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Hemodynamic review

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https://www.readbyqxmd.com/read/29451817/the-impact-of-pulse-pressure-on-cerebrovascular-events-leading-to-age-related-cognitive-decline
#1
Nathalie Thorin-Trescases, Olivia de Montgolfier, Anthony Pinçon, Adeline Raignault, Laurie Caland, Pauline Labbé, Eric Thorin
Aging is a modern concept: human life expectancy has more than doubled in less than 150 years in Western countries. Longer lifespan, however, reveals age-related diseases, including cerebrovascular diseases. The vascular system is a prime target of aging: the "wear and tear" of large elastic arteries exposed to a life-long pulsatile pressure causes arterial stiffening by fragmentation of elastin fibers and replacement by stiffer collagen. This arterial stiffening increases in return the amplitude of the pulse pressure (PP), its wave penetrating deeper into the microcirculation of low resistance, high flow organs such as the brain...
February 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29448302/retroperitoneal-laparoscopic-adrenalectomy-with-transient-renal-artery-occlusion-for-large-adrenal-tumors-%C3%A2-8-cm
#2
Binbin Gong, Ming Ma, Wenjie Xie, Xiaorong Yang, Ting Sun
OBJECTIVES: To analyze our experience in retroperitoneal laparoscopic adrenalectomy (RLA) with transient renal artery occlusion for large adrenal tumors (≥8 cm) and to explore the safety and feasibility of this surgical procedure. METHODS: A retrospective cohort study was conducted with a surgical data review of 18 patients with large adrenal tumors who underwent RLA with transient renal artery occlusion in our hospital. RESULTS: Eighteen patients were treated by RLA with transient occlusion of the renal artery, and none were converted to open adrenalectomy...
February 15, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29448035/nanomedicines-and-gene-therapy-for-the-delivery-of-growth-factors-to-improve-perfusion-and-oxygenation-in-wound-healing
#3
Céline M Desmet, Véronique Préat, Bernard Gallez
Oxygen plays a key role in wound healing, and hypoxia is a major cause of wound healing impairment; therefore, treatments to improve hemodynamics and increase wound oxygenation are of particular interest for the treatment of chronic wounds. This article describes the roles of oxygen and angiogenesis in wound healing as well as the tools used to evaluate tissue oxygenation and perfusion and then presents a review of nanomedicines and gene therapies designed to improve perfusion and oxygenation and accelerate wound healing...
February 12, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29444562/fluid-resuscitation-during-early-sepsis-a-need-for-individualization
#4
Mathieu Jozwiak, Olfa Hamzaoui, Xavier Monnet, Jean-Louis Teboul
The prognosis of septic shock is tightly linked to the earliness of both appropriate antibiotic therapy and early hemodynamic resuscitation. This latter is essentially based on fluid and vasopressors administration. The step-by-step strategy, called "early goal-directed therapy" (EGDT) developed in 2001 and endorsed by the Surviving Sepsis Campaign (SSC) between 2004 and 2016 is no longer recommended. Indeed, recent multicenter randomized clinical trials showed no reduction in all-cause mortality, duration of organ support and in-hospital length of stay with EGDT in comparison with standard care...
February 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29443857/the-fast-exam-can-reliably-identify-patients-with-significant-intraabdominal-hemorrhage-in-life-threatening-pelvic-fractures
#5
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29442469/brain-death-associated-pathological-events-and-therapeutic-options
#6
REVIEW
Paweł Chudoba, Wojciech Krajewski, Joanna Wojciechowska, Dorota Kamińska
BACKGROUND: At present, organ transplantation is the most efficient treatment of end-stage failure of various organs, including the heart, lungs, pancreas, intestines, kidney, and liver. Despite the efforts to use organs from living donors or from donors after circulatory death, most of the organs are recovered from brain dead (BD) donors. METHODS: The Medline and Web of Science databases were searched without time limit on November 2015 using the terms "brain dead donor" and "deceased donor" in conjunction with "transplantation", "graft", "organ", "hemodynamic", "hormonal", or "management"...
December 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29441818/comparative-effectiveness-and-harms-of-intraoperative-transesophageal-echocardiography-in-noncardiac-surgery-a-systematic-review
#7
Ashraf Fayad, Sasha Shillcutt, Massimiliano Meineri, Terrence D Ruddy, Mohammed Toseef Ansari
Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29439775/right-ventricular-fractional-area-of-change-is-predictive-of-ventilator-support-days-in-trauma-and-burn-patients
#8
Duraid Younan, David C Pigott, C Blayke Gibson, John P Gullett, Ahmed Zaky
Echocardiography has contributed to the care of critically ill patients but there remains a need for more publications about its association with outcomes to confirm its role. We conducted a retrospective review of trauma and burn patients that were admitted to our intensive care unit between 2015 and 2017 that underwent hemodynamic transesophageal echocardiography. Data collected included demographics, clinical and laboratory data. Right ventricle fractional area of change (RVFAC) measurements were performed on still mages obtained from mid-esophageal four-chamber-view clips...
February 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29436916/middle-cerebral-artery-pressure-changes-following-pipeline-flow-diversion
#9
Denise Brunozzi, Sophia F Shakur, Fady T Charbel, Ali Alaraj
Objective Pipeline embolization devices (PED) are commonly used for endovascular treatment of cerebral aneurysms but changes in intracranial hemodynamics after PED deployment are poorly understood. Here, we assess middle cerebral artery (MCA) and systemic blood pressure before and after PED treatment. Methods Records of patients with cerebral aneurysms proximal to the internal carotid artery terminus treated with PED at our institution between 2015 and 2017 were retrospectively reviewed. Patients were included if ipsilateral MCA pressure measurements were available...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29436717/early-hemodynamic-changes-after-fetal-aortic-stenosis-valvuloplasty-predict-biventricular-circulation-at-birth
#10
Aaron R Prosnitz, Monika Drogosz, Audrey C Marshall, Louise E Wilkins-Haug, Carol B Benson, Lynn A Sleeper, Wayne Tworetzky, Kevin G Friedman
OBJECTIVE: To describe the early hemodynamic changes after fetal aortic valvuloplasty (FAV) for evolving hypoplastic left heart syndrome due to mid-gestational aortic stenosis and to assess whether these early changes predict biventricular (BiV) circulation at neonatal discharge. METHOD: We retrospectively reviewed all technically successful FAV cases resulting in live birth between 2000 and 2015 (n=93, 45% BiV circulation at neonatal discharge). Paired testing methods were used to compare pre- and post-intervention measures of left ventricular hemodynamics...
February 13, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29435739/multiparametric-magnetic-resonance-imaging-in-the-assessment-of-pulmonary-hypertension-initial-experience-of-a-one-stop-study
#11
Gisela M B Meyer, Fernanda B Spilimbergo, Stephan Atmayer, Gabriel S Pacini, Matheus Zanon, Guilherme Watte, Edson Marchiori, Bruno Hochhegger
INTRODUCTION: Our goal was to assess the diagnostic performance of magnetic resonance imaging (MRI) as a single method to diagnose pulmonary hypertension (PH) compared to right heart catheterization (RHC), computed tomography (CT), and ventilation/perfusion (V/Q) scintigraphy. METHODS: We identified 35 patients diagnosed with PH by RHC in our institution who have also undergone a CT, a scintigraphy, and an MRI within a month. All cases were discussed in multidisciplinary meetings...
February 12, 2018: Lung
https://www.readbyqxmd.com/read/29433968/dynamic-stress-computed-tomography-myocardial-perfusion-for-detecting-myocardial-ischemia-a-systematic-review-and-meta-analysis
#12
Minjie Lu, Shuli Wang, Arlene Sirajuddin, Andrew E Arai, Shihua Zhao
BACKGROUND: Comparing to SPECT and MRI, with higher temporal and spatial resolution and development of radiation dose reduction, myocardial computed tomography perfusion has emerged as a potential method for evaluation of hemodynamic myocardial ischemia. This meta-analysis systematically analyzed the performance of dynamic CT myocardial perfusion (DCTMP) to diagnose myocardial ischemia (MI) with clinically established reference methods [MR/SPECT/PET perfusion and fractional flow reserve (FFR)] as the reference standard...
February 10, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29433561/pregnancy-outcome-in-a-pregnant-patient-with-idiopathic-pulmonary-arterial-hypertension-a-case-report-and-review-of-the-literature
#13
Farid Rashidi, Hossein Sate
BACKGROUND: Idiopathic pulmonary arterial hypertension is a rare and progressive condition which is aggravated by the physiologic changes during pregnancy. Because of high mortality rate, most physicians recommend early termination of pregnancy in patients with idiopathic pulmonary arterial hypertension. CASE PRESENTATION: Here we describe a case of a 30-year-old primigravida Caucasian housewife with functional class 1 idiopathic pulmonary arterial hypertension and a positive vasoreactive response to adenosine who had a full-term non-complicated delivery...
February 13, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29433351/transcatheter-pulmonary-valve-implantation-will-it-replace-surgical-pulmonary-valve-replacement
#14
Ahmed Kheiwa, Punag Divanji, Vaikom S Mahadevan
Right ventricular outflow tract (RVOT) dysfunction is a common hemodynamic challenge for adults with congenital heart disease (ACHD), including patients with repaired tetralogy of Fallot (TOF), truncus arteriosus (TA), and those who have undergone the Ross procedure for congenital aortic stenosis and the Rastelli repair for transposition of great vessels. Pulmonary valve replacement (PVR) has become one of the most common procedures performed for ACHD patients. Areas covered: Given the advances in transcatheter technology, we conducted a detailed review of the available studies addressing the indications for PVR, historical background, evolving technology, procedural aspects, and the future direction, with an emphasis on ACHD patients...
February 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29432502/comparison-of-the-effect-of-intravenous-anesthetics-used-for-anesthesia-during-electroconvulsive-therapy-on-the-hemodynamic-safety-and-the-course-of-ect
#15
REVIEW
Rafał Wojdacz, Łukasz Święcicki, Anna Antosik-Wójcińska
Electroconvulsive therapy (ECT) is the treatment method widely used in psychiatric disorders such as depression, bipolar disorder, schizophrenia and schizoaffective disorder. The advantage of ECT is therapeutic response that occurs significantly earlier than during pharmacotherapy. Initially ECTwas used without anesthesia. Then, in the 1950s procedures with general anesthesia were introduced to reduce the complications that may occur during a seizure caused by ECT, such as broken bones, teeth, tendon rupture, muscle damage...
December 30, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/29431283/predictive-value-of-presuperior-cavopulmonary-anastomosis-cardiac-catheterization-at-increased-altitude
#16
Michael V Di Maria, Matthew Mulvahill, James Jaggers, David Dunbar Ivy, Adel K Younoszai
OBJECTIVE: Infants with single ventricle physiology typically undergo cardiac catheterization prior to superior cavopulmonary anastomosis (SCPA) to assess operative suitability. Predictors of poor outcome at sea level include elevated pulmonary artery pressure (mPAP), indexed pulmonary vascular resistance (PVRi), age <3 months, significant atrioventricular valve regurgitation, among others. Increased altitude has vasoconstrictive effects on the pulmonary vasculature, which may affect pre-SCPA hemodynamics and outcomes...
February 12, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29427619/the-association-of-aortic-valve-pathology-with-renal-resistive-index-as-a-kidney-injury-biomarker
#17
Benjamin Y Andrew, Anne D Cherry, Jennifer N Hauck, Alina Nicoara, Cory D Maxwell, Ryan M Konoske, Annemarie Thompson, Lakshmi D Kartha, Madhav Swaminathan, Mark Stafford-Smith
BACKGROUND: Acute kidney injury (AKI) is a common serious complication following cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (insufficiency and/or stenosis) and RRI is unknown. This study aimed to investigate RRI variability related to aortic valve pathology. METHODS: In a retrospective review of cardiac surgery patients, RRI and aortic valve pathology were assessed prior to cardiopulmonary bypass using transesophageal echocardiography...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29423912/implementing-and-assessing-a-standardized-protocol-for-weaning-children-successfully-from-extracorporeal-life-support
#18
Rouven Kubicki, René Höhn, Jochen Grohmann, Thilo Fleck, Katja Reineker, Johannes Kroll, Matthias Siepe, Christoph Benk, Rolf Klemm, Frank Humburger, Brigitte Stiller
Extracorporeal life support (ECLS) weaning is a complex interdisciplinary process with no clear guidelines. To assess ventricular and pulmonary function as well as hemodynamics including end-organ recovery during ECLS weaning, we developed a standardized weaning protocol. We reviewed our experience 2 years later to assess its feasibility and efficacy. In 2015 we established an inter-professional, standardized, stepwise protocol for weaning from ECLS. If the patient did not require further surgery, weaning was conducted bedside in the intensive care unit (ICU)...
February 8, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29422276/insertion-of-the-impella-via-the-axillary-artery-for-high-risk-percutaneous-coronary-intervention
#19
Huu Tam D Truong, Glenn Hunter, Kapildeo Lotun, Ranjith Shetty, Madhan Shanmugasundaram, Divya Kapoor, Hoang M Thai
Hemodynamic support with the Impella device is an important tool during high risk percutaneous coronary intervention. This device is usually inserted via the femoral artery. However, some patients have severe peripheral artery disease precluding the use of the femoral artery for this purpose. The axillary artery is a viable alternative in these cases. We reviewed the two access techniques for inserting the Impella via the axillary artery and also described 6 cases of successful implantation.
January 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29421006/mechanism-for-temporal-changes-in-exercise-capacity-after-fontan-palliation-role-of-doppler-echocardiography
#20
Alexander Egbe, Arooj R Khan, William R Miranda, Naser M Ammash, Carole A Warnes, Sameh S Said, Nathaniel W Taggart, Emmanuel Akintoye, Gruschen R Veldtman, Heidi M Connolly
BACKGROUND: The objective was to better understand Doppler hemodynamics and exercise capacity in patients with Fontan palliation by delineating the hemodynamic mechanism for temporal changes in their peak oxygen consumption (V̇o2). METHODS: We performed a retrospective review of adult Fontan patients with systemic left ventricle (LV) who underwent serial transthoracic echocardiograms (TTE) and cardiopulmonary exercise tests (CPET) at Mayo Clinic in 2000-2015. TTE and CPET data were used (1) to determine agreement between V̇o2 and Doppler-derived LV function indices (eg, stroke volume index [SVI] and cardiac index [CI]) and (2) to determine agreement between temporal changes in peak V̇o2 and LV function indices...
February 2018: American Heart Journal
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