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https://www.readbyqxmd.com/read/29614507/renoprotective-postoperative-monitoring-what-is-the-best-method-for-computing-renal-perfusion-pressure-an-observational-prospective-multicentre-study
#1
Csaba Kopitko, Laszlo Medve, Tibor Gondos
BACKGROUND: Low mean arterial pressure (MAP) is a well-known risk factor for postoperative acute kidney injury (AKI), but probably it is not the sole hemodynamic parameter that can influence the development of renal failure. There are data in cardiac patients supporting the role of renal venous congestion in the development of AKI. The aim of our study was to determine a combination of factors best predicting the development of AKI. METHODS: Data were collected prospectively for adult patients admitted after major abdominal surgery to 9 Hungarian intensive care units...
April 3, 2018: Nephron
https://www.readbyqxmd.com/read/29593416/influence-of-stroke-volume-variation-on-fluid-treatment-and-postoperative-complications-in-thoracic-surgery
#2
Cengiz Sahutoglu, Erbil Turksal, Seden Kocabas, Fatma Zekiye Askar
Background: Fluid management in critically ill patients usually relies on increasing preload to augment cardiac output. In the present study, we aimed to evaluate whether stroke volume variation (SVV) can guide fluid therapy and reduce complications. Patients and methods: In this retrospective study, a total of 88 patients who underwent lobectomy were divided into two groups: group 1 (SVV, n=43) and group 2 (conventional or central venous pressure [CVP], n=45). Heart rate, blood pressure, oxygen saturation, SVV (only group 1), CVP (all patients), urea, creatinine, and hemoglobin levels before and after surgery, use of fluid, blood and inotropic agents, and postoperative complications were recorded retrospectively...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29573604/value-of-the-combination-of-renal-resistance-index-and-central-venous-pressure-in-the-early-prediction-of-sepsis-induced-acute-kidney-injury
#3
Jieqiong Song, Wei Wu, Yizhou He, Shilong Lin, Duming Zhu, Ming Zhong
PURPOSE: Early prediction of acute kidney injury (AKI) in septic patients is difficult. This study aimed to assess the values of renal resistive index (RI), central venous pressure (CVP), and their combination in the early prediction of sepsis-induced AKI. METHODS: A prospective cohort study was performed in septic patients. The variables potentially associated with AKI were recorded at admission and compared between the AKI and non-AKI groups. The variables independently associated with sepsis-induced AKI were identified using multivariable logistic regression, and the area under the receiver operating characteristic curve (AUROC) analysis was calculated...
March 16, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29569112/phenylephrine-increases-cardiac-output-by-raising-cardiac-preload-in-patients-with-anesthesia-induced-hypotension
#4
A F Kalmar, S Allaert, P Pletinckx, J-W Maes, J Heerman, J J Vos, M M R F Struys, T W L Scheeren
Induction of general anesthesia frequently induces arterial hypotension, which is often treated with a vasopressor, such as phenylephrine. As a pure α-agonist, phenylephrine is conventionally considered to solely induce arterial vasoconstriction and thus increase cardiac afterload but not cardiac preload. In specific circumstances, however, phenylephrine may also contribute to an increase in venous return and thus cardiac output (CO). The aim of this study is to describe the initial time course of the effects of phenylephrine on various hemodynamic variables and to evaluate the ability of advanced hemodynamic monitoring to quantify these changes through different hemodynamic variables...
March 22, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29563210/venous-waveform-morphological-changes-associated-with-treatment-of-symptomatic-venous-sinus-stenosis
#5
James L West, Rebecca M Garner, Garret P Greeneway, Justin R Traunero, Carol A Aschenbrenner, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
INTRODUCTION: Venous outflow obstruction is recognized as a contributing factor in a subset of patients with idiopathic intracranial hypertension (IIH). Little is known about venous sinus waveform morphology or how it changes after stenting. METHODS: Fifteen patients with IIH underwent waveform recording during catheter venography and manometry. Ten patients (Group A) with venous sinus stenosis and pressure gradient ≥7 mm Hg underwent waveform recording during awake venography and during stenting under general anesthesia...
March 21, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29538440/impact-of-large-volume-paracentesis-on-respiratory-parameters-including-transpulmonary-pressure-and-on-transpulmonary-thermodilution-derived-hemodynamics-a-prospective-study
#6
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
https://www.readbyqxmd.com/read/29527693/relationship-between-inferior-vena-cava-diameter-ratio-and-central-venous-pressure
#7
Qing Zhang, Xiaoting Wang, Longxiang Su, Hongmin Zhang, Wenzhao Chai, Yangong Chao, Wei He, Dawei Liu
PURPOSE: To explore the relationship between the shape of the inferior vena cava (IVC) lumen and central venous pressure (CVP). METHODS: In 60 patients undergoing mechanical ventilation and CVP monitoring in the Intensive Care Unit of Peking Union Medical College Hospital from July to October 2016, we measured with B-mode ultrasonography the transverse maximum (MXD) and minimum diameter (MID) of the IVC at end expiration, and calculated the diameter ratio (DR) as MXD/MID...
March 12, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29526051/central-venous-pressure-monitoring-in-living-donor-kidney-recipients-does-not-affect-immediate-graft-function-a-propensity-score-analysis
#8
Dieter Adelmann, Leonie Bicknell, Claus U Niemann, John Feiner, Garrett R Roll, Lyle Burdine, Elizabeth L Whitlock
BACKGROUND: During kidney transplantation, intraoperative fluid management can affect post-transplant graft function. It is unclear whether or not central venous pressure (CVP) monitoring is required to guide fluid therapy during kidney transplantation. METHODS: We compared post-transplant graft function in recipients of living donor kidney transplants between August 2006 and March 2009 based on the use or absence of intraoperative CVP monitoring. Graft function, assessed using the creatinine reduction ratio on postoperative day 2 (CCR2), was evaluated by multivariable linear regression analysis and in a propensity-matched cohort...
March 11, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29519280/-variability-of-peripheral-arterial-peak-velocity-predicts-fluid-responsiveness-in-patients-with-septic-shock
#9
Nianfang Lu, Li Jiang, Bo Zhu, Wenyong Han, Yingqi Zhao, Yuntao Shi, Fashuang Guo, Xiuming Xi
OBJECTIVE: To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. METHODS: A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29507790/hyperthermic-intrathoracic-chemotherapy-after-extended-pleurectomy-and-decortication-for-malignant-pleura-mesothelioma-an-observational-study-on-outcome-and-microcirculatory-changes
#10
Luca Luzzi, Federico Franchi, Annarita Dapoto, Marco Ghisalberti, Roberto Corzani, Daniele Marrelli, Luca Marchetti, Piero Paladini, Sabino Scolletta
Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29488025/positive-end-expiratory-pressure-induced-increase-in-external-jugular-venous-pressure-does-not-predict-fluid-responsiveness-in-laparoscopic-prostatectomy
#11
Min Hur, Seokha Yoo, Jung-Yoon Choi, Sun-Kyung Park, Dhong Eun Jung, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: Dynamic change in central venous pressure (CVP) was associated with fluid responsiveness. External jugular venous pressure (EJVP) may reliably estimate CVP and have the advantages of being less invasive. We investigated whether increase in EJVP induced by positive end-expiratory pressure (PEEP) could be a reliable predictor of fluid responsiveness in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). METHODS: Fifty patients who underwent RALP with steep Trendelenburg position were enrolled...
February 27, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29471884/should-we-measure-the-central-venous-pressure-to-guide-fluid-management-ten-answers-to-10-questions
#12
Daniel De Backer, Jean-Louis Vincent
The central venous pressure (CVP) is the most frequently used variable to guide fluid resuscitation in critically ill patients, although its use has been challenged. In this viewpoint, we use a question and answer format to highlight the potential advantages and limitations of using CVP measurements to guide fluid resuscitation.
February 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29458321/differential-effects-of-isotonic-and-hypotonic-4-albumin-solution-on-intracranial-pressure-and-renal-perfusion-and-function
#13
Naoya Iguchi, Junko Kosaka, Joseph Bertolini, Clive N May, Yugeesh R Lankadeva, Rinaldo Bellomo
OBJECTIVES: Albumin is used to resuscitate trauma patients but may increase intracranial pressure (ICP). Its effects on renal blood flow and function are unknown. Our aim was to examine the effects of hypertonic albumin on ICP and renal function, and if any effects are due to the hypotonicity of the solution containing albumin or to albumin itself. DESIGN, SETTING AND SUBJECTS: Cross-over, randomised controlled experimental study of six adult Merino ewes in the animal facility of a research institute...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29456690/protective-effects-of-recombinant-human-brain-natriuretic-peptide-in-perioperative-period-during-open-heart-surgery
#14
Yunbin Xu, Yong Li, Weiguo Bao, Shi Qiu
The aim of the present study was to evaluate the protective effects and safety aspects of recombinant human brain natriuretic peptide (rhBNP) on cardiac functions of patients undergoing open-heart surgery during perioperative period. In total, 150 patients undergoing open heart surgery in the Second Hospital of Shandong Universty from August 2015 to July 2016 were randomly divided into control group and observation group each with 75 cases. Patients in control group were treated by routine rehabilitation while patients in the observation group were treated by both the routine rehabilitation and rhBNP...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29439683/elevated-central-venous-pressure-is-associated-with-increased-mortality-in-pediatric-septic-shock-patients
#15
Seung Jun Choi, Eun-Ju Ha, Won Kyoung Jhang, Seong Jong Park
BACKGROUND: Central venous pressure (CVP) is an important factor affecting capillary blood flow, and it is associated with poor outcomes in adult septic shock patients. However, whether a similar association exists in pediatric patients remains unclear. METHODS: We retrospectively analyzed data from patients admitted to our pediatric intensive care unit (PICU) between February 2009 and July 2015. Patients were divided into two groups-survivors and nonsurvivors-according to 28-day mortality...
February 13, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29417325/preoperative-right-sided-cardiac-congestion-is-associated-with-gastrointestinal-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#16
Yutaka Tomizawa, Akiko Tanaka, Hiroto Kitahara, Atsushi Sakuraba, Nir Uriel, Valluvan Jeevanandam, Takeyoshi Ota
BACKGROUND: Large scale data on preoperative risk stratification for gastrointestinal bleeding (GIB) following continuous-flow left ventricular assist device (CF-LVAD) implantation are scarce. AIMS: To identify independent predictors for GIB following CF-LVAD implantation. METHODS: We conducted a retrospective cohort study of consecutive 243 patients who underwent CF-LVAD implantation (HeartMateII) from January 2009 to March 2015 at the University of Chicago Medical Center...
February 8, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29384288/role-of-central-venous-pressure-monitoring-in-critical-care-settings
#17
Barry Thomas Hill
Central venous pressure (CVP) monitoring is used to assess the fluid status of patients in critical care settings. This article explains CVP monitoring, discussing the rationale for its use, the ways CVP can be measured, and the physiological factors that can affect the reliability and validity of CVP measurement. It also discusses the complications associated with CVP monitoring and the nursing responsibilities in relation to this activity.
January 31, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29374921/-effects-of-cardiac-support-on-delayed-resuscitation-in-extensively-burned-patients-with-shock
#18
R Xiao, Y S Huang, G A Lin, S A Yuan, D S Hu
Objective: To explore the effects of cardiac support on delayed resuscitation in extensively burned patients with shock. Methods: Clinical data of 62 extensively burned patients with shock on admission, admitted to the 159th Hospital of PLA (hereinafter referred to as our hospital) from January 2012 to January 2017, were retrospectively analyzed. They were divided into cardiac support group ( n =35) and control group ( n =27) according to the use of deslanoside and ulinastatin. All patients were treated with routine fluid resuscitation based on the formula of the Third Military Medical University till post injury hour (PIH) 48...
January 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29335384/predictors-of-hemodynamic-improvement-and-stabilization-following-intraaortic-balloon-pump-implantation-in-patients-with-advanced-heart-failure
#19
Teruhiko Imamura, Colleen Juricek, Ann Nguyen, Ben Chung, Daniel Rodgers, Gabriel Sayer, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, David Onsanger, Daniel Burkhoff, Valluvan Jeevanandam, Nir Uriel
OBJECTIVES: The intraaortic balloon pump (IABP) is currently an essential tool to improve hemodynamics in patients with advanced heart failure (HF). This study investigated predictors for hemodynamic improvement or stabilization with IABP therapy in patients with advanced HF. METHODS: Patients with advanced HF and hemodynamic deterioration treated with IABP were enrolled in this retrospective study. Invasive hemodynamics were measured before IABP implantation and 2 weeks after IABP initiation...
February 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29314087/ultrasonographic-assessment-of-the-internal-jugular-vein-for-the-estimation-of-central-venous-pressure-in-hemodialysis-patients-a-preliminary-study
#20
Basile Kerleroux, Jeremy Pasco, Mathieu Dupuis, Marine Eustache, Ahmed Lemrabott, Charlotte Jouzel, Catherine Albert, Kevin Janot, Baptiste Morel, André Pruna
PURPOSE: To investigate a new noninvasive method to assess central venous pressure (CVP) in hemodialysis patients, based on the ultrasonographic measurement of the collapsing point of the internal jugular vein (CVPni). MATERIALS AND METHODS: In this preliminary, noninterventional, single center study, we enrolled 22 dialyzed patients with an indwelling jugular catheter. CVPni was compared to the gold-standard invasive measurement of CVP using the central venous catheter (CVPi)...
January 4, 2018: Journal of Clinical Ultrasound: JCU
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