. BACKGROUND: There has been resurgence in comprehensive hemodynamic evaluation of complex cardiovascular patients. Although dynamic assessments during cardiac catheterization have become commonplace, there remains limited information regarding left and right heart hemodynamic changes during supine exercise in young adults...
May 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28805298/female-urethral-injuries-associated-with-pelvic-fracture-a-systematic-review-of-the-literature
#8
REVIEW
Devin N Patel, Cynthia S Fok, George D Webster, Jennifer T Anger
OBJECTIVES: To systematically review the literature of female urethral injuries associated with pelvic fracture and determine optimal management of this rare injury. MATERIALS AND METHODS: Using Meta-analysis Of Observational Studies in Epidemiology criteria, we searched Cochrane, Pubmed and OVID databases for all articles available before June 30, 2016 using the terms "female pelvic fracture urethroplasty," "female urethral distraction," "female pelvic fracture urethral injury," "female pelvic fracture urethra girls...
August 14, 2017: BJU International
https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#9
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28803996/perioperative-hemodynamics-and-outcomes-of-patients-on-metyrosine-undergoing-resection-of-pheochromocytoma-or-paraganglioma
#10
James J Butz, Toby N Weingarten, Alexandre N Cavalcante, Irina Bancos, William F Young, Travis J McKenzie, Darrell R Schroeder, David P Martin, Juraj Sprung
INTRODUCTION: To describe outcomes of patients with metyrosine (MET) pretreatment for abdominal surgical resection of pheochromocytoma or paraganglioma (PCC/PGL) compared with patients who had phenoxybenzamine (PBZ) pretreatment. METHODS: Retrospective review of perioperative outcomes for PCC/PGL patients treated with MET and propensity-matched comparison of MET and PBZ (MET + PBZ) with PBZ alone. RESULTS: MET preparation was given in 63 cases (26 laparoscopic and 37 open, of which 55 also received PBZ)...
August 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28803941/fast-imaging-for-mapping-dynamic-networks
#11
REVIEW
Pierre LeVan, Burak Akin, Jürgen Hennig
The development of highly accelerated fMRI acquisition techniques has led to novel possibilities to monitor cerebral activity non-invasively and with unprecedented temporal resolutions. With the emergence of dynamic connectivity and its ability to provide a much richer characterization of brain function compared to static measures, fast fMRI may yet play a crucial role in tracking dynamically varying networks. In spite of the dominance of slow hemodynamic contributions to the BOLD signal, high temporal sampling rates nevertheless improve the measurement of physiological noise, yielding an exceptional sensitivity for the detection of periods of transient connectivity at time scales of a few tens of seconds...
August 10, 2017: NeuroImage
https://www.readbyqxmd.com/read/28803173/ruptured-vertebral-artery-dissecting-aneurysm-concurrent-with-spontaneous-cervical-internal-carotid-artery-dissection-a-report-of-three-cases-and-literature-review
#12
Yosuke Akamatsu, Kenichi Sato, Hidenori Endo, Yasushi Matsumoto, Teiji Tominaga
BACKGROUND: Multiple dissections rarely occur with ruptured vertebral artery dissecting aneurysms (VADAs). Here, we report three cases of ruptured VADA concurrent with spontaneous cervical internal carotid artery (ICA) dissection. CASE DESCRIPTION: None of the three patients had a history of vasculopathy or trauma. All ruptured VADAs were treated with internal coil trapping in the acute stage of subarachnoid hemorrhage (SAH). Rebleeding was not observed in any patients after the treatment...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28802605/laparoscopic-cholecystectomy-under-neuraxial-anesthesia-compared-with-general-anesthesia-systematic-review-and-meta-analyses
#13
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Pneumoperitoneum during laparoscopic cholecystectomy (LC) can cause hypercapnia, hypoxemia, hemodynamic changes and shoulder pain. General anesthesia (GA) enables the control of intraoperative pain and ventilation. The need for GA has been questioned by studies suggesting that neuraxial anesthesia (NA) is adequate for LC. STUDY OBJECTIVE: To quantify the prevalence of intraoperative pain and to verify whether evidence on the maintenance of ventilation, circulation and surgical anesthesia during NA compared with GA is consistent...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#14
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previous published reports suggest that these cases should be managed peri-operatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of sixty-seven isolated intestinal, intestinal-pancreas and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28799708/acute-and-mid-term-outcomes-of-stent-implantation-for-recurrent-coarctation-of-the-aorta-between-the-norwood-operation-and-fontan-completion-a-multi-center-pediatric-interventional-cardiology-early-career-society-investigation
#15
Osamah Aldoss, Bryan H Goldstein, Saar Danon, Sebastian Goreczny, Robert G Gray, Shyam Sathanandam, Wendy Whiteside, Derek A Williams, Jeffrey D Zampi
OBJECTIVES: We sought to evaluate outcomes of stent implantation (SI) for recurrent coarctation of the aorta (RC) following the Norwood operation. BACKGROUND: RC is common following the Norwood operation. Balloon angioplasty (BA) is standard treatment but may result in unsatisfactory relief of RC. SI may improve RC, but outcome data are limited. METHODS: We performed a multi-center retrospective study of patients who underwent SI for RC between the Norwood operation and Fontan completion...
August 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28799254/sex-specific-factors-regulating-pressure-and-flow
#16
Jill N Barnes
Over the last decade, there have been many published reports on sex differences in blood pressure regulation between young men and young women. The autonomic nervous system is a primary contributor to both acute and long-term blood pressure regulation. Sex differences in blood pressure regulation likely have effects that extend beyond mean arterial pressure, and which can affect blood flow and tissue function. This short review will include recent literature from our laboratory focusing on autonomic control of the circulation, specifically age and sex hormone related differences in central hemodynamics and cerebral blood flow, and discuss potential clinical implications...
August 11, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28799045/trauma-laparoscopy-when-to-start-and-when-to-convert
#17
Oleh Matsevych, Modise Koto, Moses Balabyeki, Colleen Aldous
BACKGROUND: The use of laparoscopy for stable patients with abdominal trauma is increasing and its accuracy is nearly 100%. However, indications for laparoscopy and for conversion differ among centers. The aim of this study was to investigate indications for trauma laparoscopy and for conversion to laparotomy. METHODS: All trauma patients managed with laparoscopy over a 4-year period were retrospectively analyzed. Indications for laparoscopy, morbidity, and reasons for conversion were investigated and predictors of morbidity and conversion were sought...
August 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28795027/the-ross-procedure-in-pediatric-patients-a-20-year-experience-of-ross-procedure-in-a-single-institution
#18
Dong Woog Yoon, Ji-Hyuk Yang, Tae-Gook Jun, Pyo Won Park
BACKGROUND: The Ross/Ross-Konno procedure is considered a good option for irreparable aortic valve disease in pediatric patients because of its hemodynamic performance and potential for growth of the pulmonary autograft. This study is a review of the long-term results of our 20-year experience with the Ross and Ross-Konno operations in a single institution. METHODS: Between June 1995 and January 2016, 16 consecutive patients (mean age, 6.0±5.9 years; range, 16 days to 17...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28794867/rapid-onset-of-amiodarone-induced-pulmonary-toxicity-after-lung-lobe-resection-a-case-report-and-review-of-recent-literature
#19
Heiko Baumann, Phillip Fichtenkamm, Thomas Schneider, Jürgen Biscoping, Michael Henrich
Amiodarone-induced pulmonary toxicity (APT) is a severe side effect that can lead to lung fibrosis or fatal respiratory failure. Usually APT occurs during long term therapy after administration of prolonged loading doses or high cumulative doses. We present the case of a 58 year old woman who underwent thoracic surgery with lobe resection. She developed atrial fibrillation with hemodynamic-instability on the first post-operative day. We initiated amiodarone therapy and four days later she developed respiratory failure...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#20
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
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