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https://www.readbyqxmd.com/read/29485961/cerebral-function-and-perfusion-during-cardiopulmonary-bypass-a-plea-for-a-multimodal-monitoring-approach
#1
Marcus Thudium, Ingo Heinze, Richard K Ellerkmann, Tobias Hilbert
BACKGROUND: Postoperative neurological injury still represents a major cause of morbidity after cardiac surgery. Our objective was to compare the limits as well as advantages of routine monitoring tools for the detection of cerebral function and perfusion deficits during cardiopulmonary bypass in a daily clinical setting. METHODS: Adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass were included. Patients received monitoring comprising Bispectral Index (BIS), Near Infrared Spectroscopy (NIRS) and assessment of middle cerebral artery flow velocity (MCAV) using transcranial Doppler (TCD) sonography...
January 31, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29420817/glutamine-metabolism-via-glutaminase-1-in-autosomal-dominant-polycystic-kidney-disease
#2
Irfana Soomro, Ying Sun, Zhai Li, Lonnette Diggs, Georgia Hatzivassiliou, Ajit G Thomas, Rana Rais, Barbara S Slusher, Stefan Somlo, Edward Y Skolnik
Background: Metabolism of glutamine by glutaminase 1 (GLS1) plays a key role in tumor cell proliferation via the generation of ATP and intermediates required for macromolecular synthesis. We hypothesized that glutamine metabolism also plays a role in proliferation of autosomal-dominant polycystic kidney disease (ADPKD) cells and that inhibiting GLS1 could slow cyst growth in animal models of ADPKD. Methods: Primary normal human kidney and ADPKD human cyst-lining epithelial cells were cultured in the presence or absence of two pharmacologic inhibitors of GLS1, bis-2-(5-phenylacetamido-1,2,4-thiadiazol-2-yl)ethyl sulfide 3 (BPTES) and CB-839, and the effect on proliferation, cyst growth in collagen and activation of downstream signaling pathways were assessed...
February 5, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29225156/performance-of-tci-propofol-using-the-schnider-model-for-cardiac-surgery-on-cardiopulmonary-bypass-a-pilot-study
#3
Aaron Kwang Yang Lee, Aaron Yik Hang Kong, Chee Fai Kong
OBJECTIVE: This pilot study aimed to evaluate the performance of target-controlled infusion (TCI) of propofol using the Schnider pharmacokinetic model in patients undergoing cardiac surgery requiring cardiopulmonary bypass. DESIGN: This was a prospective pharmacokinetic study. SETTING: A tertiary care hospital. PARTICIPANTS: This study is comprised of 10 patients, aged between 46 and 81, who underwent elective cardiac surgery requiring the use of cardiopulmonary bypass...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28985693/assessing-the-depth-of-isoflurane-anaesthesia-during-cardiopulmonary-bypass
#4
Ka Ting Ng, R Peter Alston, George Just, Chris McKenzie
INTRODUCTION: Bispectral index (BIS) and monitoring of end-tidal concentration may be associated with a reduction in the incidence of awareness during volatile-based general anaesthesia. An analogue of end-tidal concentration during cardiopulmonary bypass (CPB) is measuring exhausted isoflurane concentration from the oxygenator as an estimate to blood and, so, brain concentration. The aim of this study was to determine the relationships between oxygenator exhaust and blood concentrations of isoflurane and the BIS score during CPB when administering isoflurane into the sweep gas supply to the oxygenator...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28958609/the-importance-of-bilateral-monitoring-of-cerebral-oxygenation-nirs-clinical-case-of-asymmetry-during-cardiopulmonary-bypass-secondary-to-previous-cerebral-infarction
#5
S Matcan, P Sanabria Carretero, M Gómez Rojo, L Castro Parga, F Reinoso-Barbero
Cerebral oximetry based on near infrared spectroscopy (NIRS) technology is used to determine cerebral tissue oxygenation. We hereby present the clinical case of a 12-month old child with right hemiparesis secondary to prior left middle cerebral artery stroke 8 months ago. The child underwent surgical enlargement of the right ventricular outflow tract (RVOT) with cardiopulmonary bypass. During cardiopulmonary bypass, asymmetric NIRS results were detected between both hemispheres. The utilization of multimodal neuromonitoring (NIRS-BIS) allowed acting on both perfusion pressure and anesthetic depth to balance out the supply and demand of cerebral oxygen consumption...
September 25, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28543642/bidirectional-superior-cavopulmonary-anastomosis-with-or-without-cardiopulmonary-bypass-a-randomized-study
#6
RANDOMIZED CONTROLLED TRIAL
Sachin Talwar, Anish Gupta, Ashima Nehra, Neeti Makhija, Poonam Malhotra Kapoor, Vishnubhatla Sreenivas, Shiv Kumar Choudhary, Balram Airan
OBJECTIVES: This study aims to compare the bidirectional superior cavopulmonary anastomosis (BDG) with or without cardiopulmonary bypass (CPB). METHODS: 100 patients undergoing BDG were randomized into two groups: Off-CPB or on-CPB groups. All patients underwent near-infrared spectrophotometry (NIRS) and bispectral index (BIS) monitoring and pre- and postoperative serum 100 beta protein measurements (Sβ100) and neuro-cognitive evaluation. Postoperative intensive care unit (ICU) parameters were also studied...
June 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27843781/comparison-of-bispectral-index-monitoring-with-the-critical-care-pain-observation-tool-in-the-pain-assessment-of-intubated-adult-patients-after-cardiac-surgery
#7
Zahra Faritous, Arvin Barzanji, Rasoul Azarfarin, Behshid Ghadrdoost, Mohsen Ziyaeifard, Nahid Aghdaei, Mostafa Alavi
BACKGROUND: Detecting pain is crucial in sedated and mechanically ventilated patients, as they are unable to communicate verbally. OBJECTIVES: This study aimed to compare Bispectral index (BIS) monitoring with the Critical-care pain observation tool (CPOT) and vital signs for pain assessment during painful procedures in intubated adult patients after cardiac surgery. MATERIALS AND METHODS: Seventy consecutive patients who underwent cardiac surgery (coronary artery bypass graft or valvular surgery) were enrolled in the study...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27790356/moderate-hypothermia-and-its-effects-in-reducing-the-applied-dose-of-anesthetics-for-patients-with-opium-dependence-in-cardiac-surgery-a-randomized-controlled-trial
#8
Reza Jalaian Taghadomi, Ebrahim Golmakani, Kambiz Alizadeh, Behrooz Mottahedi, Ali Rahdari, Shima Sheybani
BACKGROUND: An increasing number of patients addicted to opium are experiencing awareness during coronary artery bypass surgery (CABG) as a result of tolerance to anesthetics. OBJECTIVES: This research was primarily intended to determine the potential diminishing effects of moderate hypothermia on anesthetic dosage and recall of anesthesia during the procedure. METHODS: In this double-blind randomized controlled trial, a total of 80 CABG candidates with known addiction to opium were divided into two groups: one normothermic (N) and the other moderately hypothermic (H), both undergoing induction as well as close monitoring from September 2014 to January 2016...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27644009/the-feasibility-of-a-completely-automated-total-iv-anesthesia-drug-delivery-system-for-cardiac-surgery
#9
Cedrick Zaouter, Thomas M Hemmerling, Romain Lanchon, Emanuela Valoti, Alain Remy, Sébastien Leuillet, Alexandre Ouattara
BACKGROUND: In this pilot study, we tested a novel automatic anesthesia system for closed-loop administration of IV anesthesia drugs for cardiac surgical procedures with cardiopulmonary bypass. This anesthesia drug delivery robot integrates all 3 components of general anesthesia: hypnosis, analgesia, and muscle relaxation. METHODS: Twenty patients scheduled for elective cardiac surgery with cardiopulmonary bypass were enrolled. Propofol, remifentanil, and rocuronium were administered using closed-loop feedback control...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27621316/bypass-of-dna-protein-cross-links-conjugated-to-the-7-deazaguanine-position-of-dna-by-translesion-synthesis-polymerases
#10
Susith Wickramaratne, Shaofei Ji, Shivam Mukherjee, Yan Su, Matthew G Pence, Lee Lior-Hoffmann, Iwen Fu, Suse Broyde, F Peter Guengerich, Mark Distefano, Orlando D Schärer, Yuk Yin Sham, Natalia Tretyakova
DNA-protein cross-links (DPCs) are bulky DNA lesions that form both endogenously and following exposure to bis-electrophiles such as common antitumor agents. The structural and biological consequences of DPCs have not been fully elucidated due to the complexity of these adducts. The most common site of DPC formation in DNA following treatment with bis-electrophiles such as nitrogen mustards and cisplatin is the N7 position of guanine, but the resulting conjugates are hydrolytically labile and thus are not suitable for structural and biological studies...
November 4, 2016: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/27499818/allogeneic-blood-product-usage-in-coronary-artery-bypass-grafting-cabg-with-minimalized-extracorporeal-circulation-system-mecc-versus-standard-on-pump-coronary-artery-bypass-grafting
#11
M Lisy, E Schmid, J Kozok, P Rosenberger, U A Stock, G Kalender
AIM: Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECC(TM)) compared with standard open system on-pump coronary revascularization. METHODS: Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC)...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27376808/protein-kinase-c-enhances-the-swelling-induced-chloride-current-in-human-atrial-myocytes
#12
Ye-Tao Li, Xin-Ling Du
Swelling-activated chloride currents (ICl.swell) are thought to play a role in several physiologic and pathophysiologic processes and thus represent a target for therapeutic approaches. However, the mechanism of ICl.swell regulation remains unclear. In this study, we used the whole-cell patch-clamp technique to examine the role of protein kinase C (PKC) in the regulation of ICl.swell in human atrial myocytes. Atrial myocytes were isolated from the right atrial appendages of patients undergoing coronary artery bypass and enzymatically dissociated...
June 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27271567/hmbpp-analog-prodrugs-bypass-energy-dependent-uptake-to-promote-efficient-btn3a1-mediated-malignant-cell-lysis-by-v%C3%AE-9v%C3%AE-2-t-lymphocyte-effectors
#13
Ashley M Kilcollins, Jin Li, Chia-Hung Christine Hsiao, Andrew J Wiemer
Vγ9Vδ2 effector T cells lyse cells in response to phosphorus-containing small molecules, providing primates a unique route to remove infected or malignant cells. Yet, the triggering mechanisms remain ill defined. We examined lysis mediated by human Vγ9Vδ2 effector T cells in response to the naturally occurring (E)-4-hydroxy-3-methyl-but-2-enyl diphosphate (HMBPP) or a synthetic cell-permeable prodrug, bis (pivaloyloxymethyl) (E)-4-hydroxy-3-methyl-but-2-enyl phosphonate. CD27(+)/CD45RA(-) Th1-like effector cells killed K562 target cells through a mechanism that could be enhanced by either compound or TCR Ab and blocked by Src inhibition or butyrophilin 3 isoform A1 (BTN3A1) disruption...
July 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27112317/a-multi-step-solvent-free-mechanochemical-route-to-indium-iii-complexes
#14
Jingyi Wang, Rakesh Ganguly, Li Yongxin, Jesus Díaz, Han Sen Soo, Felipe García
Mechanochemistry is well-established in the solid-phase synthesis of inorganic materials but has rarely been employed for molecular syntheses. In recent years, there has been nascent interest in 'greener' synthetic methods with less solvent, higher yields, and shorter reaction times being especially appealing to the fine chemicals and inorganic catalyst industries. Herein, we demonstrate that main-group indium(iii) complexes featuring bis(imino)acenaphthene (BIAN) ligands are readily accessible through a mechanochemical milling approach...
May 10, 2016: Dalton Transactions: An International Journal of Inorganic Chemistry
https://www.readbyqxmd.com/read/26976247/spectral-entropy-monitoring-for-adults-and-children-undergoing-general-anaesthesia
#15
REVIEW
Anjolie Chhabra, Rajeshwari Subramaniam, Anurag Srivastava, Hemanshu Prabhakar, Mani Kalaivani, Saloni Paranjape
BACKGROUND: Anaesthetic drugs during general anaesthesia are titrated according to sympathetic or somatic responses to surgical stimuli. It is now possible to measure depth of anaesthesia using electroencephalography (EEG). Entropy, an EEG-based monitor can be used to assess the depth of anaesthesia using a strip of electrodes applied to the forehead, and this can guide intraoperative anaesthetic drug administration. OBJECTIVES: The primary objective of this review was to assess the effectiveness of entropy monitoring in facilitating faster recovery from general anaesthesia...
March 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26765454/effects-of-hypothermic-cardiopulmonary-bypass-on-internal-jugular-bulb-venous-oxygen-saturation-cerebral-oxygen-saturation-and-bispectral-index-in-pediatric-patients-undergoing-cardiac-surgery-a-prospective-study
#16
COMPARATIVE STUDY
Zhiyong Hu, Lili Xu, Zhirui Zhu, Robert Seal, Patrick M McQuillan
The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients.Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded...
January 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26573650/characterizing-awake-and-anesthetized-states-using-a-dimensionality-reduction-method
#17
M Mirsadeghi, H Behnam, R Shalbaf, H Jelveh Moghadam
Distinguishing between awake and anesthetized states is one of the important problems in surgery. Vital signals contain valuable information that can be used in prediction of different levels of anesthesia. Some monitors based on electroencephalogram (EEG) such as the Bispectral (BIS) index have been proposed in recent years. This study proposes a new method for characterizing between awake and anesthetized states. We validated our method by obtaining data from 25 patients during the cardiac surgery that requires cardiopulmonary bypass...
January 2016: Journal of Medical Systems
https://www.readbyqxmd.com/read/26407878/evaluation-of-the-brain-anaesthesia-response-monitor-during-anaesthesia-for-cardiac-surgery-a-double-blind-randomised-controlled-trial-using-two-doses-of-fentanyl
#18
RANDOMIZED CONTROLLED TRIAL
Mehrnaz Shoushtarian, Desmond P McGlade, Louis J Delacretaz, David T J Liley
The brain anaesthesia response (BAR) monitor uses a method of EEG analysis, based on a model of brain electrical activity, to monitor the cerebral response to anaesthetic and sedative agents via two indices, composite cortical state (CCS) and cortical input (CI). It was hypothesised that CCS would respond to the hypnotic component of anaesthesia and CI would differentiate between two groups of patients receiving different doses of fentanyl. Twenty-five patients scheduled to undergo elective first-time coronary artery bypass graft surgery were randomised to receive a total fentanyl dose of either 12 μg/kg (fentanyl low dose, FLD) or 24 μg/kg (fentanyl moderate dose, FMD), both administered in two divided doses...
December 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/26312484/relationship-between-sevoflurane-plasma-concentration-clinical-variables-and-bispectral-index-values-during-cardiopulmonary-bypass
#19
Rainer Nitzschke, Joana Wilgusch, Jan Felix Kersten, Matthias Sebastian Goepfert
BACKGROUND: Anesthetic administration is increasingly guided by electroencephalography (EEG)-based monitoring, such as the bispectral index (BIS). However, during cardiopulmonary bypass (CPB), factors other than the administered hypnotic agents may influence EEG signals, and their effects on BIS values are unknown. METHODS: This report is a secondary analysis of data from a prospective, controlled interventional study comparing the effect of sevoflurane administration guided by BIS monitoring (group SevoBIS) and constant administration of sevoflurane (group Sevo1...
2015: PloS One
https://www.readbyqxmd.com/read/26252802/aqueous-sulfate-separation-by-crystallization-of-sulfate-water-clusters
#20
Radu Custelcean, Neil J Williams, Charles A Seipp
An effective approach to sulfate separation from aqueous solutions is based on the crystallization of extended [SO4(H2O)5(2-)]n sulfate-water clusters with a bis(guanidinium) ligand. The ligand was generated in situ by hydrazone condensation in water, thereby bypassing the need for elaborate syntheses, tedious purifications, and organic solvents. Crystallization of sulfate-water clusters represents an alternative approach to the now established sulfate separation strategies that involve encapsulation of the "naked" anion...
September 1, 2015: Angewandte Chemie
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