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https://www.readbyqxmd.com/read/29149433/predictive-values-of-pulse-pressure-variation-and-stroke-volume-variation-for-fluid-responsiveness-in-patients-with-pneumoperitoneum
#1
Marko Zlicar, Vesna Novak-Jankovic, Rok Blagus, Maurizio Cecconi
Animal studies suggest that dynamic predictors remain useful in patients with pneumoperitoneum, but human data is conflicting. Our aim was to determine predictive values of pulse pressure variation (PPV) and stroke volume variation (SVV) in patients with pneumoperitoneum using LiDCORapid™ haemodynamic monitor. Standardised fluid challenges of colloid were administered to patients undergoing laparoscopic procedures, one fluid challenge per patient. Intra-abdominal pressure was automatically held at 12 mmHg...
November 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29145824/observations-on-significant-hemodynamic-changes-caused-by-a-high-concentration-of-epidurally-administered-ropivacaine-correlation-and-prediction-study-of-stroke-volume-variation-and-central-venous-pressure-in-thoracic-epidural-anesthesia
#2
Jeong-Min Hong, Hyeon Jeong Lee, Young-Jae Oh, Ah Rhem Cho, Hyae Jin Kim, Do-Won Lee, Wang-Seok Do, Jae-Young Kwon, Haekyu Kim
BACKGROUND: Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia. METHODS: A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0...
November 16, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29141880/divergent-respiratory-and-cardiovascular-responses-to-hypoxia-in-bar-headed-geese-and-andean-birds
#3
Sabine L Lague, Beverly Chua, Luis Alza, Graham R Scott, Peter B Frappell, Yang Zhong, Anthony P Farrell, Kevin G McCracken, Yuxiang Wang, William K Milsom
Many high-altitude vertebrates have evolved increased capacities in their oxygen transport cascade (ventilation, pulmonary diffusion, circulation and tissue diffusion), enhancing oxygen transfer from the atmosphere to mitochondria. However, the extent of interspecies variation in the control processes that dictate hypoxia responses remains largely unknown. We compared the metabolic, cardiovascular and respiratory responses to progressive decreases in inspired oxygen levels of bar-headed geese (Anser indicus), birds that biannually migrate across the Himalayan mountains, with those of Andean geese (Chloephaga melanoptera) and crested ducks (Lophonetta specularioides), lifelong residents of the high Andes...
November 15, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29141045/csf-in-the-ventricles-of-the-brain-behaves-as-a-relay-medium-for-arteriovenous-pulse-wave-phase-coupling
#4
William E Butler, Pankaj K Agarwalla, Patrick Codd
The ventricles of the brain remain perhaps the largest anatomic structure in the human body without established primary purpose, even though their existence has been known at least since described by Aristotle. We hypothesize that the ventricles help match a stroke volume of arterial blood that arrives into the rigid cranium with an equivalent volume of ejected venous blood by spatially configuring cerebrospinal fluid (CSF) to act as a low viscosity relay medium for arteriovenous pulse wave (PW) phase coupling...
2017: PloS One
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#5
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29126361/a-survey-of-the-current-practice-of-intramuscular-botulinum-toxin-injections-for-hemiplegic-shoulder-pain-in-the-uk
#6
Richard J Holmes, Louise A Connell
PURPOSE: To describe the current UK practice for the use of intramuscular Botulinum Toxin type A injections to treat hemiplegic shoulder pain. METHOD: A UK-based cross-sectional study using an online survey. Participants (n = 68) were medical and non-medical practitioners recruited via the membership of the British Society for Rehabilitation Medicine and the British Neurotoxin Network. Data was analysed using descriptive statistics and content analysis. RESULTS: The majority of respondents would consider Botulinum Toxin type A for hemiplegic shoulder pain (86...
November 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29113716/plethysmography-variability-index-for-prediction-of-fluid-responsiveness-during-graded-haemorrhage-and-transfusion-in-sevoflurane-anaesthetized-mechanically-ventilated-dogs
#7
Yusuke Endo, Koudai Kawase, Taku Miyasho, Tadashi Sano, Kazuto Yamashita, William W Muir
OBJECTIVE: To examine the accuracy of plethysmography variability index (PVI) as a noninvasive indicator of fluid responsiveness in hypovolaemic dogs. STUDY DESIGN: Prospective experimental study. ANIMALS: Six adult healthy sevoflurane-anaesthetized Beagle dogs. METHODS: Dogs were anaesthetized with 1.3-fold their individual minimum alveolar concentration of sevoflurane. The lungs were mechanically ventilated after neuromuscular blockade with vecuronium bromide...
August 25, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29073613/impact-of-the-flotrac-vigileotm-monitoring-on-intraoperative-fluid-management-and-outcome-after-liver-resection
#8
Enrico Giustiniano, Fabio Procopio, Nadia Ruggieri, Stefania Grimaldi, Guido Torzilli, Ferdinando Raimondi
BACKGROUNDS: Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. METHODS: We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs...
October 26, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29070954/race-predictors-and-hemodynamic-alteration-after-an-ultra-trail-marathon-race
#9
Noppon Taksaudom, Natee Tongsiri, Amarit Potikul, Chawakorn Leampriboon, Apichat Tantraworasin, Anong Chaiyasri
OBJECTIVE: Unique rough-terrain ultra-trail running races have increased in popularity. Concerns regarding the suitability of the candidates make it difficult for organizers to manage safety regulations. The purpose of this study was to identify possible race predictors and assess hemodynamic change after long endurance races. METHODS: We studied 228 runners who competed in a 66 km-trail running race. A questionnaire and noninvasive hemodynamic flow assessment including blood pressure, heart rate, stroke volume, stroke volume variation, systemic vascular resistance, cardiac index, and oxygen saturation were used to determine physiologic alterations and to identify finish predictors...
2017: Open Access Journal of Sports Medicine
https://www.readbyqxmd.com/read/29068831/crystalloid-versus-colloid-for-intraoperative-goal-directed-fluid-therapy-using-a-closed-loop-system-a-randomized-double-blinded-controlled-trial-in-major-abdominal-surgery
#10
Alexandre Joosten, Amelie Delaporte, Brigitte Ickx, Karim Touihri, Ida Stany, Luc Barvais, Luc Van Obbergh, Patricia Loi, Joseph Rinehart, Maxime Cannesson, Philippe Van der Linden
BACKGROUND: The type of fluid and volume regimen given intraoperatively both can impact patient outcome after major surgery. This two-arm, parallel, randomized controlled, double-blind, bi-center superiority study tested the hypothesis that when using closed-loop assisted goal-directed fluid therapy, balanced colloids are associated with fewer postoperative complications compared to balanced crystalloids in patients having major elective abdominal surgery. METHODS: One hundred and sixty patients were enrolled in the protocol...
October 25, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29046152/cerebral-small-vessel-disease-is-associated-with-genetic-variations-in-cyp2j
#11
Ming Yao, Daping Lv, Jiajia Huo, Zhongwu Sun
BACKGROUND: Cerebral small vessel disease (SVD) can cause cognitive impairment, disability, and dementia. While it's still unclear about the pathogenesis of SVD, several risk factors of SVD have been identified, and studies suggested that hypertension may play a critical role in SVD. Furthermore, studies have demonstrated that CYP2J2 isoform, 50 G>T variant, is associated with increase the risk of ischemic stroke. Thus, we hypothesized that CYP2J2 50 G>T variant is associated with increased risk of cerebral SVD...
October 17, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/29031327/respiratory-variation-in-aortic-blood-peak-velocity-and-caudal-vena-cava-diameter-can-predict-fluid-responsiveness-in-anaesthetised-and-mechanically-ventilated-dogs
#12
M Bucci, R Rabozzi, C Guglielmini, P Franci
BACKGROUND AND M&MS: Dynamic preload indices, such as systolic pressure variation (SPV), aortic flow peak velocity variation (ΔVpeak) and distensibility index of the caudal vena cava (CVCDI), are reliable indices for predicting fluid responsiveness in humans. This study aimed to investigate the ability of these indices to predict fluid response in 24 healthy dogs undergoing general anaesthesia and mechanical ventilation. Aortic flow peak velocity variation (∆Vpeak), CVCDI, and SPV were calculated before volume expansion (5mL/kg bolus of lactated Ringer's solution)...
September 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29030937/changes-in-blood-volume-indicators-and-dynamic-indicators-measured-with-transpulmonary-ultrasound-velocity-during-blood-depletion-and-repletion-in-a-neonatal-swine-model
#13
Manuel Martin-Flores, Alvaro F Cisternas, Robin D Gleed
BACKGROUND: Dynamic indicators such as pulse pressure and stroke volume variations can be measured to track changes in preload during hemorrhage, and evaluate fluid therapy. However, these dynamic indicators require mechanical ventilation, and might be affected by cardiac dysrhythmias and changes in vascular tone. Blood volume indicators may offer alternatives for assessing changes in volume status. AIMS: The aims of this study were to measure changes in blood volume indicators and dynamic indicators during removal of blood in two stages and subsequent blood replacement in anesthetized, mechanically ventilated, neonatal pigs...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29023523/the-role-of-glutamate-in-neuronal-ion-homeostasis-a-case-study-of-spreading-depolarization
#14
Niklas Hübel, Mahshid S Hosseini-Zare, Jokūbas Žiburkus, Ghanim Ullah
Simultaneous changes in ion concentrations, glutamate, and cell volume together with exchange of matter between cell network and vasculature are ubiquitous in numerous brain pathologies. A complete understanding of pathological conditions as well as normal brain function, therefore, hinges on elucidating the molecular and cellular pathways involved in these mostly interdependent variations. In this paper, we develop the first computational framework that combines the Hodgkin-Huxley type spiking dynamics, dynamic ion concentrations and glutamate homeostasis, neuronal and astroglial volume changes, and ion exchange with vasculature into a comprehensive model to elucidate the role of glutamate uptake in the dynamics of spreading depolarization (SD)-the electrophysiological event underlying numerous pathologies including migraine, ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hematoma, and trauma...
October 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/29016776/atrial-fibrillation-is-associated-with-decreased-total-cerebral-blood-flow-and-brain-perfusion
#15
Marianna Gardarsdottir, Sigurdur Sigurdsson, Thor Aspelund, Hrafnhildur Rokita, Lenore J Launer, Vilmundur Gudnason, David O Arnar
Aims: Atrial fibrillation (AF) has been associated with cognitive impairment. Additionally, brain volume may be reduced in individuals with AF. Potential causes may include cerebral micro-embolism or reduced stroke volume due to the beat-to-beat variation in AF. The aims of this study were to measure cerebral blood flow and estimate whole brain perfusion in elderly individuals with and without AF. Methods and results: Blood flow in the cervical arteries was measured with phase contrast MRI and brain perfusion estimated in a large cohort from the AGES-Reykjavik Study...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28984705/the-crashing-patient-hemodynamic-collapse
#16
Hitesh Gidwani, Hernando Gómez
PURPOSE OF REVIEW: Rapid restoration of tissue perfusion and oxygenation are the main goals in the resuscitation of a patient with circulatory collapse. This review will focus on providing an evidence based framework of the technological and conceptual advances in the evaluation and management of the patient with cardiovascular collapse. RECENT FINDINGS: The initial approach to the patient in cardiovascular collapse continues to be based on the Ventilate-Infuse-Pump rule...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28982689/increase-in-endovascular-therapy-in-get-with-the-guidelines-stroke-after-the-publication-of-pivotal-trials
#17
Eric E Smith, Jeffrey L Saver, Margueritte Cox, Li Liang, Roland A Matsouaka, Ying Xian, Deepak L Bhatt, Gregg C Fonarow, Lee H Schwamm
Background -Beginning in December 2014, a series of pivotal trials showed that endovascular thrombectomy (EVT) was highly effective, prompting calls to reorganize stroke systems of care. However, there are few data on how these trials influenced the frequency of EVT in clinical practice. We used data from the Get With The Guidelines-Stroke program to determine how the frequency of EVT changed in U.S. practice. Methods -We analyzed prospectively collected data from a cohort of 2,437,975 ischemic stroke patients admitted to 2,222 participating hospitals between April 2003 and the third quarter (Q3) 2016...
October 5, 2017: Circulation
https://www.readbyqxmd.com/read/28981592/comparison-of-two-stroke-volume-variation-based-goal-directed-fluid-therapies-for-supratentorial-brain-tumour-resection-a-randomized-controlled-trial
#18
C Y Wu, Y S Lin, H M Tseng, H L Cheng, T S Lee, P L Lin, W H Chou, Y J Cheng
Background: The optimal volume status for neurosurgery has yet to be determined. We compared two fluid protocols based on different stroke volume variation (SVV) cut-offs for goal-directed fluid therapy (GDFT) during supratentorial brain tumour resection. Methods: A randomized, single-blind, open-label trial was conducted. Eighty adult patients undergoing elective supratentorial brain tumour resection were randomly divided into a low SVV and a high SVV group. The SVV cut-offs were used to determine when to initiate colloid infusion...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28974059/predictor-of-fluid-responsiveness-in-the-grey-zone-augmented-pulse-pressure-variation-through-a-temporary-increase-in-tidal-volume
#19
J J Min, N-S Gil, J-H Lee, D K Ryu, C S Kim, S M Lee
Background: Pulse pressure variation (PPV) is widely used as a predictor of fluid responsiveness. However, a previous study has suggested a 'grey zone' between 9 and 13% in which PPV would be inconclusive to predict fluid responsiveness. Considering PPV is based on cardiopulmonary interactions, we evaluated whether an augmented PPV using a temporary increase in tidal volume (V T ) from 8 to 12 ml kg -1 has the predictability for fluid responsiveness in patients within the grey zone...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28971030/data-availability-and-feasibility-of-various-techniques-to-predict-response-to-volume-expansion-in-critically-ill-patients
#20
Michael J Lanspa, Benjamin J Briggs, Eliotte L Hirshberg, Cristina M Pratt, Colin K Grissom, Samuel M Brown
OBJECTIVE: The accuracy of various techniques to predict response to volume expansion in shock has been studied, but less well known is how feasible these techniques are in the ICU. METHODS: This is a prospective observation single-center study of inpatients from a mixed profile ICU who received volume expansion. At time of volume expansion, we determined whether a particular technique to predict response was feasible, according to rules developed from available literature and nurse assessment...
July 2017: International Journal of Critical Illness and Injury Science
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