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https://www.readbyqxmd.com/read/29916835/the-modern-cardiovascular-care-unit-the-cardiologist-managing-multiorgan-dysfunction
#1
Thomas Bochaton, Eric Bonnefoy-Cudraz, Nadia Aissaoui
PURPOSE OF REVIEW: Despite many advances in the management of critically ill patients, cardiogenic shock remains a challenge because it is associated with high mortality. Even if there is no universally accepted definition of cardiogenic shock, end-perfusion organ dysfunction is an obligatory and major criterion of its definition.Organ dysfunction is an indicator that cardiogenic shock is already at an advanced stage and is undergoing a rapid self-aggravating evolution. The aim of the review is to highlight the importance to diagnose and to manage the organ dysfunction occurring in the cardiogenic shock patients by providing the best literature published this year...
June 16, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29913298/antihypertensive-effect-of-the-methanolic-extract-from-eruca-sativa-mill-brassicaceae-in-rats-muscarinic-receptor-linked-vasorelaxant-and-cardiotonic-effects
#2
Umme Salma, Taous Khan, Abdul Jabbar Shah
ETHNOPHARMACOLOGICAL RELEVANCE: Eruca sativa Mill., (Brassicaceae) is a popular remedy for the treatment of hypertension in Pakistan. However, direct effect of the extract and its fractions on blood pressure and vascular tone are unknown. AIM OF THE STUDY: This investigation was aimed to explore the pharmacological base for the traditional use of E. sativa in hypertension. MATERIALS AND METHODS: In-vivo blood pressure study was carried out using normotensive and high salt-induced hypertensive rats under anaesthesia...
June 15, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29913033/comparison-of-propofol-based-versus-volatile-based-anaesthesia-and-postoperative-sedation-in-cardiac-surgical-patients-a-prospective-randomized-study
#3
Marcin Wąsowicz, Angela Jerath, Warren Luksun, Vivek Sharma, Nicholas Mitsakakis, Massimilaino Meineri, Rita Katznelson, Terrence Yau, Vivek Rao, William Scott Beattie
BACKGROUND: Clinical trials have shown conflicting results regarding the use of volatile anesthesia before or after the ischemic insult in cardiac surgical patients and effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesized that combined volatile-based anesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared to intravenous, propofol-based approach...
June 18, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29912813/an-observational-cohort-feasibility-study-to-identify-microvesicle-and-micro-rna-biomarkers-of-acute-kidney-injury-following-pediatric-cardiac-surgery
#4
Nikol Sullo, Silvia Mariani, Maria JnTala, Tracy Kumar, Marcin J Woźniak, Dawn Smallwood, Paolo Pais, Claire Westrope, Attilio Lotto, Gavin J Murphy
OBJECTIVES: Micro-RNA, small noncoding RNA fragments involved in gene regulation, and microvesicles, membrane-bound particles less than 1 μm known to regulate cellular processes including responses to injury, may serve as disease-specific biomarkers of acute kidney injury. We evaluated the feasibility of measuring these signals as well as other known acute kidney injury biomarkers in a mixed pediatric cardiac surgery population. DESIGN: Single center prospective cohort feasibility study...
June 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912235/-peripartum-cardiomyopathy-a-little-known-disease
#5
Angela Beatrice Scardovi, Renata De Maria
Peripartum cardiomyopathy (PPCM) is a relatively rare cardiac disease that manifests itself in the final stage of pregnancy and in the first months after delivery in women with no previous history of cardiovascular disease. The incidence of PPCM varies widely across geographic areas and seems to be on the rise as a result of increased awareness and socioeconomic changes. PPCM recognizes a still partially undefined multifactorial etiology. Various pathogenetic hypotheses have been proposed, that range from autoimmune mechanisms to myocarditis to the hormonal hypothesis for aberrant, antiangiogenic and cardiotoxic prolactin (PRL) production, apoptosis, prolonged exposure to tocolytic drugs, malnutrition and genetic predisposition...
April 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29912068/hemodynamic-tolerance-to-iv-clonidine-infusion-in-the-picu
#6
Niina Kleiber, Joost van Rosmalen, Dick Tibboel, Saskia N de Wildt
OBJECTIVES: Clonidine is an antihypertensive drug used for analgosedation in the PICU. Lack of reliable data on its hemodynamic tolerance limits its use. This study explores the hemodynamic tolerance of IV clonidine infusion in a broad population of children with high severity of disease. DESIGN: Retrospective analysis of prospectively collected data. SETTING: A tertiary and quaternary referral PICU. PATIENTS: Critically ill children age 0-18 years old who received an IV clonidine infusion for analgosedation of at least 1 hour...
June 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29910676/lipid-emulsion-for-treating-local-anesthetic-systemic-toxicity
#7
REVIEW
Seong-Ho Ok, Jeong-Min Hong, Soo Hee Lee, Ju-Tae Sohn
Lipid emulsion has been shown to be an effective treatment for systemic toxicity induced by local anesthetics, which is reflected in case reports. A systemic review and meta-analysis confirm the efficacy of this treatment. Investigators have suggested mechanisms associated with the lipid emulsion-mediated recovery of cardiovascular collapse caused by local anesthetic systemic toxicity; these mechanisms include lipid sink, a widely accepted theory in which highly soluble local anesthetics (particularly bupivacaine) are absorbed into the lipid phase of plasma from tissues (e...
2018: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29910113/evaluation-of-the-vasoactive-inotropic-score-mid-regional-pro-adrenomedullin-and-cardiac-troponin-i-as-predictors-of-low-cardiac-output-syndrome-in-children-after-congenital-heart-disease-surgery
#8
J L Pérez-Navero, C Merino-Cejas, I Ibarra de la Rosa, S Jaraba-Caballero, M Frias-Perez, E Gómez-Guzmán, M Gil-Campos, M J de la Torre-Aguilar
OBJECTIVE: To determine the predictive value of the inotropic score (IS) and vasoactive-inotropic score (VIS) in low cardiac output syndrome (LCOS) in children after congenital heart disease surgery involving cardiopulmonary bypass (CPB), and to establish whether mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I), associated to the IS and VIS scores, increases the predictive capacity in LCOS. DESIGN: A prospective observational study was carried out...
June 14, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29908678/nutritional-practices-and-adequacy-in-children-supported-on-extracorporeal-membrane-oxygenation
#9
Chengsi Ong, Yee Hui Mok, Zhen Han Tan, Carey Y S Lim, Bixia Ang, Teng Hong Tan, Yee Jim Loh, Yoke Hwee Chan, Jan Hau Lee
BACKGROUND AND AIMS: Use of extracorporeal membrane oxygenation (ECMO) in children is increasing. Yet, little is known about optimal nutritional practices in these children. We aim to describe the nutritional adequacy, factors associated with enteral nutrition, and the association between nutritional adequacy and mortality in children supported on ECMO. METHODS: We conducted a retrospective review of all children (1 month-18 years) requiring ECMO between 2010 and 2016...
August 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29908289/decreased-contractility-and-altered-responses-to-inotropic-agents-in-myocytes-from-tachypacing-induced-heart-failure-canines
#10
BaoXi Gao, Yusheng Qu, Weston Sutherland, Ray W Chui, Kim Hoagland, Hugo M Vargas
Contractility measurements using primary isolated cardiac myocytes (CM) have commonly been used in understanding the physiology and pharmacology of cellular mechanics. In the majority of studies, CM from healthy animals were used, and fewer studies were performed with CM from diseased hearts. To better understand the translational value of contractility on the cellular level of a diseased animal model, myocytes were isolated from left ventricles of a tachypacing-induced heart failure (HF) canine model, and their contractility was measured by recording sarcomere shortening using an image-based IonOptix video system...
June 13, 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29907406/first-spot-urine-sodium-after-initial-diuretic-identifies-patients-at-high-risk-for-adverse-outcome-after-heart-failure-hospitalization
#11
Adriana Luk, John D Groarke, Akshay S Desai, Syed Saad Mahmood, Deepa M Gopal, Emer Joyce, Sachin P Shah, Joann Lindenfeld, Lynne Stevenson, Neal K Lakdawala
BACKGROUND: Relief of congestion is the primary goal of initial therapy for acute decompensated heart failure (ADHF). Early measurement of urine sodium concentration (UNa) may be useful to identify patients with diminished response to diuretics. The aim of this study was to determine if the first spot UNa after diuretic initiation could select patients likely to require more intensive therapy during hospitalization. METHODS: At the time of admission, 103 patients with ADHF were identified prospectively, and UNa was measured after the first dose of intravenous diuretic...
May 19, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29903715/unmasking-myocardial-bridge-related-ischemia-by-intracoronary-functional-evaluation
#12
Giuseppe Tarantini, Alberto Barioli, Luca Nai Fovino, Chiara Fraccaro, Giulia Masiero, Sabino Iliceto, Massimo Napodano
BACKGROUND: Invasive physiological assessment of myocardial bridges (MBs) is largely unsettled. Unlike fractional flow reserve (FFR), instantaneous wave-free ratio (iFR) is a diastole-specific index. As such, its value might not be hampered by systolic pressure overshooting and negative systolic pressure gradient caused by the compression of the tunneled coronary artery. METHODS AND RESULTS: We prospectively enrolled 20 patients with angina and/or positive noninvasive stress test, absence of significant coronary artery stenosis, and angiographic suspicion/evidence of MB in the left anterior descending artery...
June 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29903693/mechanical-circulatory-support-in-patients-with-cardiogenic-shock-in-intensive-care-units-a-position-paper-of-the-unit%C3%A3-de-soins-intensifs-de-cardiologie-group-of-the-french-society-of-cardiology-endorsed-by-the-groupe-ath%C3%A3-rome-et-cardiologie-interventionnelle
#13
REVIEW
Laurent Bonello, Clement Delmas, Guillaume Schurtz, Guillaume Leurent, Eric Bonnefoy, Nadia Aissaoui, Patrick Henry
Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines...
June 11, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29903518/3d-echocardiography-derived-right-ventricular-function-is-associated-with-right-ventricular-failure-and-mid-term-survival-after-left-ventricular-assist-device-implantation
#14
Harry Magunia, Clemens Dietrich, Harald F Langer, David Schibilsky, Christian Schlensak, Peter Rosenberger, Martina Nowak-Machen
BACKGROUND: Right heart failure remains a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Multiple 2D echocardiography derived parameters are associated with right ventricular failure (RV failure), but none of them has been proven to be a reliable predictor to date. We hypothesized that novel 3D-echocardiography (3DE) based parameters are associated with RV failure and predict long term outcome in patients undergoing LVAD implantation. METHODS: This single-center study retrospectively enrolled 26 patients undergoing continuous-flow LVAD implantation...
June 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29898149/on-pump-beating-non-beating-cabg-in-stable-angina-have-similar-outcomes
#15
Victor Dayan, Juan Jose Paganini, Alvaro Marichal, Daniel Brusich
OBJECTIVE: On pump beating/non-beating coronary artery bypass grafts (CABG) has been compared in patients with unstable angina and/or severe left ventricular dysfunction. There is scarce evidence regarding the beneficial use of on-pump beating CABG in patients with stable angina and normal left ventricular function. Our aim was to study the postoperative results using both techniques in this group of patients. METHODS: One thousand one hundred and forty-five patients with stable angina underwent on-pump isolated CABG in Uruguay from 2011 to 2015...
March 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29893667/open-heart-surgery-at-patient-s-own-temperature-without-active-cooling
#16
Mehmet Kaplan, Anil Karaagac, Tolga Can, Sahin Yilmaz, Mehmet Inanc Yesilkaya, Adlan Olsun, Hakki Aydogan
BACKGROUND: Hypothermia is a method of myocardial protection in cardiac surgery. This protection occurs by decreasing the metabolic demands, however, it creates susceptibility to various problems. In this study, we investigated patients operated on under normothermia (at the patient's own temperature) and hypothermia for postoperative differences. METHODS: The study was conducted between June 2015 and September 2016 with 167 patients. The patients were divided into two groups in accordance with our routine clinical practice: the normothermic group (native temperature goup; intraoperative body temperature ≥ 34°C), and the hypothermic group intraoperative body temperature  < 34°C - ≥ 28°C)...
April 18, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29892068/suppression-of-detyrosinated-microtubules-improves-cardiomyocyte-function-in-human-heart-failure
#17
Christina Yingxian Chen, Matthew A Caporizzo, Kenneth Bedi, Alexia Vite, Alexey I Bogush, Patrick Robison, Julie G Heffler, Alex K Salomon, Neil A Kelly, Apoorva Babu, Michael P Morley, Kenneth B Margulies, Benjamin L Prosser
Detyrosinated microtubules provide mechanical resistance that can impede the motion of contracting cardiomyocytes. However, the functional effects of microtubule detyrosination in heart failure or in human hearts have not previously been studied. Here, we utilize mass spectrometry and single-myocyte mechanical assays to characterize changes to the cardiomyocyte cytoskeleton and their functional consequences in human heart failure. Proteomic analysis of left ventricle tissue reveals a consistent upregulation and stabilization of intermediate filaments and microtubules in failing human hearts...
June 11, 2018: Nature Medicine
https://www.readbyqxmd.com/read/29888440/kawasaki-disease-shock-syndrome-a-unique-and-severe-subtype-of-kawasaki-disease
#18
Luisa Berenise Gamez-Gonzalez, Isabel Moribe-Quintero, Martin Cisneros-Castolo, Javier Varela-Ortiz, Mireya Muñoz-Ramírez, Martin Garrido-García, Marco Yamazaki-Nakashimada
BACKGROUND: Kawasaki disease shock syndrome (KDSS) is an uncommon presentation of Kawasaki disease (KD). KDSS has been associated with more severe markers of inflammation, coronary abnormalities and IVIG resistance. METHODS: A retrospective, descriptive study of children with KDSS in two hospitals was performed. Relevant articles about KD and shock were collected, demographic data, clinical presentation, laboratory variables, echocardiogram findings, treatment and special features were analyzed when available...
June 11, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29887481/new-onset-atrial-fibrillation-in-critically-ill-patients-and-its-association-with-mortality-a-report-from-the-frog-icu-study
#19
Mattia Arrigo, Shiro Ishihara, Elodie Feliot, Alain Rudiger, Nicolas Deye, Alain Cariou, Bertrand Guidet, Samir Jaber, Marc Leone, Matthieu Resche-Rigon, Antoine Vieillard Baron, Matthieu Legrand, Etienne Gayat, Alexandre Mebazaa
BACKGROUND: Atrial fibrillation (AFib) is associated with adverse outcome in critical illness, but whether this effect is independent from other risk factors remains uncertain. New-onset AFib during critical illness may be independently associated with increased in-hospital and long-term risk of death. METHODS: FROG-ICU was a prospective, observational, multi-centre cohort study designed to investigate the outcome of critically ill patients. Inclusion criteria were invasive mechanical ventilation and/or treatment with a positive inotropic agent for >24 h...
September 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29882346/efficacy-of-prophylactic-dexmedetomidine-in-preventing-postoperative-junctional-ectopic-tachycardia-in-pediatric-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#20
REVIEW
Laxmi V Ghimire, Fu-Sheng Chou
BACKGROUND: Junctional ectopic tachycardia is a serious tachyarrhythmic complication following pediatric cardiac surgery. It is difficult to manage and is associated with significant morbidity and mortality. Conventional nonpharmacological and pharmacological measures have shown limited effects. Dexmedetomidine is an α2 agonist which has recently been shown in multiple studies to be effective. AIMS: The aim of this systematic review with meta-analysis was to evaluate the efficacy of prophylactic dexmedetomidine administration in the prevention of junctional ectopic tachycardia in pediatric patients following cardiac surgeries...
June 7, 2018: Paediatric Anaesthesia
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