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https://www.readbyqxmd.com/read/28632543/stroke-volume-variation-guided-versus-central-venous-pressure-guided-low-central-venous-pressure-with-milrinone-during-living-donor-hepatectomy-a-randomized-double-blinded-clinical-trial
#1
Jiwon Lee, Won Ho Kim, Ho-Geol Ryu, Hyung-Chul Lee, Eun-Jin Chung, Seong-Mi Yang, Chul-Woo Jung
BACKGROUND: We previously demonstrated the usefulness of milrinone for living donor hepatectomy. However, a less-invasive alternative to central venous catheterization and perioperative contributors to good surgical outcomes remain undetermined. The current study evaluated whether the stroke volume variation (SVV)-guided method can substitute central venous catheterization during milrinone-induced profound vasodilation. METHODS: We randomly assigned 42 living liver donors to receive either SVV guidance or central venous pressure (CVP) guidance to obtain milrinone-induced low CVP...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28617162/the-use-of-stroke-volume-variation-to-guide-donor-management-is-associated-with-increased-organs-transplanted-per-donor
#2
Benjamin Bergstrom, J Salvador de la Cruz, Mitch Sally, Scott Louis, Melissa Friedman, Floyd Petersen, Darren Malinoski
BACKGROUND: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28616545/assessment-of-various-parameters-using-simple-non-invasive-tests-in-patients-with-cardiovascular-diseases-with-or-without-cardiac-rehabilitation
#3
Takashi Ueda, Shin-Ichiro Miura, Kanta Fujimi, Toshihisa Ishida, Takuro Matsuda, Masaomi Fujita, Yoshiyuki Ura, Kouji Kaino, Maya Sakamoto, Tomoe Horita, Tadaaki Arimura, Yuhei Shiga, Takashi Kuwano, Ken Kitajima, Keijiro Saku
Cardiac rehabilitation (CR) improves cardiac function and exercise capacity in patients with cardiovascular disease (CVD). Simpler techniques are needed for use by physicians in the examination room to assess the usefulness of CR. We enrolled 46 consecutive CVD patients in a CR program (CR group) and prospectively followed them for 3 months. We compared them to 18 age-, gender- and body mass index-matched CVD patients without CR (non-CR group). Various parameters were measured at baseline and after 3 months using 3 simple non-invasive tests: severity of atherosclerosis [arterial velocity pulse index and arterial pressure volume index (API)] were determined using PASESA®, an autonomic nerve total activity amount index and a coefficient of variation of the R-R interval (CVRR) were determined using eHEART®, and peripheral resistance index, pressure rate product, stroke volume and cardiac index were determined using nico®]...
September 2016: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616241/passive-leg-raising-test-with-minimally-invasive-monitoring-the-way-forward-for-guiding-septic-shock-resuscitation
#4
Patrick M Honore, Herbert D Spapen
BACKGROUND: Swift and adequate fluid loading is a cornerstone of septic shock therapy. Yet, careful assessment of volume responsiveness and volume amount during the resuscitation process is a prerequisite. Both overzealous initial fluid administration and late fluid overload are harmful and may be associated with increased mortality. MAIN BODY: Static (i.e., central venous or pulmonary artery occlusion) pressure readings are erroneous for monitoring fluid resuscitation and should be abandoned...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28595621/transthoracic-echocardiography-an-accurate-and-precise-method-for-estimating-cardiac-output-in-the-critically-ill-patient
#5
Pablo Mercado, Julien Maizel, Christophe Beyls, Dimitri Titeca-Beauport, Magalie Joris, Loay Kontar, Antoine Riviere, Olivier Bonef, Thierry Soupison, Christophe Tribouilloy, Bertrand de Cagny, Michel Slama
BACKGROUND: Cardiac output (CO) monitoring is a valuable tool for the diagnosis and management of critically ill patients. In the critical care setting, few studies have evaluated the level of agreement between CO estimated by transthoracic echocardiography (CO-TTE) and that measured by the reference method, pulmonary artery catheter (CO-PAC). The objective of the present study was to evaluate the precision and accuracy of CO-TTE relative to CO-PAC and the ability of transthoracic echocardiography to track variations in CO, in critically ill mechanically ventilated patients...
June 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28593456/impact-of-hemodynamic-goal-directed-resuscitation-on-mortality-in-adult-critically-ill-patients-a-systematic-review-and-meta-analysis
#6
Maria Cronhjort, Olof Wall, Erik Nyberg, Ruifeng Zeng, Christer Svensen, Johan Mårtensson, Eva Joelsson-Alm
The effect of hemodynamic optimization in critically ill patients has been challenged in recent years. The aim of the meta-analysis was to evaluate if a protocolized intervention based on the result of hemodynamic monitoring reduces mortality in critically ill patients. We performed a systematic review and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions. The study was registered in the PROSPERO database (CRD42015019539). Randomized controlled trials published in English, reporting studies on adult patients treated in an intensive care unit, emergency department or equivalent level of care were included...
June 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28583532/prediction-of-fluid-responsiveness-by-a-non-invasive-respiratory-systolic-time-interval-variation-using-heart-sound-signals-in-recipients-undergoing-liver-transplantation
#7
S-H Kim, Y-J Moon, J-W Kim, J-G Song, G-S Hwang
BACKGROUND: The fluid management of cirrhotic patients undergoing liver transplantation (LT) is challenging. Phonocardiography, a graphic recording of heart sounds, provides valuable information concerning heart function and hemodynamic condition. We assessed whether the systolic time interval (STI) and its respiratory variation could predict fluid responsiveness in cirrhotic patients undergoing LT. METHODS: Thirty LT recipients who needed volume expansion were included...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28580763/knowledge-based-reconstruction-for-measurement-of-right-ventricular-volumes-on-cardiovascular-magnetic-resonance-images-in-a-mixed-population
#8
Elise D Pieterman, Ricardo P J Budde, Daniëlle Robbers-Visser, Ron T van Domburg, Willem A Helbing
OBJECTIVE: Follow-up of right ventricular performance is important for patients with congenital heart disease. Cardiac magnetic resonance imaging is optimal for this purpose. However, observer-dependency of manual analysis of right ventricular volumes limit its use. Knowledge-based reconstruction is a new semiautomatic analysis tool that uses a database including knowledge of right ventricular shape in various congenital heart diseases. We evaluated whether knowledge-based reconstruction is a good alternative for conventional analysis...
June 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28575332/effects-of-arterial-load-variations-on-dynamic-arterial-elastance-an-experimental-study
#9
M I Monge García, P Guijo González, M Gracia Romero, A Gil Cano, A Rhodes, R M Grounds, M Cecconi
Background.: Dynamic arterial elastance (Ea dyn ), the relationship between pulse pressure variation (PPV) and stroke volume variation (SVV), has been suggested as a functional assessment of arterial load. The aim of this study was to evaluate the impact of arterial load changes during acute pharmacological changes, fluid administration, and haemorrhage on Ea dyn . Methods.: Eighteen anaesthetized, mechanically ventilated New Zealand rabbits were studied. Arterial load changes were induced by phenylephrine ( n =9) or nitroprusside ( n =9)...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28557569/the-global-end-diastolic-volume-gedv-could-be-more-appropiate-to-fluid-management-than-central-venous-pressure-cvp-during-closed-hyperthermic-intrabdominal-chemotherapy-with-co2-circulation
#10
Francisco Javier Redondo, David Padilla, Pedro Villarejo, Victor Baladron, Patricia Faba, Sergio Sánchez, José Ramón Muñoz-Rodríguez, Natalia Bejarano
BACKGROUND: Closed hyperthermic intraperitoneal chemotherapy (HIPEC) may increase abdominal pressure and effects of hemodynamic changes due to maintenance hyperthermia. Our aim was to analyze the safety and effectiveness of our closed technique with CO2 circulation in management fluid status and hemodynamic parameters by means of cardiac preload control measured by Global End Diastolic Values (GEDV) and a gas exchanger. MATERIAL AND METHODS: A Pilot Clinical Study that included 18 advanced ovarian cancer patients undergoing citoreductive surgery and HIPEC...
May 30, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28540781/haemodynamic-changes-during-hyperthermic-intra-thoracic-chemotherapy-for-pseudomyxoma-peritonei
#11
Nina Ashraf-Kashani, John Bell
PURPOSE: Hyperthermic intra-thoracic chemotherapy (HITOC) combined with cytoreductive surgery (CRS) is a novel approach in the management of pseuodmyxoma peritonei with thoracic extension. The haemodynamic effects of hyperthermic chemotherapy present an anaesthetic challenge. Here, we describe the haemodynamic changes seen during HITOC. MATERIALS AND METHODS: A retrospective case note review of adult patients undergoing CRS with HITOC from 2009 to 2016. Intra-operative haemodynamics were measured using the LIDCOrapid(TM) brand of invasive cardiac output (CO) monitor...
March 19, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28539573/identification-of-the-state-of-maximal-hyperemia-in-the-assessment-of-coronary-fractional-flow-reserve-using-non-invasive-electrical-velocimetry
#12
Takahide Murasawa, Masao Takahashi, Masahiro Myojo, Arihiro Kiyosue, Atsushi Oguri, Jiro Ando, Issei Komuro
Previous research revealed that, in patients with coronary pressure-derived fractional flow reserve (FFR) in the 'grey zone' (0.75-0.85), repeated FFR assessments sometimes yield conflicting results. One of the causes of the fluctuations in FFR values around the grey zone may be imprecise identification of the point where maximal hyperemia is achieved. Identification of the state of maximal hyperemia during assessment of FFR can be challenging. This study aimed to determine whether non-invasive electrical velocimetry (EV) can be used to identify the state of maximal hyperemia...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28506136/predictors-to-intravenous-fluid-responsiveness
#13
Jorge Iván Alvarado Sánchez, William Fernando Amaya Zúñiga, Manuel Ignacio Monge García
Management with intravenous fluids can improve cardiac output in some surgical patients. Management with static preload indicators, such as central venous pressure and pulmonary artery occlusion pressure, has not demonstrated a suitable relationship with changes in the cardiac output induced by intravenous fluid therapy. Dynamic indicators, such as the variability of arterial pulse pressure or stroke volume variation, have demonstrated a suitable relationship. Since improvement in cardiac output does not guarantee an adequate perfusion pressure, in patients with hypotension, it is also necessary to know whether arterial pressure will also increase with intravenous fluid therapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28506087/differential-variations-of-autophagy-and-apoptosis-in-permanent-focal-cerebral-ischaemia-rat-model
#14
Pengyue Zhang, Liqiang Yang, Hongyun He, Yihao Deng
OBJECTIVE: Autophagy and apoptosis coexist in stroke, but the relationship between effects and complex is poorly understood. Herein, we investigated dynamic changes of autophagy and apoptosis at the penumbra in permanent cerebral ischaemia. METHODS: Sprague-Dawley rat models were prepared by middle cerebral artery occlusion. The autophagy and apoptosis were evaluated by Western blotting and immunofluorescence with LC3-II and cleaved caspase-3, respectively. The neurological deficit score and infarct volume were assessed...
May 16, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28504996/stroke-volume-variation-and-pulse-pressure-variation-are-not-useful-for-predicting-fluid-responsiveness-in-thoracic-surgery
#15
Dae Myoung Jeong, Hyun Joo Ahn, Hyo Won Park, Mikyung Yang, Jie Ae Kim, Joohyun Park
BACKGROUND: Stroke volume variation (SVV) and pulse pressure variation (PPV) are used as indicators of fluid responsiveness, but little is known about the usefulness of these dynamic preload indicators in thoracic surgery, which involves an open thoracic cavity and one-lung ventilation (OLV). Therefore, we investigated whether SVV and PPV could predict fluid responsiveness, and whether the thresholds of these parameters should be adjusted for thoracic surgery. METHODS: This was a prospective, controlled study conducted in a tertiary care center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28498858/does-stroke-volume-variation-predict-fluid-responsiveness-in-children-a-systematic-review-and-meta-analysis
#16
Ling Yi, Zhongqiang Liu, Lina Qiao, Chaomin Wan, Dezhi Mu
OBJECTIVE: Stroke volume variation (SVV) is a reliable predictor of fluid responsiveness in adult patients. However, the predictive value of SVV is uncertain in pediatric patients. We performed the first systematic meta-analysis to evaluate the diagnostic value of SVV in predicting fluid responsiveness in children. METHODS: PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials were searched up to December 2016. Original studies assessing the diagnostic accuracy of SVV in predicting fluid responsiveness in children were considered to be eligible...
2017: PloS One
https://www.readbyqxmd.com/read/28476893/bigger-is-not-better-cortisol-induced-cardiac-growth-and-dysfunction-in-salmonids
#17
Ida B Johansen, Erik Sandblom, Peter V Skov, Albin Gräns, Andreas Ekström, Ida G Lunde, Marco A Vindas, Lili Zhang, Erik Höglund, Michael Frisk, Ivar Sjaastad, Göran E Nilsson, Øyvind Øverli
Stress and elevated cortisol levels are associated with pathological heart growth and cardiovascular disease in humans and other mammals. We recently established a link between heritable variation in post-stress cortisol production and cardiac growth also in salmonid fish. A conserved stimulatory effect of the otherwise catabolic steroid hormone cortisol is likely implied, but has to date not been established experimentally. Furthermore, whereas cardiac growth is associated with failure of the mammalian heart, pathological cardiac hypertrophy has not previously been described in fish...
May 5, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28460504/-the-predictive-value-of-dynamic-arterial-elastance-in-arterial-pressure-response-after-norepinephrine-dosage-reduction-in-patients-with-septic-shock
#18
F M Liang, T Yang, L Dong, J J Hui, J Yan
Objective: To assess whether dynamic arterial elastance(Ea(dyn))can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock. Methods: A prospective observational cohort study was conducted. Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University. Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO)monitoring technology before and after decreasing norepinephrine dosage...
May 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28448528/minimally-invasive-estimation-of-ventricular-dead-space-volume-through-use-of-frank-starling-curves
#19
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
#20
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
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