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Invasive hemodynamic monitoring

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https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#1
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29145331/severe-hemodynamic-instability-after-indocyanine-green-injection-during-off-pump-coronary-artery-bypass-grafting-a-case-report
#2
Qing Zhai, Yun Wang, Ayong Tian
RATIONALE: The increasingly intraoperative use of indocyanine green (ICG) means that it is necessary to be aware of both its advantages and potential adverse effects. PATIENT CONCERNS: A 76-year-old woman developed symptoms of sudden severe hemodynamic instability while undergoing coronary artery bypass grafting with ICG injection to detect the patency of the graft. The main clinical manifestations were a sudden drop in blood pressure and increased heart rate. DIAGNOSES: Severe side effects or allergic reaction of ICG...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#3
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy (HDP) is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in HDP considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVES: This study aimed to examine cardiovascular parameters in a cohort of patients affected by HDP according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of HDP...
November 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29099725/limitations-and-challenges-of-eit-based-monitoring-of-stroke-volume-and-pulmonary-artery-pressure
#4
Fabian Braun, Martin Proença, Mathieu Lemay, Mattia Bertschi, Andy Adler, Jean-Philippe Thiran, Josep Sola
<i>Objective</i>: Electrical impedance tomography (EIT) shows potential for radiation-free and non-invasive hemodynamic monitoring. However, many factors degrade the accuracy and repeatability of these measurements. Our goal is to estimate the impact of this variability on EIT-based monitoring of two important central hemodynamic parameters: stroke volume (SV) and pulmonary artery pressure (PAP). <i>Approach</i>: We performed simulations on a 4D (3D + t) bioimpedance model of a human volunteer to study the influence of four potential confounding factors (electrode belt displacement, electrode detachment, changes in hematocrit and lung air volume) on the performance of EIT-based SV and PAP estimation...
November 3, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29090260/assessment-of-method-agreement-between-two-minimally-invasive-hemodynamic-measurements-in-septic-shock-patients-on-high-doses-of-vasopressor-drugs-a-preliminary-study
#5
Oana Antal, Mihai Mărginean, Natalia Hagău
BACKGROUND: Minimally invasive hemodynamic monitoring is still controversial among the methods used to assess the hemodynamic profile of the septic shock patient. The aim of this study was to test the level of agreement between two different devices. METHODS: We collected 385 data entries during 12-hour intervals from four critically ill patients with septic shock and high doses of vasoactive therapy using two minimally invasive methods at the same time: Vigileo™ device which uses the pulse contour principle, and EV1000™ monitoring platform which uses the transpulmonary thermodilution principle...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29075895/cerebral-ischaemia-following-anterior-upper-thoracic-spinal-surgery-utilizing-a-partial-manubrial-resection
#6
David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Cecile Roscop, Louis Boissiere, Ibrahim Obeid, Olivier Gille, Jean-Marc Vital, Vincent Pointillart
PURPOSE: Firstly, to describe two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery and define the likely cause of this complication. Secondly, to describe preventative measures and the effect these have had in reducing this complication within our institution. METHODS: Firstly, a review of two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery utilizing a partial manubrial resection. Secondly, cadaveric dissections of the carotid arteries to determine the effect of neck positioning and aortic arch retraction during a simulated procedure...
October 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29073613/impact-of-the-flotrac-vigileotm-monitoring-on-intraoperative-fluid-management-and-outcome-after-liver-resection
#7
Enrico Giustiniano, Fabio Procopio, Nadia Ruggieri, Stefania Grimaldi, Guido Torzilli, Ferdinando Raimondi
BACKGROUNDS: Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. METHODS: We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs...
October 26, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29071338/prognostic-effect-and-longitudinal-hemodynamic-assessment-of-borderline-pulmonary-hypertension
#8
Tufik R Assad, Bradley A Maron, Ivan M Robbins, Meng Xu, Shi Huang, Frank E Harrell, Eric H Farber-Eger, Quinn S Wells, Gaurav Choudhary, Anna R Hemnes, Evan L Brittain
Importance: Pulmonary hypertension (PH) is diagnosed by a mean pulmonary arterial pressure (mPAP) value of at least 25 mm Hg during right heart catheterization (RHC). While several studies have demonstrated increased mortality in patients with mPAP less than that threshold, little is known about the natural history of borderline PH. Objective: To test the hypothesis that patients with borderline PH have decreased survival compared with patients with lower mPAP and frequently develop overt PH and to identify clinical correlates of borderline PH...
October 25, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29061119/computer-controlled-closed-loop-drug-infusion-system-for-automated-hemodynamic-resuscitation-in-endotoxin-induced-shock
#9
Kazunori Uemura, Toru Kawada, Can Zheng, Meihua Li, Masaru Sugimachi
BACKGROUND: Hemodynamic resuscitation in septic shock requires aggressive fluid replacement and appropriate use of vasopressors to optimize arterial pressure (AP) and cardiac output (CO). Because responses to these drugs vary between patients and within patient over time, strict monitoring of patient condition and repetitive adjustment of drug dose are required. This task is time and labor consuming, and is associated with poor adherence to resuscitation guidelines. To overcome this issue, we developed a computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in septic shock, and evaluated the performance of the system in a canine model of endotoxin shock...
October 23, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29059883/monitoring-of-cardiac-output-and-lung-ventilation-by-electrical-impedance-tomography-in-a-porcine-model-of-acute-lung-injury
#10
Nadine Hochhausen, Henriette Dohmeier, Rolf Rossaint, Michael Czaplik
Adequate medical treatment of the Acute Respiratory Distress Syndrome is still challenging since patient-individual aspects have to be taken into account. Lung protective ventilation and hemodynamic stability have always been two of the most crucial aims of intensive care therapy. For both aspects, a continuous - preferably non-invasive - monitoring is desirable that is available at the bedside. Unfortunately, there is no technique clinically established yet, that provides both measurement of cardiac stroke volume and ventilation dynamics in real-time...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29034783/cerebral-and-limb-tissue-oxygenation-during-peripheral-venoarterial-extracorporeal-life-support
#11
Nousjka P A Vranken, Anouk A M A Lindelauf, Antoine P Simons, Marcel J H Ariës, Jos G Maessen, Patrick W Weerwind
Femoral access in extracorporeal life support (ECLS) has been associated with regional variations in arterial oxygen saturation, potentially predisposing the patient to ischemic tissue damage. Current monitoring techniques, however, are limited to intermittent bedside evaluation of capillary refill among other factors. The aim of this study was to assess whether cerebral and limb regional tissue oxygen saturation (rSO2) values reflect changes in various patient-related parameters during venoarterial ECLS (VA-ECLS)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29030623/monitoring-cerebral-hemodynamic-change-during-transcranial-ultrasound-stimulation-using-optical-intrinsic-signal-imaging
#12
Evgenii Kim, Eloise Anguluan, Jae Gwan Kim
Transcranial ultrasound stimulation (tUS) is a promising non-invasive approach to modulate brain circuits. The application is gaining popularity, however the full effect of ultrasound stimulation is still unclear and further investigation is needed. This study aims to apply optical intrinsic signal imaging (OISI) for the first time, to simultaneously monitor the wide-field cerebral hemodynamic change during tUS on awake animal with high spatial and temporal resolution. Three stimulation paradigms were delivered using a single-element focused transducer operating at 425 kHz in pulsed mode having the same intensity (ISPPA = 1...
October 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29027094/multimodal-functional-neuroimaging-by-simultaneous-bold-fmri-and-fiber-optic-calcium-recordings-and-optogenetic-control
#13
REVIEW
Franziska Albers, Lydia Wachsmuth, Timo Mauritz van Alst, Cornelius Faber
Recent developments of optogenetic tools and fluorescence-based calcium recording techniques enable the manipulation and monitoring of neural circuits on a cellular level. Non-invasive imaging of brain networks, however, requires the application of methods such as blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI), which is commonly used for functional neuroimaging. While BOLD fMRI provides brain-wide non-invasive reading of the hemodynamic response, it is only an indirect measure of neural activity...
October 12, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/29026684/combined-multi-distance-frequency-domain-and-diffuse-correlation-spectroscopy-system-with-simultaneous-data-acquisition-and-real-time-analysis
#14
Stefan A Carp, Parisa Farzam, Norin Redes, Dennis M Hueber, Maria Angela Franceschini
Frequency domain near infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS) have emerged as synergistic techniques for the non-invasive assessment of tissue health. Combining FD-NIRS oximetry with DCS measures of blood flow, the tissue oxygen metabolic rate can be quantified, a parameter more closely linked to underlying physiology and pathology than either NIRS or DCS estimates alone. Here we describe the first commercially available integrated instrument, called the "MetaOx", designed to enable simultaneous FD-NIRS and DCS measurements at rates of 10 + Hz, and offering real-time data evaluation...
September 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28993402/exercise-intolerance-in-hfpef-diagnosing-and-ranking-its-causes-using-personalized-o2-pathway-analysis
#15
Nicholas E Houstis, Aaron S Eisman, Paul P Pappagianopoulos, Luke Wooster, Cole S Bailey, Peter D Wagner, Gregory D Lewis
Background -Heart failure with preserved ejection fraction (HFpEF) is a common syndrome with a pressing shortage of therapies. Exercise intolerance is a cardinal symptom of HFpEF, yet its pathophysiology remains uncertain. Methods -We investigated the mechanism of exercise intolerance in each of 134 patients referred for cardiopulmonary exercise testing (CPET): 79 with HFpEF and 55 controls. We performed CPET with invasive monitoring to measure hemodynamics, blood gases, and gas exchange during exercise. We used these measurements to quantify 6 steps of oxygen transport and utilization (the "O2 pathway") in each HFpEF patient, identifying the defective steps that impair each one's exercise capacity (peak VO2)...
October 9, 2017: Circulation
https://www.readbyqxmd.com/read/28956200/magnetic-resonance-guided-renal-denervation-using-active-tracking-first-in-vivo-experience-in-swine
#16
F Bönner, S Haberkorn, P Behm, B Schnackenburg, S Krüger, S Weiss, C Meyer, M Kelm, M Neizel-Wittke
Interventional cardiovascular magnetic resonance (iCMR) might evolve as a technique to improve procedural success rates in cardiovascular interventions by combining intraprocedural guidance and simultaneous lesion imaging. The objective of the present study was to prove feasibility and estimate safety of renal sympathetic denervation guided by real-time iCMR using active tracking. Six pigs were examined in a 1.5 T MRI-System (Achieva, Philips Healthcare, Best, Netherlands) equipped with non-invasive hemodynamic control and in-room monitors displaying an interventional software platform [Interventional MRI Suite (iSuite), Philips Research, Hamburg, Germany]...
September 27, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28934895/high-early-fluid-input-after-aneurysmal-subarachnoid-hemorrhage-combined-report-of-association-with-delayed-cerebral-ischemia-and-feasibility-of-cardiac-output-guided-fluid-restriction
#17
Leonie J M Vergouw, Mohamud Egal, Bas Bergmans, Diederik W J Dippel, Hester F Lingsma, Mervyn D I Vergouwen, Peter W A Willems, Annemarie W Oldenbeuving, Jan Bakker, Mathieu van der Jagt
BACKGROUND: Guidelines on the management of aneurysmal subarachnoid hemorrhage (aSAH) recommend euvolemia, whereas hypervolemia may cause harm. We investigated whether high early fluid input is associated with delayed cerebral ischemia (DCI), and if fluid input can be safely decreased using transpulmonary thermodilution (TPT). METHODS: We retrospectively included aSAH patients treated at an academic intensive care unit (2007-2011; cohort 1) or managed with TPT (2011-2013; cohort 2)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28925890/the-use-of-hemodynamic-and-cerebral-monitoring-to-study-pharmacodynamics-in-neonates
#18
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
#19
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/28916602/validation-study-of-image-based-fractional-flow-reserve-during-coronary-angiography
#20
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
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