keyword
https://read.qxmd.com/read/38524770/impact-of-goal-directed-hemodynamic-therapy-on-perioperative-outcomes-in-head-and-neck-free-flap-surgery-a-before-and-after-pilot-study
#1
JOURNAL ARTICLE
Justine Philteos, Stuart A McCluskey, Sophia Emerson, George Djaiani, David Goldstein, Sabri Soussi
BACKGROUND: Free flap reconstruction for head and neck cancer is associated with a high risk of perioperative complications. One of the modifiable risk factors associated with perioperative morbidity is intraoperative hypotension (IOH). The main aim of this pilot study is to determine if the intraoperative use of goal-directed hemodynamic therapy (GDHT) is associated with a reduction in the number of IOH events in this population. METHODS: A before-and-after study design...
March 2024: Health Science Reports
https://read.qxmd.com/read/38518863/hemodynamic-management-of-cardiogenic-shock-in-the-intensive-care-unit
#2
REVIEW
Hoong Sern Lim, José González-Costello, Jan Belohlavek, Elric Zweck, Vanessa Blumer, Benedikt Schrage, Thomas C Hanff
Hemodynamic derangements are defining features of cardiogenic shock. Randomized clinical trials have examined the efficacy of various therapeutic interventions, from percutaneous coronary intervention to inotropes and mechanical circulatory support (MCS). However, hemodynamic management in cardiogenic shock has not been well-studied. This State-of-the-Art review will provide a framework for hemodynamic management in cardiogenic shock, including a description of the four therapeutic phases from initial 'Rescue' to 'Optimization', 'Stabilization' and 'de-Escalation or Exit therapy' (R-O-S-E), phenotyping and phenotype-guided tailoring of pharmacological and MCS support, to achieve hemodynamic and therapeutic goals...
March 20, 2024: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/38512646/comparison-of-dynamic-measures-in-intraoperative-goal-directed-fluid-therapy-of-patients-with-morbid-obesity-undergoing-laparoscopic-sleeve-gastrectomy
#3
JOURNAL ARTICLE
Gökhan Urhan, İsmail Demirel, Ahmet Deniz, Ahmet Aksu, Aysun Yıldız Altun, Esef Bolat, Azize Beştaş, Gülsüm Altuntaş
INTRODUCTION: Obesity increases the risk of morbidity and mortality during surgical procedures. Goal-directed fluid therapy (GDFT) is a new concept for perioperative fluid management that has been shown to improve patient prognosis. This study aimed to investigate the role of the Pleth Variability Index (PVI), systolic pressure variation (SPV), and pulse pressure variation (PPV) in maintaining tissue perfusion and renal function during GDFT management in patients undergoing laparoscopic sleeve gastrectomy (LSG)...
March 21, 2024: Obesity Surgery
https://read.qxmd.com/read/38392609/challenges-in-septic-shock-from-new-hemodynamics-to-blood-purification-therapies
#4
REVIEW
Fernando Ramasco, Jesús Nieves-Alonso, Esther García-Villabona, Carmen Vallejo, Eduardo Kattan, Rosa Méndez
Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; however, there are aspects that have changed. This narrative review highlights current and avant-garde methods of handling patients experiencing septic shock based on the experience of its authors and the best available evidence in a context of uncertainty. Following the first recommendation of the Surviving Sepsis Campaign guidelines, it is recommended that specific sepsis care performance improvement programs are implemented in hospitals, i...
February 3, 2024: Journal of Personalized Medicine
https://read.qxmd.com/read/38348932/goal-directed-fluid-therapy-guided-by-plethysmographic-variability-index-versus-conventional-liberal-fluid-therapy-in-neonates-undergoing-abdominal-surgery-a-prospective-randomized-controlled-trial
#5
JOURNAL ARTICLE
A S Swathy, Anudeep Jafra, Neerja Bhardwaj, Ravi P Kanojia, Monika Bawa
BACKGROUND: Intraoperative fluid therapy maintains normovolemia, normal tissue perfusion, normal metabolic function, normal electrolytes, and acid-base status. Plethysmographic variability index has been shown to predict fluid responsiveness but its role in guiding intraoperative fluid therapy is still elusive. AIMS: The aim of the present study was to compare intraoperative goal-directed fluid therapy based on plethysmographic variability index with liberal fluid therapy in term neonates undergoing abdominal surgeries...
February 13, 2024: Paediatric Anaesthesia
https://read.qxmd.com/read/38341053/pulmonary-vein-flow-morphology-after-transcatheter-mitral-valve-edge-to-edge-repair-as-predictor-of-survival
#6
JOURNAL ARTICLE
Ahmed El Shaer, Alejandra A Chavez Ponce, Mays T Ali, Didem Oguz, Sorin V Pislaru, Vuyisile T Nkomo, Ratnasari Padang, Mackram F Eleid, Mayra Guerrero, Guy S Reeder, Charanjit S Rihal, Mohamad Alkhouli, Jeremy J Thaden
BACKGROUND: Data on the prognostic factors after mitral valve (MV) transcatheter edge-to-edge repair (TEER; MV-TEER) are limited. Pulsed-wave Doppler interrogation of pulmonary vein flow (PVF) is a convenient method to assess the hemodynamic burden of residual mitral regurgitation (MR), which could be of utility as a predictor of outcomes. METHODS: Patients that underwent MV-TEER between May 2014 and December 2021 at our institution were evaluated. Pulmonary vein flow patterns post-MV-TEER were reviewed on the procedural transesophageal echocardiogram and classified as normal (systolic dominant or codominant) or abnormal (systolic blunting or reversal)...
February 8, 2024: Journal of the American Society of Echocardiography
https://read.qxmd.com/read/38335896/the-effect-of-goal-directed-fluid-therapy-on-delayed-graft-function-in-kidney-transplant-recipients-a-systematic-review-and-meta-analysis
#7
REVIEW
Michael P Klonarakis, Mannat Dhillon, Emir Sevinc, Meghan J Elliott, Matthew T James, Ngan N Lam, Kevin J McLaughlin, Paul E Ronksley, Shannon M Ruzycki, Tyrone G Harrison
Delayed graft function (DGF) is a common post-operative complication with potential long-term sequelae for many kidney transplant recipients, and hemodynamic factors and fluid status play a role. Fixed perioperative fluid infusions are the standard of care, but more recent evidence in the non-transplant population has suggested benefit with goal-directed fluid strategies based on hemodynamic targets. We searched MEDLINE, EMBASE, Cochrane Controlled Trials Registry and Google Scholar through December 2022 for randomized controlled trials comparing risk of DGF between goal-directed and conventional fluid therapy in adults receiving a living or deceased donor kidney transplant...
February 5, 2024: Transplantation Reviews
https://read.qxmd.com/read/38252193/can-perioperative-pco-2-gaps-predict-complications-in-patients-undergoing-major-elective-abdominal-surgery-randomized-to-goal-directed-therapy-or-standard-care-a-secondary-analysis
#8
JOURNAL ARTICLE
Ilonka N de Keijzer, Thomas Kaufmann, Eric E C de Waal, Michael Frank, Dianne de Korte-de Boer, Leonard M Montenij, Wolfgang Buhre, Thomas W L Scheeren
The difference between venous and arterial carbon dioxide pressure (pCO2 gap), has been used as a diagnostic and prognostic tool. We aimed to assess whether perioperative pCO2 gaps can predict postoperative complications. This was a secondary analysis of a multicenter RCT comparing goal-directed therapy (GDT) to standard care in which 464 patients undergoing high-risk elective abdominal surgery were included. Arterial and central venous blood samples were simultaneously obtained at four time points: after induction, at the end of surgery, at PACU/ICU admission, and PACU/ICU discharge...
January 22, 2024: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/38248759/personalized-predictive-hemodynamic-management-for-gynecologic-oncologic-surgery-feasibility-of-cost-benefit-derivatives-of-digital-medical-devices
#9
JOURNAL ARTICLE
Luciano Frassanito, Rossella Di Bidino, Francesco Vassalli, Kristian Michnacs, Pietro Paolo Giuri, Bruno Antonio Zanfini, Stefano Catarci, Nicoletta Filetici, Chiara Sonnino, Americo Cicchetti, Giovanni Arcuri, Gaetano Draisci
BACKGROUND: Intraoperative hypotension is associated with increased perioperative complications, hospital length of stay (LOS) and healthcare expenditure in gynecologic surgery. We tested the hypothesis that the adoption of a machine learning-based warning algorithm (hypotension prediction index-HPI) might yield an economic advantage, with a reduction in adverse outcomes that outweighs the costs for its implementation as a medical device. METHODS: A retrospective-matched cohort cost-benefit Italian study in gynecologic surgery was conducted...
December 30, 2023: Journal of Personalized Medicine
https://read.qxmd.com/read/38152505/pulse-pressure-variance-ppv-guided-fluid-management-in-adult-patients-undergoing-supratentorial-tumor-surgeries-a-randomized-controlled-trial
#10
JOURNAL ARTICLE
Janani Gopal, Shashi Srivastava, Nidhi Singh, Rudrashish Haldar, Ruchi Verma, Devendra Gupta, Prabhakar Mishra
Objective  Appropriate fluid management in neurosurgery is critical due to the risk of secondary brain injury. Determination of volume status is challenging with static variables being unreliable. Goal-directed fluid therapy with dynamic variables allows reliable determination of fluid responsiveness and promises better outcomes. We aimed to compare the intraoperative fluid requirement between conventional central venous pressure (CVP)-guided and pulse pressure variance (PPV)-guided fluid management in supratentorial tumor surgeries...
September 2023: Asian Journal of Neurosurgery
https://read.qxmd.com/read/38114371/unresponsive-low-mixed-venous-oxygen-saturation-during-early-intensive-care-unit-stay-is-associated-with-increased-risk-of-organ-dysfunction-after-cardiac-surgery-a-single-center-retrospective-study
#11
JOURNAL ARTICLE
Petteri Holm, Tiina M Erkinaro, Jaana M Karhu, Pasi P Ohtonen, Janne H Liisanantti, Panu Taskinen, Tero I Ala-Kokko, Timo I Kaakinen
OBJECTIVES: The aim of the study was to determine if unresponsive mixed venous oxygen saturation (SvO2 ) values during early postoperative hours are associated with postoperative organ dysfunction. DESIGN: A single-center retrospective observational study. SETTING: A university hospital. PARTICIPANTS: A total of 6,282 adult patients requiring cardiac surgery who underwent surgery in a University Hospital from 2007 to 2020...
February 2024: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/38032246/hemodynamic-monitoring-in-liver-transplantation-the-hemodynamic-system
#12
REVIEW
Sherif Kandil, Ashraf Sedra
PURPOSE OF REVIEW: The purpose of this article is to provide a comprehensive review of hemodynamic monitoring in liver transplantation. RECENT FINDINGS: Radial arterial blood pressure monitoring underestimates the aortic root arterial blood pressure and causes excessive vasopressor and worse outcomes. Brachial and femoral artery monitoring is well tolerated and should be considered in critically ill patients expected to be on high dose pressors. The pulmonary artery catheter is the gold standard of hemodynamic monitoring and is still widely used in liver transplantation; however, it is a highly invasive monitor with potential for serious complications and most of its data can be obtained by other less invasive monitors...
February 1, 2024: Current Opinion in Organ Transplantation
https://read.qxmd.com/read/38028714/goal-directed-therapy-in-cardiovascular-surgery-a-case-series-study
#13
Nader Givtaj, Elnaz Hosseinzadeh, Fatemeh Shima Hadipourzadeh, Zahra Faritous, Mohammad Hasan Askari, Maryam Ghanbari Garekani
Hemodynamic and intravascular volume monitoring has been utilized and significantly improved thanks to the technology revolution. Goal-Directed Therapy (GDT) derived from this advanced monitoring is beneficial for complex surgeries, and it shifted the medical approaches from static therapy to more personalized functional treatments. Conventional monitoring methods such as blood pressure, heart rate, urinary output, and central venous pressure are commonly used. However, studies have shown these routine parameters often cannot precisely estimate the quality of tissue perfusion...
2023: Journal of Cardiovascular and Thoracic Research
https://read.qxmd.com/read/38024002/pulse-pressure-variation-based-intraoperative-fluid-management-versus-traditional-fluid-management-for-colon-cancer-patients-undergoing-open-mass-resection-and-anastomosis-a-randomized-controlled-trial
#14
JOURNAL ARTICLE
Ramy Mahrose, Amr A Kasem
BACKGROUND: Bowel edema leads to decreased perfusion and oxygenation of the intestine at the anastomotic site after colonic mass resection with failure of healing and leakage. Additionally, dehydration causes bowel hypoperfusion and difficulty healing with more complications. Fluid therapy guided by dynamic monitoring of fluid response can help avoid bowel dehydration and edema with fewer complications. OBJECTIVES: The main goal of this study was to compare the effects of intraoperative fluid therapy based on pulse pressure variation (PPV) to traditional fluid therapy to maintain adequate hydration without intraoperative instability of hemodynamics and postoperative complications...
August 2023: Anesthesiology and Pain Medicine
https://read.qxmd.com/read/38021968/takotsubo-cardiomyopathy-induced-by-stress-from-amyotrophic-lateral-sclerosis-and-a-mechanical-fall
#15
Nicholas R Munoz, Chibuike C Agwuegbo, Ali Ghorbani, John M Vincent Coralde, Robin Abdelmalik
Named after the Japanese octopus trap, Takotsubo cardiomyopathy is an acute myocardial condition characterized by a reversible ventricular dysfunction with ballooning of the left ventricle (LV) during systole. A catecholamine surge is likely the primary mechanism responsible for myocardial damage in this condition. The association between amyotrophic lateral sclerosis (ALS) and Takotsubo cardiomyopathy has not been well established. We present a unique case of Takotsubo cardiomyopathy diagnosed in a patient with ALS who presented after a fall with shortness of breath, generalized weakness, and hypotension...
October 2023: Curēus
https://read.qxmd.com/read/37992534/determinants-of-postoperative-complications-in-high-risk-noncardiac-surgery-patients-optimized-with-hemodynamic-treatment-strategies-a-post-hoc-analysis-of-a-randomized-multicenter-clinical-trial
#16
JOURNAL ARTICLE
Stéphane Bar, Mouhamed Djahoum Moussa, Richard Descamps, Younes El Amine, Belaid Bouhemad, Marc-Olivier Fischer, Emmanuel Lorne, Hervé Dupont, Momar Diouf, Pierre Grégoire Guinot
STUDY OBJECTIVE: This post-hoc analysis of a randomized controlled trial was undertaken to establish the determinants of postoperative complications and acute kidney injury in high-risk noncardiac surgery patients supported with hemodynamic treatment strategies. DESIGN: We conducted a post-hoc analysis of patients enrolled in the OPtimization Hemodynamic Individualized by the respiratory QUotiEnt (OPHIQUE) trial. SETTING: Operating rooms in four university medical centers and one non-university hospital from December 26, 2018, to September 9, 2021...
November 21, 2023: Journal of Clinical Anesthesia
https://read.qxmd.com/read/37991835/dobutamine-and-goal-directed-fluid-therapy-for-improving-tissue-oxygenation-in-deep-inferior-epigastric-perforator-diep-flap-breast-reconstruction-surgery-protocol-for-a-randomized-controlled-trial
#17
JOURNAL ARTICLE
Glenio B Mizubuti, Anthony M-H Ho, Rachel Phelan, Deborah DuMerton, Jessica Shelley, Elorm Vowotor, Jessica Xiong, Bethany Smethurst, Michael McMullen, Wilma M Hopman, Glykeria Martou, Robert Wesley Edmunds, Robert Tanzola
BACKGROUND: Breast reconstruction is an integral part of breast cancer care. There are 2 main types of breast reconstruction: alloplastic (using implants) and autologous (using the patient's own tissue). The latter creates a more natural breast mound and avoids the long-term need for surgical revision-more often associated with implant-based surgery. The deep inferior epigastric perforator (DIEP) flap is considered the gold standard approach in autologous breast reconstruction. However, complications do occur with DIEP flap surgery and can stem from poor flap tissue perfusion/oxygenation...
November 22, 2023: JMIR Research Protocols
https://read.qxmd.com/read/37908429/the-effect-of-goal-directed-fluid-management-based-on-stroke-volume-variation-on-icu-length-of-stay-in-elderly-patients-undergoing-elective-craniotomy-a-randomized-controlled-trial
#18
JOURNAL ARTICLE
Vorrachai Sae-Phua, Sophitnapa Tanasittiboon, Sunisa Sangtongjaraskul
BACKGROUND: Inappropriate fluid management during neurosurgery can increase postoperative complications. In this study, we aimed to investigate the effect of goal-directed fluid therapy using stroke volume variation (SVV) in elderly patients undergoing elective craniotomy. MATERIALS AND METHODS: We randomized 100 elderly patients scheduled for elective craniotomy into two groups: goal-directed therapy (GDT, n = 50) group and conventional group ( n = 50). Fluid management protocol using SVV was applied in the GDT group...
October 2023: Indian Journal of Critical Care Medicine
https://read.qxmd.com/read/37873014/reduced-order-models-of-endocardial-shear-stress-patterns-in-the-left-atrial-appendage-from-a-data-augmented-patient-specific-database
#19
Jorge Dueñas-Pamplona, Sergio Rodríguez-Aparicio, Alejandro Gonzalo, Savannah F Bifulco, Francisco Castro, Conrado Ferrera, Óscar Flores, Patrick M Boyle, José Sierra-Pallares, Javier García García, Juan C Del Álamo
BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting over 1% of the population. It is usually triggered by irregular electrical impulses that cause the atria to contract irregularly and ineffectively. It increases blood stasis and the risk of thrombus formation within the left atrial appendage (LAA), and aggravates adverse atrial remodeling. Despite recent efforts, LAA flow patterns representative of AF conditions and their association with LAA stasis remain poorly characterized...
October 9, 2023: ArXiv
https://read.qxmd.com/read/37814224/the-effect-of-goal-directed-hemodynamic-therapy-on-clinical-outcomes-in-patients-undergoing-radical-cystectomy-a-randomized-controlled-trial
#20
JOURNAL ARTICLE
Hyun-Kyu Yoon, Min Hur, Dong Hyuk Kim, Ja Hyeon Ku, Jin-Tae Kim
BACKGROUND: This study investigated the effects of intraoperative goal-directed hemodynamic therapy (GDHT) on postoperative outcomes in patients undergoing open radical cystectomy. METHODS: This prospective, single-center, randomized controlled trial included 82 patients scheduled for open radical cystectomy between September 2018 and November 2021. The GDHT group (n = 39) received the stroke volume index- and cardiac index-based hemodynamic management using advanced hemodynamic monitoring, while the control group (n = 36) received the standard care under the discretion of attending anesthesiologists during surgery...
October 9, 2023: BMC Anesthesiology
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