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Invasive hemodynamic monitoring

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https://www.readbyqxmd.com/read/27923692/a-hemodynamic-directed-approach-to-pediatric-cardiopulmonary-resuscitation-hd-cpr-improves-survival
#1
Ryan W Morgan, Todd J Kilbaugh, Wesley Shoap, George Bratinov, Yuxi Lin, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27903458/cardiac-arrest-among-patients-with-infections-causes-clinical-practice-and-research-implications
#2
REVIEW
Davide Leoni, Jordi Rello
The incidence of sepsis is increasing, and the condition is now the leading cause of death in general intensive care units (ICUs). Our review failed to identify studies of the causes of cardiac arrest among infected patients, even though non-cardiac causes represent 15% of out-of-hospital cardiac arrests and though one-third of events have positive blood cultures. Sudden cardiac arrest is the result of local damage to the heart and of the impact of systemic and pulmonary conditions on cardiac performance, and its danger is underestimated...
November 26, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27896466/early-hemodynamic-assessment-and-treatment-of-elderly-patients-in-the-medical-icu
#3
Gorazd Voga, Lucija Gabršček-Parežnik
BACKGROUND AND OBJECTIVES: The aim of this retrospective study was to analyze differences in the initial hemodynamic assessment and its impact on the treatment in patients aged 80 years or older compared to younger patients during the first 6 h after admission to the medical intensive care unit (ICU). RESULTS: We analyzed 615 consecutive patients admitted to the medical ICU of which 124 (20%) were aged 80 years or more. The older group had a significantly higher acute physiology and chronic health evaluation (APACHE II) score, an overall mortality in the ICU and a presence of pre-existing cardiac disease...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27894069/association-between-left-atrial-dilatation-and-invasive-hemodynamics-at-rest-and-during-exercise-in-asymptomatic-aortic-stenosis
#4
Nicolaj Lyhne Christensen, Jordi Sanchez Dahl, Rasmus Carter-Storch, Rine Bakkestrøm, Kurt Jensen, Flemming Hald Steffensen, Eva Vad Søndergaard, Lars Videbæk, Jacob Eifer Møller
BACKGROUND: Transition from an asymptomatic to symptomatic state in severe aortic stenosis is often difficult to assess. Identification of a morphological sign of increased hemodynamic load may be important in asymptomatic aortic stenosis to identify patients at risk. METHODS AND RESULTS: Thirty-nine patients with asymptomatic severe aortic stenosis (aortic valve area <1 cm(2), peak jet velocity >3.5 m/s) underwent exercise testing with simultaneous invasive hemodynamic monitoring and Doppler echocardiography...
October 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27878445/can-non-invasive-ventilation-modify-central-venous-pressure-comparison-between-invasive-measurement-and-ultrasonographic-evaluation
#5
Maurizio Zanobetti, Alessio Prota, Alessandro Coppa, Laura Giordano, Sofia Bigiarini, Peiman Nazerian, Francesca Innocenti, Alberto Conti, Federica Trausi, Simone Vanni, Giuseppe Pepe, Riccardo Pini
Central venous pressure (CVP) is primarily measured to assess intravascular volume status and heart preload. In clinical practice, the measuring device most commonly used in emergency departments and intensive care units, is an electronic transducer that interconnects a central venous catheter (CVC) with a monitoring system. Non-invasive ventilation (NIV) consists in a breathing support that supplies a positive pressure in airways through a mask or a cask though not using an endotracheal prosthesis. In emergency settings, non-invasive ultrasonography evaluation of CVP, and hence of intravascular volume status entail the measurement by a subxiphoid approach of inferior vena cava diameter and its variations in relation to respiratory activity...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27875074/right-ventricular-dysfunction-after-cardiac-surgery-diagnostic-options
#6
Lars Grønlykke, Hanne Berg Ravn, Finn Gustafsson, Christian Hassager, Jesper Kjaergaard, Jens C Nilsson
Right ventricular (RV) failure after cardiac surgery is associated with an ominous prognosis. The aetiology of RV failure is multifaceted and the ability to recognize RV failure early is paramount in order to initiate timely treatment. The present review focuses on different diagnostic modalities for RV function and discusses the normal versus abnormal findings in RV monitoring after cardiac surgery and the limitations of the applicable diagnostic modalities. There are specific challenges in RV assessment after cardiac surgery due to a loss of longitudinal contraction and a concomitant gain of transverse contraction...
November 22, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27874050/automatic-identification-of-systolic-time-intervals-in-seismocardiogram
#7
Ghufran Shafiq, Sivanagaraja Tatinati, Wei Tech Ang, Kalyana C Veluvolu
Continuous and non-invasive monitoring of hemodynamic parameters through unobtrusive wearable sensors can potentially aid in early detection of cardiac abnormalities, and provides a viable solution for long-term follow-up of patients with chronic cardiovascular diseases without disrupting the daily life activities. Electrocardiogram (ECG) and siesmocardiogram (SCG) signals can be readily acquired from light-weight electrodes and accelerometers respectively, which can be employed to derive systolic time intervals (STI)...
November 22, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27858083/-cardiovascular-depression-and-intravascular-hemolysis-secondary-to-ethanol-injection-for-arteriovenous-malformation
#8
Mei-Hua Cai, Li-Xin Su, Lin Qiu
Ethanol is the only liquid embolization agent which can cure arteriovenous malformation. Complications of ethanol embolization are not rare including local tissue injury, intravascular hemolysis and cardiovascular depression even collapse, etc. This report presented a case of long time cardiovascular depression and intravascular hemolysis secondary to ethanol embolotherapy of right ear. In order to avoid the fatal complications that are associated with ethanol sclerotherapy, anesthesiologists should consider the use of continuously invasive hemodynamic monitoring while surgeons should carefully choose the dose of ethanol...
August 2016: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
https://www.readbyqxmd.com/read/27849259/reduced-systolic-volume-main-pathophysiological-mechanism-in-patients-with-orthostatic-intolerance
#9
Maria Zildany P Távora-Mehta, Niraj Mehta, Adriano Magajevski, Larissa de Oliveira, Débora Lee Smith Maluf, Letícia Concato, Eduardo Doubrawa, Márcio Rogério Ortiz, Cláudio L Pereira da Cunha
BACKGROUND: Orthostatic intolerance patients' pathophysiological mechanism is still obscure, contributing to the difficulty in their clinical management. OBJECTIVE: To investigate hemodynamic changes during tilt test in individuals with orthostatic intolerance symptoms, including syncope or near syncope. METHODS: Sixty-one patients who underwent tilt test at - 70° in the phase without vasodilators were divided into two groups. For data analysis, only the first 20 minutes of tilting were considered...
October 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27795989/normothermic-machine-perfusion-of-deceased-donor-liver-grafts-is-associated-with-improved-postreperfusion-hemodynamics
#10
Roberta Angelico, M Thamara P R Perera, Reena Ravikumar, David Holroyd, Constantin Coussios, Hynek Mergental, John R Isaac, Asim Iqbal, Hentie Cilliers, Paolo Muiesan, Peter J Friend, Darius F Mirza
BACKGROUND: Graft reperfusion poses a critical challenge during liver transplantation and can be associated with hemodynamic instability/postreperfusion syndrome. This is sequel to ischemia-reperfusion injury and normothermic machine preservation (NMP) may affect hemodynamic changes. Herein, we characterize postreperfusion hemodynamics in liver grafts after NMP and traditional cold preservation. MATERIALS AND METHODS: Intraoperative records of patients receiving grafts after NMP (n = 6; NMP group) and cold storage (CS) (n = 12; CS group) were compared...
September 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27794361/the-vulnerable-microcirculation-in-the-critically-ill-pediatric-patient
#11
REVIEW
J W Kuiper, D Tibboel, C Ince
In neonates, cardiovascular system development does not stop after the transition from intra-uterine to extra-uterine life and is not limited to the macrocirculation. The microcirculation (MC), which is essential for oxygen, nutrient, and drug delivery to tissues and cells, also develops. Developmental changes in the microcirculatory structure continue to occur during the initial weeks of life in healthy neonates. The physiologic hallmarks of neonates and developing children make them particularly vulnerable during critical illness; however, the cardiovascular monitoring possibilities are limited compared with critically ill adult patients...
October 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27764870/-invasive-and-minimally-invasive-hemodynamic-monitoring
#12
Matthias Hansen
Advanced hemodynamic monitoring is necessary for adequate management of high-risk patients or patients with derangement of circulation. Studies demonstrate a benefit of early goal directed therapy in unstable cardiopulmonary situations. In these days we have different possibilities of minimally invasive or invasive hemodynamic monitoring. Minimally invasive measurements like pulse conture analysis or pulse wave analysis being less accurate under some circumstances, however only an artery catheter is needed for cardiac output monitoring...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27764869/-hemodynamic-monitoring-basic-monitoring
#13
Torsten Schröder
Basic haemodynamic monitoring is an essential part of the anaesthesia work place. This includes Monitoring of ECG, blood pressure and pulse oximetry. For early assessement of perioperative complications every patient should have a basic haemodynamic monitoring, independant of current health status or the type of anaesthesia applied. Knowledge of function, principles and limitations ais necessary for proper interpretation of the measured values. Here, we describe the function and application of ECG, non - invasive intermittent blood pressure and pulse oximetry in the perioperative setting...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#14
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27725296/dural-traction-a-possible-cause-of-hemodynamic-changes-during-single-level-transforaminal-lumbar-interbody-fusion
#15
Jonathan M Weimer, Martin Marinov, Rafi Avitsian
A 58-year old male with grade II L4-L5 spondylolisthesis and degenerative changes presented for single level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on both EKG and invasive hemodynamic monitoring. The events correlated with and could possibly be a result of traction on the dura. Lumbar spinal surgery may be associated with electrophysiological and hemodynamic abnormalities, and anesthesia providers should be aware of such possibilities and the need to respond appropriately with sympathomimetic or vagolytic interventions...
October 7, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27723828/role-of-transcranial-doppler-in-the-evaluation-of-vasculopathy-in-tuberculous-meningitis
#16
Mei-Ling Sharon Tai, Vijay K Sharma
BACKGROUND: Vascular complications are important causes of cerebral infarction in tuberculous meningitis (TBM).Transcranial Doppler ultrasonography (TCD) is a non-invasive tool that can provide real-time information about cerebral hemodynamics. However, the literature on the role of TCD in the diagnosis or monitoring of vasculopathy associated with TBM is scarce. We explored the role of TCD in the diagnosis and monitoring of TBM-related vasculopathy of the major intracranial arteries...
2016: PloS One
https://www.readbyqxmd.com/read/27722956/measurement-of-arterial-stiffness-a-novel-tool-of-risk-stratification-in-hypertension
#17
János Nemcsik, Orsolya Cseprekál, András Tislér
Cardiovascular diseases are the leading causes of morbidity and mortality in industrialized countries worldwide, despite highly effective preventive treatments available. As a difference continues to exist between the estimated and true number of events, further improvement of risk stratification is an essential part of cardiovascular research.Among hypertensive patients measurement of arterial stiffness parameters, like carotid-femoral pulse wave velocity (cfPWV) or brachial-ankle pulse wave velocity (baPWV) can contribute to the identification of high-risk subpopulation of patients...
October 9, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27721647/optical-coherence-tomography-for-brain-imaging-and-developmental-biology
#18
Jing Men, Yongyang Huang, Jitendra Solanki, Xianxu Zeng, Aneesh Alex, Jason Jerwick, Zhan Zhang, Rudolph E Tanzi, Airong Li, Chao Zhou
Optical coherence tomography (OCT) is a promising research tool for brain imaging and developmental biology. Serving as a three-dimensional optical biopsy technique, OCT provides volumetric reconstruction of brain tissues and embryonic structures with micrometer resolution and video rate imaging speed. Functional OCT enables label-free monitoring of hemodynamic and metabolic changes in the brain in vitro and in vivo in animal models. Due to its non-invasiveness nature, OCT enables longitudinal imaging of developing specimens in vivo without potential damage from surgical operation, tissue fixation and processing, and staining with exogenous contrast agents...
July 2016: IEEE Journal of Selected Topics in Quantum Electronics
https://www.readbyqxmd.com/read/27716702/global-end-diastolic-volume-an-emerging-preload-marker-vis-a-vis-other-markers-have-we-reached-our-goal
#19
P M Kapoor, Vandana Bhardwaj, Amita Sharma, Usha Kiran
A reliable estimation of cardiac preload is helpful in the management of severe circulatory dysfunction. The estimation of cardiac preload has evolved from nuclear angiography, pulmonary artery catheterization to echocardiography, and transpulmonary thermodilution (TPTD). Global end-diastolic volume (GEDV) is the combined end-diastolic volumes of all the four cardiac chambers. GEDV has been demonstrated to be a reliable preload marker in comparison with traditionally used pulmonary artery catheter-derived pressure preload parameters...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27699112/continuous-cerebral-hemodynamic-measurement-during-deep-hypothermic-circulatory-arrest
#20
David R Busch, Craig G Rusin, Wanda Miller-Hance, Kathy Kibler, Wesley B Baker, Jeffrey S Heinle, Charles D Fraser, Arjun G Yodh, Daniel J Licht, Kenneth M Brady
While survival of children with complex congenital heart defects has improved in recent years, roughly half suffer neurological deficits suspected to be related to cerebral ischemia. Here we report the first demonstration of optical diffuse correlation spectroscopy (DCS) for continuous and non-invasive monitoring of cerebral microvascular blood flow during complex human neonatal or cardiac surgery. Comparison between DCS and Doppler ultrasound flow measurements during deep hypothermia, circulatory arrest, and rewarming were in good agreement...
September 1, 2016: Biomedical Optics Express
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