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https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#1
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
December 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28087308/myocardial-inotropic-reserve-an-old-twist-that-constitutes-a-reliable-index-in-the-modern-era-of-heart-failure
#2
REVIEW
Fragkiskos Parthenakis, Spyridon Maragkoudakis, Maria Marketou, Alexandros Patrianakos, Evaggelos Zacharis, Panos Vardas
Current national and international guidelines, including those of the European Society of Cardiology, recognize that the assessment of prognosis should be a part of the standard management for patients with chronic heart failure (CHF). However, these same guidelines recognize the inherent difficulty of this process. A variety of factors contribute to this difficulty, including the varying etiology, frequent co-morbidity and, perhaps most importantly, huge inter-individual variability in the disease progression and outcome...
November 22, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28087157/the-association-of-blood-urea-nitrogen-levels-with-mortality-in-acute-pulmonary-embolism
#3
Mustafa A Tatlisu, Adnan Kaya, Muhammed Keskin, Sahin Avsar, Mehmet Bozbay, Kiymet Tatlisu, Mehmet Eren
BACKGROUND: The aim of this study was to investigate the association of BUN levels with in-hospital and long-term adverse clinical outcomes in acute pulmonary embolism (APE) patients treated with tissue-plasminogen activator (t-PA). METHODS: This retrospective study included 252 consecutive confirmed APE patients treated with t-PA. An admission BUN of 34.5 mg/dL was identified through an ROC analysis as an optimal cutoff value to predict the in-hospital mortality with 85% sensitivity and 91% specificity (AUC: 0...
December 29, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28079557/dobutamine-aggravates-haemodynamic-deterioration-induced-by-pleural-effusion-a-randomised-controlled-porcine-study
#4
Kristian B Wemmelund, Anders H Sørensen, Viktor K Ringgård, Erik Sloth, Peter Juhl-Olsen
BACKGROUND: Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. OBJECTIVE: We hypothesised that dobutamine would affect the physiological determinants preload, afterload, contractility and changes of inferior vena cava characteristics during experimental pleural effusion. DESIGN: A randomised, controlled laboratory study. SETTING: Animal laboratory, conducted from March 2013 to May 2013...
January 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28078759/bufalin-a-bufanolide-steroid-from-the-parotoid-glands-of-the-chinese-toad-inhibits-l-type-ca-2-channels-and-contractility-in-rat-ventricular-myocytes
#5
Tao Song, Xi Chu, Xuan Zhang, Qiong Tao Song, Ying Zhang, Yuanyuan Zhang, Xue Han, Jianping Zhang, Li Chu
Bufalin is a bufanolide steroid compound in Chan Su. Chan Su is a traditional Chinese medicine prepared from the dried white secretion of the auricular and skin glands of toads, and has been used as an Oriental drug. However, the effect of bufalin on cardiac function and its underlying cellular mechanisms remain unclear. Here, we explore the cellular mechanisms of bufalin on myocardial protection via the whole-cell patch-clamp recording and video-based edge detection system. Exposure to bufalin resulted in a concentrated-dependent blockade of ICa-L , with the half-maximal inhibitory concentration (IC50 ) of 60 μM and the maximal inhibitory effect of 71...
January 11, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28074802/goal-directed-therapy-improves-the-outcome-of-high-risk-cardiac-patients-undergoing-off-pump-coronary-artery-bypass
#6
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Singh Rawat, Yatin Mehta, Sameer Taneja, R Ravi, Milind P Hote
BACKGROUND: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074797/minimally-invasive-compared-to-conventional-approach-for-coronary-artery-bypass-grafting-improves-outcome
#7
Jitumoni Baishya, Antony George, Jayaprakash Krishnamoorthy, Geetha Muniraju, Murali Chakravarthy
INTRODUCTION: Minimally invasive (MI) cardiac surgery is a rapidly gaining popularity, globally as well as in India. We aimed to compare the outcome of MI to the conventional approach for coronary artery bypass graft (CABG) surgery. METHODS: This prospective, comparative study was conducted at a tertiary care cardiac surgical center. All patients who underwent CABG surgery via MI approach (MI group) from July 2015 to December 2015 were enrolled and were compared against same number of EuroSCORE II matched patients undergoing CABG through conventional mid-sternotomy approach (CON group)...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073175/post-reperfusion-microcirculatory-derangements-after-liver-transplantation-relationship-to-hemodynamics-serum-mediators-and-outcome
#8
Carlo Pulitano, David Joseph, Charbel Sandroussi, Deborah Verran, Phong Ho, Ashe Debiasio, Adriano Luongo, Geoffrey W McCaughan, Nicholas Shackel, Michael Crawford
INTRODUCTION: Despite the growing data supporting the role of microcirculation in regulating liver function, little of this knowledge has been translated into clinical practice. The aim of this study is to quantify hepatic microcirculation in-vivo using sidestream dark-field (SDF) imaging and correlate these finding with hepatic blood flow, hemodynamic parameters, and soluble mediators. METHODS: Post-reperfusion hepatic microcirculation was assessed using SDF imaging...
January 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28072937/prognosis-of-patients-with-rheumatic-diseases-admitted-to-intensive-care
#9
M Beil, S Sviri, V de la Guardia, I Stav, E Ben-Chetrit, P V van Heerden
Variable mortality rates have been reported for patients with rheumatic diseases admitted to an intensive care unit (ICU). Due to the absence of appropriate control groups in previous studies, it is not known whether the presence of a rheumatic disease constitutes a risk factor. Moreover, the accuracy of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score for predicting outcome in this group of patients has been questioned. The primary goal of this study was to compare outcome of patients with rheumatic diseases admitted to a medical ICU to those of controls...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#10
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072739/risk-factors-and-outcomes-associated-with-a-higher-use-of-inotropes-in-kidney-transplant-recipients
#11
Jae Moon Choi, Jun-Young Jo, Jae-Won Baik, Sooyoung Kim, Chan Sik Kim, Sung-Moon Jeong
Preservation of adequate perfusion pressures to the graft is a main focus of intraoperative management during kidney transplantation. We undertook this study to investigate the incidence of the higher use of inotropes in kidney transplant recipients and identify the patient outcomes and preoperative and intraoperative variables related to this.We retrospectively analyzed 1053 patients who underwent kidney transplantation at Asan Medical Center between January 2006 and February 2012, stratified by their inotropic score ([dopamine] + [dobutamine] + [epinephrine × 100] + [norepinephrine × 100]) <7 versus ≥7, wherein all doses are expressed as μg/kg/min...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071786/functional-and-cardioprotective-effects-of-simultaneous-and-individual-activation-of-protein-kinase-a-and-epac
#12
Igor Khaliulin, Mark Bond, Andrew F James, Zara Dyar, Raheleh Amini, Jason L Johnson, M-Saadeh Suleiman
BACKGROUND AND PURPOSE: Myocardial cAMP elevation confers cardioprotection against ischaemia/reperfusion (I/R) injury. cAMP activates two independent signalling pathways, PKA and Epac. This study investigated the cardiac effects of activating PKA and/or Epac and their involvement in cardioprotection against I/R. EXPERIMENTAL APPROACH: Hearts extracted from male rats were used either for determination of PKA and PKC activation or perfused in the Langendorff mode for either cardiomyocytes isolation or used to monitor functional activity at basal levels and after 30 min global ischaemia and 2 h reperfusion...
January 10, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28070237/to-ventricular-assist-devices-or-not-when-is-implantation-of-a-ventricular-assist-device-appropriate-in-advanced-ambulatory-heart-failure
#13
EDITORIAL
Emily Cerier, Brent C Lampert, Arman Kilic, Asia McDavid, Salil V Deo, Ahmet Kilic
Advanced heart failure has been traditionally treated via either heart transplantation, continuous inotropes, consideration for hospice and more recently via left ventricular assist devices (LVAD). Heart transplantation has been limited by organ availability and the futility of other options has thrust LVAD therapy into the mainstream of therapy for end stage heart failure. Improvements in technology and survival combined with improvements in the quality of life have made LVADs a viable option for many patients suffering from heart failure...
December 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/28069985/high-throughput-imaging-of-cardiac-microtissues-for-the-assessment-of-cardiac-contraction-during-drug-discovery
#14
Amy Pointon, James Pilling, Thierry Dorval, Yinhai Wang, Caroline Archer, Christopher Pollard
Cardiotoxicity is a common cause of attrition in preclinical and clinical drug development. Current in vitro approaches have two main limitations, they either are limited to low throughput methods not amendable to drug discovery or lack the physiological responses to allow an integrated risk assessment. A human 3D cardiac microtissue containing human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs), cardiac endothelial cells and cardiac fibroblast were used to assess their suitability to detect drug induced changes in cardiomyocyte contraction...
November 15, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28069537/cardiac-actions-of-thyroid-hormone-metabolites
#15
Grazia Rutigliano, Riccardo Zucchi
Thyroid hormones (THs) have a major role in regulating cardiac function. Their classical mechanism of action is genomic. Recent findings have broadened our knowledge about the (patho)physiology of cardiac regulation by THs, to include non-genomic actions of THs and their metabolites (THM). This review provides an overview of classical and non-classical cardiac effects controlled by: i) iodothyronines (thyroxine, T4; 3,5,3'-triiodothyronine,T3; 3, 5-diiodothyronine, T2); ii) thyronamines (thyronamine, T0AM; 3-iodothyronamine, T1AM); and iii) iodothyroacetic acids (3, 5, 3', 5'-tetraiodothyroacetic acid, tetrac; 3, 5, 3'-triiodothyroacetic acid, triac; 3-iodothyroacetic acid, TA1)...
January 6, 2017: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/28065821/an-evaluation-of-the-utility-of-lvdp-dt40-qa-interval-lvdp-dtmin-and-tau-as-indicators-of-drug-induced-changes-in-contractility-and-lusitropy-in-dogs
#16
Michael K Pugsley, Brian Guth, Alan Y Chiang, Jennifer M Doyle, Michael Engwall, Jean-Michel Guillon, Peter K Hoffmann, John E Koerner, Scott W Mittelstadt, Jennifer Beck Pierson, Eric I Rossman, R Dustan Sarazan, Stan Parish
INTRODUCTION: The importance of drug-induced effects on the inotropic state of the heart is well known.Unlike hemodynamic and cardiac electrophysiological methods, which have been routinely used in drug safety testing for years, the non-clinical assessment of drug effects on myocardial contractility is used less frequently with no established translation to humans. The goal of these studies was to determine whether assessment of alternate measures of cardiac inotropy could detect drug-induced changes in the contractile state of the heart using drugs known to have clinically relevant positive and negative effects on myocardial contractility...
January 5, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28063919/proteomic-analysis-of-the-protective-effects-of-aqueous-bark-extract-of-terminalia-arjuna-roxb-on-isoproterenol-induced-cardiac-hypertrophy-in-rats
#17
Santosh Kumar, Md Jahangir Alam, Pankaj Prabhakar, Sayeed Ahmad, Subir K Maulik, Manish Sharma, Shyamal K Goswami
ETHNOPHARMACOLOGICAL RELEVANCE: Aqueous bark extract of Terminalia arjuna (TA) has been in use as an ethnomedicine for cardiovascular ailments in the Indian subcontinent for centuries. Studies using hemodynamic, ROS scavenging and anti-inflammatory parameters in animal models have shown its anti-atherogenic, hypotensive, inotropic, anti-inflammatory effects. However, details analysis on its effects on established molecular and cell biological markers are a prerequisite for its wider acceptance to the medical community...
January 4, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28060164/great-way-to-clarify-the-use-of-inotropic-agents-in-newborns
#18
Romy Schmidt Brock Zacharias, Werther Brunow de Carvalho
No abstract text is available yet for this article.
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#19
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28057037/role-of-vasopressin-and-terlipressin-in-refractory-shock-compared-to-conventional-therapy-in-the-neonatal-and-pediatric-population-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#20
Reem Masarwa, Gideon Paret, Amichai Perlman, Shimon Reif, Bruria Hirsh Raccah, Ilan Matok
BACKGROUND: Vasopressin (AVP) and terlipressin (TP) have been used as last-line therapy in refractory shock in children. However, the efficacy and safety profiles of AVP and TP have not been determined in pediatric refractory shock of different origins. We aimed to assess the efficacy and safety of the addition of AVP/TP therapy in pediatric refractory shock of all causes compared to conventional therapy with fluid resuscitation and vasopressor and inotropic therapy. METHODS: We conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) comparing AVP and TP to conventional therapy...
January 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
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