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https://www.readbyqxmd.com/read/28448528/minimally-invasive-estimation-of-ventricular-dead-space-volume-through-use-of-frank-starling-curves
#1
Shaun Davidson, Chris Pretty, Antoine Pironet, Thomas Desaive, Nathalie Janssen, Bernard Lambermont, Philippe Morimont, J Geoffrey Chase
This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and condition dependent portion of measured ventricular volume that is not actively participating in ventricular function. It is employed in models based on the time varying elastance concept, which see widespread use in haemodynamic studies, and may have direct diagnostic use. The proposed method involves linear extrapolation of a Frank-Starling curve (stroke volume vs end-diastolic volume) and its end-systolic equivalent (stroke volume vs end-systolic volume), developed across normal clinical procedures such as recruitment manoeuvres, to their point of intersection with the y-axis (where stroke volume is 0) to determine Vd...
2017: PloS One
https://www.readbyqxmd.com/read/28444075/applicability-of-respiratory-variations-in-stroke-volume-and-its-surrogates-for-dynamic-fluid-responsiveness-prediction-in-critically-ill-patients-a-systematic-review-of-the-prevalence-of-required-conditions
#2
Leandro Utino Taniguchi, Fernando Godinho Zampieri, Antonio Paulo Nassar
Objective: The present systematic review searched for published data on the prevalence of required conditions for proper assessment in critically ill patients. Methods: The Medline, Scopus and Web of Science databases were searched to identify studies that evaluated the prevalence of validated conditions for the fluid responsiveness assessment using respiratory variations in the stroke volume or another surrogate in adult critically ill patients. The primary outcome was the suitability of the fluid responsiveness evaluation...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28442482/a-bag3-coding-variant-in-mice-determines-susceptibility-to-ischemic-limb-muscle-myopathy-by-directing-autophagy
#3
Joseph M McClung, Timothy J McCord, Terence E Ryan, Cameron A Schmidt, Thomas D Green, Kevin W Southerland, Jessica L Reinardy, Sarah B Mueller, Talaignair N Venkatraman, Christopher D Lascola, Sehoon Keum, Douglas A Marchuk, Espen E Spangenburg, Ayotunde O Dokun, Brian H Annex, Christopher D Kontos
Background -Critical limb ischemia (CLI) is a manifestation of peripheral artery disease (PAD) that carries significant mortality and morbidity risk in humans, although its genetic determinants remain largely unknown. We previously discovered two overlapping quantitative trait loci (QTL) in mice, Lsq-1 and Civq-1, that affected limb muscle survival and stroke volume following femoral artery or middle cerebral artery ligation, respectively. Here we report that a Bag3 variant (Ile81Met) segregates with tissue protection from hindlimb ischemia (HLI)...
April 25, 2017: Circulation
https://www.readbyqxmd.com/read/28432561/predicting-fluid-responsiveness-in-whom-a-simulated-example-of-patient-spectrum-influencing-the-receiver-operating-characteristics-curve
#4
Lars Øivind Høiseth, Jostein S Hagemo
The influence of patient spectrum on the sensitivities and specificities of diagnostic methods has been termed spectrum bias or spectrum effect. Receiver operating characteristics curves are often used to assess the ability of diagnostic methods to predict fluid responsiveness. As a receiver operating characteristics curve is a presentation of sensitivity and specificity, the purpose of the present manuscript was to explore if patient spectrum could affect areas under receiver operating characteristics curves and their gray zones...
April 21, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28421732/comparison-of-absolute-fluid-restriction-versus-relative-volume-redistribution-strategy-in-low-central-venous-pressure-anesthesia-in-liver-resection-surgery-a-randomized-controlled-trial
#5
Jan Zatloukal, Richard Pradl, Jakub Kletečka, Tomáš Skalický, Václav Liška, Jan Benes
BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17)...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28421530/time-of-day-dependent-neuronal-injury-after-ischemic-stroke-implication-of-circadian-clock-transcriptional-factor-bmal1-and-survival-kinase-akt
#6
Mustafa Caglar Beker, Berrak Caglayan, Esra Yalcin, Ahmet Burak Caglayan, Seyma Turkseven, Busra Gurel, Taha Kelestemur, Elif Sertel, Zafer Sahin, Selim Kutlu, Ulkan Kilic, Ahmet Tarik Baykal, Ertugrul Kilic
Occurrence of stroke cases displays a time-of-day variation in human. However, the mechanism linking circadian rhythm to the internal response mechanisms against pathophysiological events after ischemic stroke remained largely unknown. To this end, temporal changes in the susceptibility to ischemia/reperfusion (I/R) injury were investigated in mice in which the ischemic stroke induced at four different Zeitgeber time points with 6-h intervals (ZT0, ZT6, ZT12, and ZT18). Besides infarct volume and brain swelling, neuronal survival, apoptosis, ischemia, and circadian rhythm related proteins were examined using immunohistochemistry, Western blot, planar surface immune assay, and liquid chromatography-mass spectrometry tools...
April 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28417009/revised-definition-of-predicted-left-ventricular-mass-using-ambulatory-blood-pressure-in-healthy-korean-adults
#7
Bae Keun Kim, Enshi Xu, Bo Youl Choi, Yonggu Lee, Soon Gil Kim, Yukio Yamori, Jinho Shin
BACKGROUND: Left ventricular hypertrophy is influenced by both hemodynamic and non-hemodynamic factors. Ambulatory blood pressure is correlated with left ventricular hypertrophy. We established the influences of hemodynamic and non-hemodynamic factors, including ambulatory blood pressure, on variation in left ventricular mass in healthy Korean adults. METHOD: We included 172 subjects (male = 71, female = 101), with normal body mass index and blood pressure, in an analysis of data from the Yangpyung and Yeoju cohort studies and a tertiary cardiovascular center...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#8
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28393776/serial-semi-invasive-hemodynamic-assessment-following-pericardiectomy-for-chronic-constrictive-pericarditis
#9
Ujjwal Kumar Chowdhury, Poonam Malhotra Kapoor, Adil Rizvi, Vishwas Malik, Sandeep Seth, Rajiv Narang, Mani Kalaivani, Sarvesh Pal Singh, Sathiya Selvam
OBJECTIVES: This study was designed to prospectively investigate the effects of pericardiectomy via median sternotomy on intra- and postoperative hemodynamics by a new semi-invasive device (Flotrac/VigileoTM monitor) using arterial pressure waveform analysis. PATIENTS AND METHODS: Thirty consecutive patients aged 15 to 55 years (mean+SD, 31.73 + 13.53 years), who had undergone total pericardiectomy via median sternotomy underwent serial hemodynamic evaluation. FlotracTM Sensor - derived stroke volume, stroke volume variation, systemic vascular resistance index (SVRI), cardiac index and right atrial pressure were measured just before and after pericardiectomy, at 12 hours, 24 hours, 48 hours, 72 hours and at discharge postoperatively...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28363617/exploring-the-best-predictors-of-fluid-responsiveness-in-patients-with-septic-shock
#10
Nianfang Lu, Xiuming Xi, Li Jiang, Degang Yang, Kai Yin
OBJECTIVE: To evaluate respiratory variations in carotid and brachial peak velocity and other hemodynamic parameters to predict responsiveness to fluid challenge. METHODS: A prospective observational study was performed on mechanically ventilated patients with septic shock. Outcomes included the measurements of central venous pressure, intrathoracic blood volume index, stroke volume variation (SVV), pleth variability index(PVI), and ultrasound assessments of respiratory variations in inferior vena cava diameter (ΔIVC), carotid Doppler peak velocity (ΔCDPV), and brachial artery peak velocity (ΔVpeak brach)...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28321415/assessment-of-longitudinal-reproducibility-of-mice-lv-function-parameters-at-11-7%C3%A2-t-derived-from-self-gated-cine-mri
#11
Zhi Zuo, Anne Subgang, Alireza Abaei, Wolfgang Rottbauer, Detlef Stiller, Genshan Ma, Volker Rasche
The objective of this work was the assessment of the reproducibility of self-gated cardiac MRI in mice at ultra-high-field strength. A group of adult mice (n = 5) was followed over 360 days with a standardized MR protocol including reproducible animal position and standardized planning of the scan planes. From the resulting CINE MRI data, global left ventricular (LV) function parameters including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and left ventricular mass (LVM) were quantified...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28299589/respiratory-variation-in-peak-aortic-velocity-accurately-predicts-fluid-responsiveness-in-children-undergoing-neurosurgery-under-general-anesthesia
#12
Kavita G Morparia, Srijaya K Reddy, Laura J Olivieri, Michael C Spaeder, Jennifer J Schuette
The determination of fluid responsiveness in the critically ill child is of vital importance, more so as fluid overload becomes increasingly associated with worse outcomes. Dynamic markers of volume responsiveness have shown some promise in the pediatric population, but more research is needed before they can be adopted for widespread use. Our aim was to investigate effectiveness of respiratory variation in peak aortic velocity and pulse pressure variation to predict fluid responsiveness, and determine their optimal cutoff values...
March 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28296183/high-stroke-volume-variation-is-an-independent-predictor-for-decreased-blood-pressure-during-hemodialysis
#13
Fumiki Yoshihara, Masatsugu Kishida, Koji Ogawa, Takayuki Nishigaki, Hironori Nakasaki, Azusa Ishizuka, Ryo Koezuka, Miki Matsuo, Teruyuki Hayashi, Satoko Nakamura
It currently remains unclear whether stroke volume variation (SVV) before hemodialysis (HD) is an independent predictor of decreased blood pressure (BP) during HD. Fifty-two patients were divided into two groups (Decreased BP during HD group: N = 10, Non-decreased BP group: N = 42). Fractional shortening was lower, and mean arterial pressure (MAP) and SVV were higher in the Decreased BP during HD group. A multiple logistic regression analysis identified low fractional shortening, high MAP, and high SVV as independent predictors of decreased BP during HD...
March 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28275226/prediction-of-fluid-responsiveness-based-on-liver-compression-induced-blood-pressure-changes-in-children-after-cardiac-surgery
#14
Ji-Hyun Lee, In-Kyung Song, Eun-Hee Kim, Hee-Soo Kim, Jin-Tae Kim
BACKGROUND: This study evaluated whether liver compression-induced blood pressure changes can predict fluid responsiveness in children after cardiac surgery. METHODS: Children aged < 5 years who were undergoing cardiac surgery were evaluated after the sternum was closed. Before fluid loading, the right upper abdomen was compressed at a pressure of 30 mmHg for 15 seconds and changes in blood pressure waves were recorded. Then, 10 ml/kg of colloid solution was administered...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28275197/relationship-between-changes-in-the-temporal-dynamics-of-the-blood-oxygen-level-dependent-signal-and-hypoperfusion-in-acute-ischemic-stroke
#15
Ahmed A Khalil, Ann-Christin Ostwaldt, Till Nierhaus, Ramanan Ganeshan, Heinrich J Audebert, Kersten Villringer, Arno Villringer, Jochen B Fiebach
BACKGROUND AND PURPOSE: Changes in the blood-oxygen-level-dependent (BOLD) signal provide a noninvasive measure of blood flow, but a detailed comparison with established perfusion parameters in acute stroke is lacking. We investigated the relationship between BOLD signal temporal delay and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in stroke patients. METHODS: In 30 patients with acute (<24 hours) ischemic stroke, we performed Pearson correlation and multiple linear regression between DSC-MRI parameters (time to maximum [Tmax], mean transit time, cerebral blood flow, and cerebral blood volume) and BOLD-based parameters (BOLD delay and coefficient of BOLD variation)...
March 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28253850/pulmonary-hypertension-attenuates-the-dynamic-preload-indicators-increase-during-experimental-hypovolemia
#16
Juan P Bouchacourt, Juan Riva, Juan C Grignola
BACKGROUND: Pulse pressure (PPV) and stroke volume (SVV) variations may not be reliable in the setting of pulmonary hypertension and/or right ventricular (RV) failure. We hypothesized that RV afterload increase attenuates SVV and PPV during hypovolemia in a rabbit model of pulmonary embolism (PE) secondary to RV dysfunction. METHODS: Seven anesthetized and mechanically ventilated rabbits were studied during four experimental conditions: normovolemia, blood withdrawal, pulmonary embolism and fluid loading of a colloidal solution...
March 3, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28249083/provider-induced-demand-in-the-treatment-of-carotid-artery-stenosis-variation-in-treatment-decisions-between-private-sector-fee-for-service-vs-salary-based-military-physicians
#17
Louis L Nguyen, Ann D Smith, Rebecca E Scully, Wei Jiang, Peter A Learn, Stuart R Lipsitz, Joel S Weissman, Lorens A Helmchen, Tracey Koehlmoos, Andrew Hoburg, Linda G Kimsey
Importance: Although many factors influence the management of carotid artery stenosis, it is not well understood whether a preference toward procedural management exists when procedural volume and physician compensation are linked in the fee-for-service environment. Objective: To explore evidence for provider-induced demand in the management of carotid artery stenosis. Design, Setting, and Participants: The Department of Defense Military Health System Data Repository was queried for individuals diagnosed with carotid artery stenosis between October 1, 2006, and September 30, 2010...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#18
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#19
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28188261/role-of-genetic-variation-in-collateral-circulation-in-the-evolution-of-acute-stroke-a-multimodal-magnetic-resonance-imaging-study
#20
Yu-Chieh Jill Kao, Esteban A Oyarzabal, Hua Zhang, James E Faber, Yen-Yu Ian Shih
BACKGROUND AND PURPOSE: No studies have determined the effect of differences in pial collateral extent (number and diameter), independent of differences in environmental factors and unknown genetic factors, on severity of stroke. We examined ischemic tissue evolution during acute stroke, as measured by magnetic resonance imaging and histology, by comparing 2 congenic mouse strains with otherwise identical genetic backgrounds but with different alleles of the Determinant of collateral extent-1 (Dce1) genetic locus...
March 2017: Stroke; a Journal of Cerebral Circulation
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