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https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#1
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29744245/reliability-of-passive-leg-raising-stroke-volume-variation-and-pulse-pressure-variation-to-predict-fluid-responsiveness-during-weaning-from-mechanical-ventilation-after-cardiac-surgery-a-prospective-observational-study
#2
Christoph Karl Hofer, Martin Geisen, Sonja Hartnack, Omer Dzemali, Michael Thomas Ganter, Andreas Zollinger
Objective: During assisted ventilation and spontaneous breathing, functional haemodynamic parameters, including stroke volume variation (SVV) and pulse pressure variation (PPV), are of limited value to predict fluid responsiveness, and the passive leg raising (PLR) manoeuvre has been advocated as a surrogate method. We aimed to study the predictive value of SVV, PPV and PLR for fluid responsiveness during weaning from mechanical ventilation after cardiac surgery. Methods: Haemodynamic variables and fluid responsiveness were assessed in 34 patients...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29740065/comparison-of-first-line-and-second-line-terlipressin-versus-sole-norepinephrine-in-fulminant-ovine-septic-shock
#3
Tim G Kampmeier, Philip H Arnemann, Michael Hessler, Laura M Seidel, Karsten Becker, Andrea Morelli, Sebastian W Rehberg, Christian Ertmer
The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1 -selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29737037/sensitivity-analysis-of-geometrical-parameters-to-study-haemodynamics-and-thrombus-formation-in-the-left-atrial-appendage
#4
Guadalupe García Isla, Andy Luis Olivares, Etelvino Silva, Marta Nuñez-García, Constantine Butakoff, Damian Sanchez-Quintana, Hernán Morales, Xavier Freixa, Jérôme Noailly, Tom de Potter, Oscar Camara
The left atrial appendage (LAA) is a complex and heterogeneous protruding structure of the left atrium (LA). In atrial fibrillation (AF) patients, it is the location where 90% of the thrombi are formed. However, the role of the LAA in thrombus formation is not fully known yet. The main goal of this work is to perform a sensitivity analysis to identify the most relevant LA and LAA morphological parameters in atrial blood flow dynamics. Simulations were run on synthetic ellipsoidal left atria models where different parameters were individually studied: pulmonary veins (PV) and mitral valve (MV) dimensions; LAA shape; and LA volume...
May 8, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29713734/advances-in-critical-care-management-of-patients-undergoing-cardiac-surgery
#5
REVIEW
Anders Aneman, Nicholas Brechot, Daniel Brodie, Frances Colreavy, John Fraser, Charles Gomersall, Peter McCanny, Peter Hasse Moller-Sorensen, Jukka Takala, Kamen Valchanov, Michael Vallely
Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increasing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent advances have occurred in several areas, including ventilation, haemodynamics and mechanical circulatory support, bleeding and coagulation, acute kidney injury, and neurological management. This narrative review describes standard care, recent advances, and future areas of research in the critical care management of patients undergoing cardiac surgery...
April 30, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29709420/outcome-of-patients-with-cardiac-amyloidosis-admitted-to-an-intensive-care-unit-for-acute-heart-failure
#6
Thomas d'Humières, Damien Fard, Thibaud Damy, Francois Roubille, Arnaud Galat, Huy-Long Doan, Leopold Oliver, Jean-Luc Dubois-Randé, Pierre Squara, Pascal Lim, Julien Ternacle
BACKGROUND: The outcome of cardiac amyloidosis (CA) has been reported mainly in stable populations; limited data are available in patients referred for acute heart failure (AHF) to an intensive cardiac care unit (ICCU). AIMS: To address the characteristics and outcomes of patients with confirmed CA admitted to an ICCU for AHF and then to identify the predictors of evolution to cardiogenic shock. METHODS: All patients with CA referred to an ICCU for AHF between 2009 and 2015 were included...
April 27, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29700664/halving-the-volume-of-anaconda-initial-clinical-experience-with-a-new-small-volume-anaesthetic-reflector-in-critically-ill-patients-a-quality-improvement-project
#7
Hagen Bomberg, Franziska Meiser, Sarah Zimmer, Martin Bellgardt, Thomas Volk, Daniel I Sessler, Heinrich V Groesdonk, Andreas Meiser
AnaConDa-100 ml (ACD-100, Sedana Medical, Uppsala, Sweden) is well established for inhalation sedation in the intensive care unit. But because of its large dead space, the system can retain carbon dioxide (CO2 ) and increase ventilatory demands. We therefore evaluated whether AnaConDa-50 ml (ACD-50), a device with half the internal volume, reduces CO2 retention and ventilatory demands during sedation of invasively ventilated, critically ill patients. Ten patients participated in this cross-over protocol. After sedation with isoflurane via ACD-100 for 24 h, the 5-h observation period started...
April 26, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29680790/clinical-aspects-of-incorporating-cord-clamping-into-stabilisation-of-preterm-infants
#8
REVIEW
Ronny Knol, Emma Brouwer, Alex S N Vernooij, Frans J C M Klumper, Philip DeKoninck, Stuart B Hooper, Arjan B Te Pas
Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal resuscitation guidelines, comprehensive recommendations are available on supporting pulmonary transition and delaying clamping of the cord in preterm infants. Recent experimental studies demonstrated that the pulmonary and haemodynamic transition are intimately linked, could influence each other and that the timing of umbilical cord clamping should be incorporated into the respiratory stabilisation...
April 21, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29664034/incidence-prognosis-of-acute-kidney-injury-in-individuals-of-snakebite-in-a-tertiary-care-hospital-in-india
#9
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29642690/impella-protected-pci-the-clinical-results-achieved-so-far
#10
Gabriele Pesarini, Andrea Gratta, Giulia Dolci, Mattia Lunardi, Flavio L Ribichini
The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to the interventional toolbox...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29607742/evaluation-of-cardiac-autonomic-functions-in-myasthenia-gravis
#11
Zehra Uysal Kocabas, Ferah Kizilay, Ibrahim Basarici, Hilmi Uysal
OBJECTIVE: We aimed to comprehensively evaluate cardiac autonomic function in patients with MG and to investigate the relationship between this disorder and disease duration, thymoma and acetylcholine receptor antibody positivity in cases of cardiac autonomic disorder. METHODS: The study included 30 patients with MG and 30 age-matched healthy control subjects. Haemodynamic parameters (heart rate, systolic and diastolic blood pressure) and autonomic parameters (low frequency [LF], high-frequency [HF], sympathovagal balance [LF/HF], baroreceptor reflex sensitivity [BRS]) of the patients were automatically measured at rest and in a tilted position with the Task Force Monitor...
April 2, 2018: Neurological Research
https://www.readbyqxmd.com/read/29607162/early-and-mid-term-haemodynamic-performance-and-clinical-outcomes-of-st-jude-medical-trifecta%C3%A2-valve
#12
Renata Raimundo, Soraia Moreira, Francisca Saraiva, Rui J Cerqueira, Pedro Teixeira, Elson Salgueiro, André Lourenço, Mário J Amorim, Jorge Almeida, Paulo Pinho, Adelino F Leite-Moreira
Background: New models of aortic bioprostheses have proven excellent early haemodynamic profile, but their mid and long-term performance warrants further systematic assessment. The aim of this study is to report clinical and haemodynamic performance of St. Jude Medical Trifecta bioprosthesis during 5 years of implantation. Methods: We performed a single centre, retrospective, observational and descriptive study including all 556 individuals who underwent aortic valve replacement (AVR) with the Trifecta bioprosthesis (between July of 2011 and June of 2016)...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29602889/adult-scurvy-associated-with-psychiatric-disorders-and-breast-feeding
#13
Stefania Urueña-Palacio, Bruno L Ferreyro, Lucas G Fernández-Otero, Pablo D Calo
Scurvy is a nutritional disease caused by ascorbic acid deficiency and is potentially fatal. It was originally described in the 18th century by James Lind and associated with long sea voyages and insufficient citrus consumption. Its prevalence has declined markedly over the years but has still been described sporadically in certain countries. A 22-year-old woman with an anxiety disorder and anorexia nervosa, recent pregnancy and ongoing breast feeding, presented with a 10-day history of spontaneous haematomas in the lower limbs, gingivorrhagia and fatigue...
March 30, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29588737/performing-and-interpreting-fractional-flow-reserve-measurements-in-clinical-practice-an-expert-consensus-document
#14
Stephan Achenbach, Tanja Rudolph, Johannes Rieber, Holger Eggebrecht, Gert Richardt, Thomas Schmitz, Nikos Werner, Florian Boenner, Helge Möllmann
Fractional flow reserve (FFR) measurements can determine the haemodynamic relevance of coronary artery stenoses. Current guidelines recommend their use in lesions in the absence of non-invasive proof of ischaemia. The prognostic impact of FFR has been evaluated in randomised trials, and it has been shown that revascularisation can be safely deferred if FFR is >0.80, while revascularisation of stenoses with FFR values ≤0.80 results in significantly lower event rates compared to medical treatment. Left main stenoses, aorto-ostial lesions, as well as patients with left ventricular hypertrophy and severely-impaired ejection fraction, have been excluded from large, randomised trials...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29560788/major-adverse-cardiovascular-events-while-awaiting-staged-non-culprit-percutaneous-coronary-intervention-after-st-segment-elevation-myocardial-infarction
#15
Keir McCutcheon, Andreas S Triantafyllis, Thomas Marynissen, Tom Adriaenssens, Johan Bennett, Christophe Dubois, Peter R Sinnaeve, Walter Desmet
BACKGROUND: The optimal therapeutic strategy for ST-segment elevation myocardial infarction (STEMI) patients found to have multi-vessel disease (MVD) is controversial but recent data support complete revascularisation (CR). Whether CR should be completed during the index admission or during a second staged admission remains unclear. Our main objective was to measure rates of major adverse cardiovascular events (MACEs) during the waiting period in STEMI patients selected for staged revascularisation (SR), in order to determine the safety of delaying CR...
March 21, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29555789/targeting-skeletal-muscle-tissue-oxygenation-sto-2-in-adults-with-severe-sepsis-and-septic-shock-a-randomised-controlled-trial-oto-sts-study
#16
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29529331/the-relationship-between-pre-operative-hypertension-and-intra-operative-haemodynamic-changes-known-to-be-associated-with-postoperative-morbidity
#17
M Crowther, K van der Spuy, F Roodt, M B Nejthardt, J G Davids, J Roos, E Cloete, T Pretorius, G L Davies, J G van der Walt, C van der Westhuizen, M Flint, J L C Swanevelder, B M Biccard
Hypertension is not consistently associated with postoperative cardiovascular morbidity and is therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with peri-operative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes...
March 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29520968/post-operative-arterio-venous-fistula-blood-flow-influences-primary-and-secondary-patency-following-access-surgery
#18
Kapila S Benaragama, Jennifer Barwell, Chris Lord, Biku J John, Adarsh Babber, Shella Sandoval, Ben Lindsey, Bimbi Fernando
PURPOSE: Primary arteriovenous fistula arterio venous fistula (AVF) formation has proven to be the best and optimal vascular access for the majority of haemodialysis patients. At present there are limited data to suggest which haemodynamic parameters most correlate with the likelihood of early failure. The aim of this study is to identify the haemodynamic predictors of early failure, hence identify which fistulae may benefit from timely pre-emptive intervention. MATERIAL AND METHODS: Retrospective analysis of data was performed of 201 patients undergoing native AVF creation over a one year period...
March 9, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29515457/oxidative-stress-and-nlrp3-inflammasome-activity-as-significant-drivers-of-diabetic-cardiovascular-complications-therapeutic-implications
#19
REVIEW
Arpeeta Sharma, Mitchel Tate, Geetha Mathew, James E Vince, Rebecca H Ritchie, Judy B de Haan
It is now increasingly appreciated that inflammation is not limited to the control of pathogens by the host, but rather that sterile inflammation which occurs in the absence of viral or bacterial pathogens, accompanies numerous disease states, none more so than the complications that arise as a result of hyperglycaemia. Individuals with type 1 or type 2 diabetes mellitus (T1D, T2D) are at increased risk of developing cardiac and vascular complications. Glucose and blood pressure lowering therapies have not stopped the advance of these morbidities that often lead to fatal heart attacks and/or stroke...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29514222/short-term-mechanical-circulatory-support-for-severe-primary-graft-dysfunction-following-orthotopic-heart-transplant
#20
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
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