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hyperdynamic phase

Kai O Hensel
Cardiovascular complications are the key cause for mortality in diabetes mellitus. Besides ischemia-related cardiac malfunction there is growing evidence for non-ischemic diabetes-associated heart failure in both type 1 and type 2 diabetes mellitus. The underlying pathophysiology of non-ischemic diabetic cardiomyopathy (NIDC) is poorly understood and data on myocardial mechanics in early stages of the disease are rare. However, several studies in both human and experimental animal settings have reported prima facie unexplained features indicating myocardial hyperdynamics early in the course of the disease...
September 2016: Medical Hypotheses
William G Bradley, Victor Haughton, Kent-Andre Mardal
This chapter uses magnetic resonance imaging phase-contrast cerebrospinal fluid (CSF) flow measurements to predict which clinical normal-pressure hydrocephalus (NPH) patients will respond to shunting as well as which patients with Chiari I are likely to develop symptoms of syringomyelia. Symptomatic NPH patients with CSF flow (measured as the aqueductal CSF stroke volume) which is shown to be hyperdynamic (defined as twice normal) are quite likely to respond to ventriculoperitoneal shunting. The hyperdynamic CSF flow results from normal systolic brain expansion compressing the enlarged ventricles...
2016: Handbook of Clinical Neurology
William G Bradley
Normal pressure hydrocephalus (NPH) is a syndrome found in the elderly, which is characterized by ventriculomegaly and deep white matter ischemia (DWMI) on magnetic resonance imaging (MRI) and the clinical triad of gait disturbance, dementia, and urinary incontinence. NPH has been estimated to account for up to 10% of cases of dementia and is significant because it is treatable by ventriculoperitoneal shunting. Patients with a known cause of chronic communicating hydrocephalus, that is, meningitis or hemorrhage, tend to respond better than patients with the so-called "idiopathic" form, most likely because of poor selection criteria in the past...
April 2016: Seminars in Ultrasound, CT, and MR
Mateusz Sporek, Paulina Dumnicka, Agnieszka Gala-Bladzinska, Piotr Ceranowicz, Zygmunt Warzecha, Artur Dembinski, Ewa Stepien, Jerzy Walocha, Ryszard Drozdz, Marek Kuzniewski, Beata Kusnierz-Cabala
Within the first week of the disease, acute kidney injury (AKI) is among the most common causes of mortality in acute pancreatitis (AP). Recently, serum angiopoietin-2 (Ang-2) has been associated with hyperdynamic state of the systemic circulation. The aim of this study was to examine the associations between Ang-2 and the clinical AP severity during the first 72 hours of the disease, and organ disfunction, including AKI. Methods. Study included patients admitted to the surgery ward, diagnosed with AP. AKI was diagnosed according to KDIGO guidelines and renal failure according to modified Marshall scoring system...
2016: Mediators of Inflammation
N C McAvoy, S Semple, J M J Richards, A J Robson, D Patel, A G M Jardine, K Leyland, A S Cooper, D E Newby, P C Hayes
BACKGROUND: With advancing liver disease and the development of portal hypertension, there are major alterations in somatic and visceral blood flow. Using phase-contrast magnetic resonance angiography, we characterised alterations in blood flow within the hepatic, splanchnic and extra-splanchnic circulations of patients with established liver cirrhosis. AIM: To compare blood flow in splanchnic and extra-splanchnic circulations in patients with varying degrees of cirrhosis and healthy controls...
May 2016: Alimentary Pharmacology & Therapeutics
C W White, R Lillico, J Sandha, D Hasanally, F Wang, E Ambrose, A Müller, O Rachid, Y Li, B Xiang, H Le, S Messer, A Ali, S R Large, T W Lee, I M C Dixon, T M Lakowski, K Simons, R C Arora, G Tian, J Nagendran, L V Hryshko, D H Freed
Hearts donated following circulatory death (DCD) may represent an additional source of organs for transplantation; however, the impact of donor extubation on the DCD heart has not been well characterized. We sought to describe the physiologic changes that occur following withdrawal of life-sustaining therapy (WLST) in a porcine model of DCD. Physiologic changes were monitored continuously for 20 min following WLST. Ventricular pressure, volume, and function were recorded using a conductance catheter placed into the right (N = 8) and left (N = 8) ventricles, and using magnetic resonance imaging (MRI, N = 3)...
March 2016: American Journal of Transplantation
Jordi Gracia-Sancho, Raquel Maeso-Díaz, Jaime Bosch
Portal hypertension is a common complication of chronic liver disease. Its relevance comes from the fact that it determines most complications leading to death or liver transplantation in patients with cirrhosis of the liver: bleeding from esophageal or gastric varices, ascites and renal dysfunction, sepsis and hepatic encephalopathy. Portal hypertension results from increased resistance to portal blood flow through the cirrhotic liver. This is caused by two mechanisms: (1) distortion of the liver vascular architecture due to the liver disease causing structural abnormalities (nodule formation, remodeling of liver sinusoids, fibrosis, angiogenesis and vascular occlusion), and (2) increased hepatic vascular tone due to sinusoidal endothelial dysfunction, which results in a defective production of endogenous vasodilators, mainly nitric oxide (NO), and increased production of vasoconstrictors (thromboxane A2, cysteinyl leukotrienes, angiotensin II, endothelins and an activated adrenergic system)...
2015: Digestive Diseases
Edward A Bittner, Erik Shank, Lee Woodson, J A Jeevendra Martyn
Care of burn-injured patients requires knowledge of the pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Massive airway and/or lung edema can occur rapidly and unpredictably after burn and/or inhalation injury. Hemodynamics in the early phase of severe burn injury is characterized by a reduction in cardiac output and increased systemic and pulmonary vascular resistance. Approximately 2 to 5 days after major burn injury, a hyperdynamic and hypermetabolic state develops...
February 2015: Anesthesiology
Mingxiao Guo, Linlin Li, Chunlei Lu
PURPOSE: Transplantation of donation after cardiac death (DCD) intestine has higher rates of organ failure and complications. Fortunately, this is less grievous in a subclass of DCD called controlled (CDCD), those with irreversible but incomplete brain injury. The aim of the paper is to establish a CDCD porcine model which is closely mimicking human CDCD scenario, and investigate the physiologic changes from withdrawal of ventilatory support to circulatory arrest. METHOD: Ten domestic crossbred pigs were anesthetized and ventilated with room air...
2014: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Javier Pascual-Ramírez, Susana Sánchez García, Francisco González Ruiz de la Herrán, Pedro Villarejo Campos, Carlos López de la Manzanara Cano, Javier Haya Palazuelo, David Padilla Valverde, Jesús Martín Fernández
OBJECTIVE: To present physiologic intraoperative data and immediate postoperative outcomes of patients diagnosed with epithelial ovarian cancer submitted to cytoreductive surgery and hyperthermic peritoneal intraoperative chemotherapy (HIPEC) with a closed-circuit, turbulent-flow system. MATERIALS AND METHODS: A closed-circuit system with CO2 turbulent flow was used for paclitaxel HIPEC during 60 min for patients diagnosed with stage II or higher and recurrent epithelial ovarian cancer...
July 2014: Archives of Gynecology and Obstetrics
Hamzeh Hosseinzadeh, Mahmood Eidy, Mehdi Ghaffarlou, Kamyar Ghabili, Samad Ej Golzari
PURPOSE: Patients with increased intracranial pressure (ICP) are prone to severe cardiac and or cerebral complications following emergence from general anesthesia and especially post-extubation phase. Administering beta blockers including esmolol is believed to be helpful in providing a stable hemodynamic at the end of the surgery and recovery stages and reducing recovery phase length. METHOD: In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving esmolol (n=30) and placebo (n=30) as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation...
2012: Advanced Pharmaceutical Bulletin
Hamzeh Hosseinzadeh, Mahmood Eydi, Mehdi Ghaffarlou, Kamyar Ghabili, Samad Ej Golzari, Amir Mohammad Bazzazi
INTRODUCTION: Emergence from general anesthesia and especially post-extubation phase are the stages associated with cardiovascular hyperdynamic status in which patients with increased intracranial pressure (ICP) could be affected by severe cardiac and or cerebral complications. Administering remifentanil could be helpful in maintaining the hemodynamic stability at the end of the surgery and recovery stages and reducing recovery phase length. METHODS: In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving remifentanil and placebo as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation...
2012: Journal of Cardiovascular and Thoracic Research
Natalie Mutig, Cornelia Geers-Knoerr, Birgit Piep, Aanchal Pahuja, Peter M Vogt, Bernhard Brenner, Andreas D Niederbichler, Theresia Kraft
Lipoteichoic acid (LTA) is the key pathogenic factor of gram-positive bacteria and contributes significantly to organ dysfunction in sepsis, a frequent complication in critical care patients. We hypothesized that LTA directly affects cardiomyocyte function, thus contributing to cardiac failure in sepsis. This study was designed to evaluate the effects of LTA on contractile properties and calcium-transients of isolated adult rat cardiomyocytes. When myocytes were exposed to LTA for 1h prior to analysis, the amplitudes of calcium-transients as well as sarcomere shortening increased to 130% and 142% at 1 Hz stimulation frequency...
December 2013: Molecular Immunology
Joseph Rinehart, Christine Lee, Maxime Cannesson, Guy Dumont
BACKGROUND: Surgical patients present with a wide variety of body sizes and blood volumes, have large differences in baseline volume status, and may exhibit significant differences in cardiac function. Any closed-loop fluid administration system must be robust against these differences. In the current study, we tested the stability and robustness of the closed-loop fluid administration system against the confounders of body size, starting volume status, and cardiac contractility using control engineering methodology...
November 2013: Anesthesia and Analgesia
Annette M van de Sandt, Rainer Windler, Axel Gödecke, Jan Ohlig, Simone Zander, Michael Reinartz, Jürgen Graf, Ernst E van Faassen, Tienush Rassaf, Jürgen Schrader, Malte Kelm, Marc W Merx
Endothelial nitric oxide synthase (NOS)3-derived nitric oxide (NO) modulates inotropic response and diastolic interval for optimal cardiac performance under non-inflammatory conditions. In sepsis, excessive NO production plays a key role in severe hypotension and myocardial dysfunction. We aimed to determine the role of NOS3 on myocardial performance, NO production, and time course of sepsis development. NOS3(-/-) and C57BL/6 wildtype mice were rendered septic by cecum ligation and puncture (CLP). Cardiac function was analyzed by serial echocardiography, in vivo pressure and isolated heart measurements...
March 2013: Basic Research in Cardiology
Richard B Arbour
Patients with terminal brain stem herniation experience global physiological consequences and represent a challenging population in critical care practice as a result of multiple factors. The first factor is severe depression of consciousness, with resulting compromise in airway stability and lung ventilation. Second, with increasing severity of brain trauma, progressive brain edema, mass effect, herniation syndromes, and subsequent distortion/displacement of the brain stem follow. Third, with progression of intracranial pathophysiology to terminal brain stem herniation, multisystem consequences occur, including dysfunction of the hypothalamic-pituitary axis, depletion of stress hormones, and decreased thyroid hormone bioavailability as well as biphasic cardiovascular state...
January 2013: AACN Advanced Critical Care
A Siniscalchi, L Aurini, S Spedicato, E Bernardi, A Zanoni, A Dante, M Cimatti, L Gamberini, S Faenza
BACKGROUND: Liver cirrhosis is associated with a hyperdynamic circulation (HC). In this observational study, we aimed to investigate the predictive factors of HC, its impact on intraoperative hemodynamic and postoperative outcome, early ICU and in-hospital mortality, in cirrhotic patients undergoing orthotopic liver transplantation (OLT). METHODS: Two hundred and forty-two patients with cirrhosis undergoing cadaveric OLT were included. Before starting the transplant procedure and under general anesthesia, a pulmonary artery catheter was introduced to assess hemodynamic parameters...
January 2013: Minerva Anestesiologica
Lindsay Vaughn, Nicole Beckel
OBJECTIVE: To review the literature related to severe burn injury (SBI), burn shock, and smoke inhalation injury in domestic animals. Current animal- and human-based research and literature were evaluated to provide an overview of thermal burn classification and the pathophysiology of burn shock and smoke inhalation injury. ETIOLOGY: Severe burn injury, burn shock, and smoke inhalation injury may be encountered as a result of thermal injury, radiation injury, chemical injury, or electrical injury...
April 2012: Journal of Veterinary Emergency and Critical Care
Tamás Kovács, Gabriella Varga, Dániel Erces, Tünde Tőkés, László Tiszlavicz, Miklós Ghyczy, Mihály Boros, József Kaszaki
This study was designed to follow the time course of inflammatory activation in a rodent model of 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis. We hypothesized that oral phosphatidylcholine (PC) pretreatment regimens may influence leukocyte-mediated microcirculatory reactions in this condition. In series I, Wistar rats were monitored 1 day after colitis induction (n = 24), and in series II (n = 24) on day 6 following a TNBS enema. The PC-pretreated animals received a 2% PC-enriched diet for 6 days before the TNBS enema (series I), or for 3 days before and 3 days after TNBS treatment (series II)...
August 2012: Shock
Richard B Arbour
Brain death is characterised by a flaccid, areflexic neurological examination; fixed, dilated and midpoint pupils and total absence of intrinsic respiratory drive. A non-reversible clinical state or brain lesion must also be identified. Integral to brain death diagnosis is loss of respiratory drive. Following terminal brainstem herniation, a cardiovascular hyperdynamic state often occurs. This hyperdynamic state causes cyclical volume displacement within the chest in phase with the cardiac cycle, causing oscillations in gas flow patterns and may be reflected in ventilator airway pressure and flow waveforms...
December 2012: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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