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Vascular anesthesia

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https://www.readbyqxmd.com/read/28328586/percutaneous-isolated-hepatic-perfusion-hemodynamic-monitoring-and-goal-directed-anesthetic-management-a-case-report
#1
Oscar Martin-Delgado, Miguel Rodriguez, Andres Lopez, Miguel A Reina, Emilio De Vicente, Yolanda Quijano, Antonio Echenagusia, Juan A Martinez
The percutaneous isolated hepatic perfusion utilizes a venovenous bypass to administer high-dose chemotherapy exclusively in the liver, getting depurated through a hemofilter before returning to the systemic circulation. The hepatic perfusion is managed under general anesthesia and invasive monitoring as a result of very abrupt changes in venous return and vascular resistances because of the isolation of the hepatic territory and absorption of circulating catecholamines by the hemofilter. We report a case in which we describe the technique, physiologic implications, anesthetic, and goal-directed hemodynamic management for this procedure...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28323163/cerebrospinal-and-interstitial-fluid-transport-via-the-glymphatic-pathway-modeled-by-optimal-mass-transport
#2
Vadim Ratner, Yi Gao, Hedok Lee, Rena Elkin, Maiken Nedergaard, Helene Benveniste, Allen Tannenbaum
The glymphatic pathway is a system which facilitates continuous cerebrospinal fluid (CSF) and interstitial fluid (ISF) exchange and plays a key role in removing waste products from the rodent brain. Dysfunction of the glymphatic pathway may be implicated in the pathophysiology of Alzheimer's disease. Intriguingly, the glymphatic system is most active during deep wave sleep general anesthesia. By using paramagnetic tracers administered into CSF of rodents, we previously showed the utility of MRI in characterizing a macroscopic whole brain view of glymphatic transport but we have yet to define and visualize the specific flow patterns...
March 18, 2017: NeuroImage
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#3
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28298801/stellate-ganglion-block-as-rescue-therapy-in-refractory-ventricular-tachycardia
#4
M C Rajesh, K V Deepa, E K Ramdas
Pain physicians and anesthesiologists routinely perform stellate ganglion block for the treatment of painful upper extremity sympathetic dystrophy. Close proximity of ganglion to vascular structures warrants some expertise and training in the procedure. Off late, successful use of the technique in intractable ventricular tachyarrhythmias has come in literature. We have few cases wherein we could successfully ablate intractable ventricular tachycardia with stellate block which was refractory to repeated shocks...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#5
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28297053/general-regional-or-local-anesthesia-for-successful-radial-cephalic-arteriovenous-fistula
#6
David Shemesh, Yefim Raikhinstein, Ilya Goldin, Oded Olsha
Autogenous fistulas and in particular radiocephalic fistulas are recommended as the first vascular access for hemodialysis. Unfortunately, the rates of early failure and non-maturation are very high. For more than a decade, brachial plexus block has been proposed as the anesthesia of choice for fistula creation due to its beneficial sympathectomy-like effect, causing vasodilation and attenuation of spasm. Until recently, there was not a single randomized clinical study supporting this proposition. Because performing regional anesthesia is time-consuming and requires expertise, many surgeons prefer local or general anesthesia for vascular access surgery...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28293478/disrupted-brain-network-functional-dynamics-and-hyper-correlation-of-structural-and-functional-connectome-topology-in-patients-with-breast-cancer-prior-to-treatment
#7
Shelli R Kesler, Marjorie Adams, Melissa Packer, Vikram Rao, Ashley M Henneghan, Douglas W Blayney, Oxana Palesh
INTRODUCTION: Several previous studies have demonstrated that cancer chemotherapy is associated with brain injury and cognitive dysfunction. However, evidence suggests that cancer pathogenesis alone may play a role, even in non-CNS cancers. METHODS: Using a multimodal neuroimaging approach, we measured structural and functional connectome topology as well as functional network dynamics in newly diagnosed patients with breast cancer. Our study involved a novel, pretreatment assessment that occurred prior to the initiation of any cancer therapies, including surgery with anesthesia...
March 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#8
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28287528/ultrasound-based-pulse-wave-velocity-evaluation-in-mice
#9
Nicole Di Lascio, Claudia Kusmic, Francesco Stea, Francesco Faita
Arterial stiffness can be evaluated by calculating pulse wave velocity (PWV), i.e., the speed with which the pulse wave travels in a conduit vessel. This parameter is being increasingly investigated in small rodent models in which it is used for assessing alterations in vascular function related to particular genotypes/treatments or for characterizing cardiovascular disease progression. This protocol describes an image processing algorithm which leads to non-invasive arterial PWV measurement in mice using ultrasound (US) images only...
February 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#10
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28283308/percutaneous-collagen-induction-as-an-additive-treatment-for-scar-formation-following-thermal-injuries-preliminary-experience-in-47-children
#11
Rainer Kubiak, Bettina Lange
BACKGROUND: Thermal injuries are one of the most physically and psychologically devastating causes of pediatric trauma. Post-traumatic sequelae such as hypertrophic scars and contractures often result in long lasting morbidity and disfigurement. Conservative therapy, including pressure garments and silicone, is the gold standard for scar management in the pediatric population. Most recently percutaneous collagen induction (PCI) was introduced as an alternative treatment in adults. The aim of this report was to share our experience with PCI in children and adolescents in scar management following thermal injuries...
March 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28277329/sevoflurane-compared-with-isoflurane-minimizes-lung-damage-in-pulmonary-but-not-in-extrapulmonary-acute-respiratory-distress-syndrome-in-rats
#12
Mariana N Araújo, Cíntia L Santos, Cynthia S Samary, Luciana B B Heil, Vinicius C M Cavalcanti, Fernanda F Cruz, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Paolo Pelosi, Fatima C Fernandes, Nivaldo R Villela, Pedro L Silva, Patricia R M Rocco
BACKGROUND: Volatile anesthetics modulate inflammation in acute respiratory distress syndrome (ARDS). However, it is unclear whether they act differently depending on ARDS etiology. We hypothesized that the in vivo and in vitro effects of sevoflurane and isoflurane on lung damage would not differ in pulmonary (p) and extrapulmonary (exp) ARDS. METHODS: Twenty-four Wistar rats were randomized to undergo general anesthesia (1-2 minutes) with sevoflurane and isoflurane...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28277256/-anesthetic-considerations-for-awake-craniotomy-case-report
#13
Cassiano Hamacek de Freitas, Celso Homero Santos Oliveira, Daniel Câmara de Rezende, Joyce Romano, Henrique Rodrigues Lemos Silva, Ivana Mares Trivellato
BACKGROUND AND OBJECTIVES: The conscious patient cooperation during neurological procedures has become necessary for the delimitation of areas to be managed by a neurosurgeon, with better results in the treatment of tumor lesions, vascular or epileptic foci, and sequelae minimization. The need for perioperative awareness (responsiveness to commands) challenges anesthesiologists to further ensure patient safety during the procedure. Several techniques have been described for this purpose...
October 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28270765/cafedrine-theodrenaline-20-1-is-an-established-alternative-for-the-management-of-arterial-hypotension-in-germany-a-review-based-on-a-systematic-literature-search
#14
REVIEW
Berthold Bein, Torsten Christ, Leopold H J Eberhart
A 20:1 combination of cafedrine:theodrenaline (Akrinor®) is widely used in Germany for the treatment of hypotensive states during anesthesia and in emergency medicine. Although this drug formulation has been available since 1963, there are few studies relating to its use and many of the data are only available in German. In this article, we summarize the available data and propose mechanisms for the effects of cafedrine/theodrenaline on cardiac muscle cells and vascular smooth muscle cells. Cafedrine/theodrenaline leads to a rapid increase in mean arterial pressure that is characterized by increased cardiac preload, stroke volume, and cardiac output...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28270592/evidence-that-remodeling-of-insular-cortex-neurovascular-unit-contributes-to-hypertension-related-sympathoexcitation
#15
Fernanda R Marins, Jennifer A Iddings, Marco A P Fontes, Jessica A Filosa
The intermediate region of the posterior insular cortex (intermediate IC) mediates sympathoexcitatory responses to the heart and kidneys. Previous studies support hypertension-evoked changes to the structure and function of neurons, blood vessels, astrocytes and microglia, disrupting the organization of the neurovascular unit (NVU). In this study, we evaluated the functional and anatomical integrity of the NVU at the intermediate IC in the spontaneously hypertensive rat (SHR) and its control the Wistar-Kyoto (WKY)...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28258299/vasopressors-induce-passive-pulmonary-hypertension-by-blood-redistribution-from-systemic-to-pulmonary-circulation
#16
Chunling Jiang, Hong Qian, Shuhua Luo, Jing Lin, Jerry Yu, Yajiao Li, Qi An, Nanfu Luo, Lei Du
Vasopressors are widely used in resuscitation, ventricular failure, and sepsis, and often induce pulmonary hypertension with undefined mechanisms. We hypothesize that vasopressor-induced pulmonary hypertension is caused by increased pulmonary blood volume and tested this hypothesis in dogs under general anesthesia. In normal hearts (model 1), phenylephrine (2.5 μg/kg/min) transiently increased right but decreased left cardiac output, associated with increased pulmonary blood volume (63% ± 11.8, P = 0...
May 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28242819/a-rat-long-lasting-cystitis-model-induced-by-intravesical-injection-of-hydrogen-peroxide
#17
Koji Dogishi, Ken Okamoto, Tsuyoshi Majima, Shizuka Konishi-Shiotsu, Takashi Homan, Mizuki Kodera, Shohei Oyama, Tatsuya Oyama, Hisashi Shirakawa, Naoki Yoshimura, Takayuki Nakagawa, Shuji Kaneko
Novel longer lasting inflammatory bladder animal models are needed to better understand the pathophysiology of chronic cystitis. We previously developed a relatively long-lasting mouse cystitis model by intravesical injection of hydrogen peroxide (H2O2). To further evaluate its pathophysiology, in this study, we established and analyzed a rat cystitis model. Under anesthesia, 1.5% H2O2 solution was introduced transurethrally into the bladder of female rats, and kept for 30 min. The H2O2 injection significantly increased the number of micturition events up to day 14 and decreased urine volume per micturition, with the smallest volumes on day 3, compared with the vehicle-treated group...
February 2017: Physiological Reports
https://www.readbyqxmd.com/read/28240718/a-peripherally-inserted-central-catheter-line-inserted-the-day-before-surgery-decreases-the-time-from-induction-to-incision-for-spinal-deformity-surgery-and-safely-provides-central-venous-access-during-surgery-a-pilot-study
#18
Anne E Stuedemann, Richard M Schwend, Valorie K Thomas, Julia M Leamon, Tammy S Lightner
Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28224207/-differentiated-application-of-recommended-guideline-techniques-for-treatment-of-inguinal-hernia
#19
H Niebuhr, M Pawlak, F Köckerling
The new worldwide guidelines of all international hernia societies only recommend the mesh-based methods TEP, TAPP and Lichtenstein. The best mesh-free technique, the Shouldice operation, should only be used if the patient has declined the use of a mesh or no mesh is available. The systematic use of the Shouldice technique for smaller inguinal hernias and younger men should be confined to study settings. A tailored approach should be taken for mesh-based procedures to minimize the risk to patients. Due to lower pain rates the laparoendoscopic techniques TEP and TAPP are the methods of choice for primary male unilateral inguinal hernia...
February 21, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28215468/outcome-of-patients-undergoing-tavr-with-and-without-the-attendance-of-an-anesthesiologist
#20
Maayan Konigstein, Jeremy Ben-Shoshan, David Zahler, Nir Flint, Gilad Margolis, Yoav Granot, Galit Aviram, Amir Halkin, Gad Keren, Shmuel Banai, Ariel Finkelstein
BACKGROUND: During the last few years there is a shift from performing Transcatheter Aortic Valve Replacement (TAVR) under general anesthesia towards conscious sedation and local anesthesia only. In the vast majority of centers, sedation is guided by a qualified anesthesiologist. In our center, all TAVR procedures are being performed under local anesthesia and mild sedation, however, since September 2014, a large portion of TAVR procedures are being performed under local anesthesia without the presence of an anesthesiologist...
February 9, 2017: International Journal of Cardiology
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