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https://www.readbyqxmd.com/read/29151002/management-of-arrhythmia-in-sepsis-and-septic-shock
#1
Martin Balik, Vojtech Matousek, Michal Maly, Tomas Brozek
The occurrence of supraventricular arrhythmias is associated with an unfavourable prognosis in septic shock. Available trials are difficult to apply in sepsis and septic shock patients due to included cohorts, control groups and because "one size does not fit all". The priorities in the critically ill are maintenance of a sinus rhythm and diastolic ventricular filling. The rate control modality should be reserved for chronic AF and in situations when a sinus rhythm is difficult to maintain due to extreme stress conditions resulting from a high dosage of vasoactive agents...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29149863/pearls-and-pitfalls-in-comprehensive-critical-care-echocardiography
#2
REVIEW
Sam Orde, Michel Slama, Andrew Hilton, Konstantin Yastrebov, Anthony McLean
Critical care echocardiography is developing rapidly with an increasing number of specialists now performing comprehensive studies using Doppler and other advanced techniques. However, this imaging can be challenging, interpretation is far from simple in the complex critically ill patient and mistakes can be easy to make. We aim to address clinically relevant areas where potential errors may occur and suggest methods to hopefully improve accuracy of imaging and interpretation.
November 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#3
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29137093/an-incidental-encounter-of-a-rare-high-take-off-right-coronary-artery-a-case-report
#4
Xicheng Deng, Peng Huang, Wenjuan Chen, Xiaohui Yang, Qianjun Liu, Yunbin Xiao, Cheng He
RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#5
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29127129/heart-failure-in-dilated-cardiomyopathy-mimicking-asthma-triggered-by-pneumonia
#6
Kenichi Tetsuhara, Satoshi Tsuji, Katsutoshi Nakano, Mitsuru Kubota
Heart failure is a rare cause of wheezing and may develop into a critical condition in children. Few cases report patients with heart failure, secondary to dilated cardiomyopathy, with high fever. A 23-month-old girl visited the emergency department with high fever, cough, first wheezing episode, chest retraction and tachycardia. The chest X-ray revealed consolidation on the left lower lung field; the cardiothoracic ratio was 60%. She was diagnosed with bronchial asthma triggered by pneumonia, which remained unchanged during four visits...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#7
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29121301/tissue-doppler-assessment-of-diastolic-function-and-relationship-with-mortality-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#8
F Sanfilippo, C Corredor, A Arcadipane, G Landesberg, A Vieillard-Baron, M Cecconi, N Fletcher
Background: Myocardial dysfunction may contribute to circulatory failure in sepsis. There is growing evidence of an association between left ventricular diastolic dysfunction (LVDD) and mortality in septic patients. Utilizing echocardiography, we know that tissue Doppler imaging (TDI) variables e' and E/e' are reliable predictors of LVDD and are useful measurements to estimate left ventricular (LV) filling pressures. Methods: We conducted a systematic review and meta-analysis to investigate the association of e' and E/e' with mortality of patients with severe sepsis or septic shock...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118832/the-impact-of-focused-echocardiography-using-the-focused-intensive-care-echo-protocol-on-the-management-of-critically-ill-patients-and-comparison-with-full-echocardiographic-studies-by-bse-accredited-sonographers
#9
David P Hall, Helen Jordan, Shirjel Alam, Michael A Gillies
Introduction: Focused echocardiography is widely used to assist clinical decision-making in critically ill patients. In the UK, the Focused Intensive Care Echo protocol is recommended by the Intensive Care Society to ensure consistency of approach and guarantee training standards. Concerns remain about the reliability of information attained by non-expert clinicians in focused echocardiography, particularly when this is used to alter clinical management. Methods: A prospective, observational evaluation of 60 consecutive patients undergoing Focused Intensive Care Echo studies in a single ICU...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29118831/basic-critical-care-echocardiography-how-many-studies-equate-to-competence-a-pilot-study-using-high-fidelity-echocardiography-simulation
#10
Emma M Bowcock, Idunn S Morris, Anthony S Mclean, Sam R Orde
Background: Assessment of competence in basic critical care echocardiography is complex. Competence relies on not only imaging accuracy but also interpretation and appropriate management decisions. The experience to achieve these skills, real-time, is likely more than required for imaging accuracy alone. We aimed to assess the feasibility of using simulation to assess number of studies required to attain competence in basic critical care echocardiography. Methods: This is a prospective pilot study recruiting trainees at various degrees of experience in basic critical care echocardiography using experts as reference standard...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29117535/rescuing-infusion-of-mirna-1-prevents-cardiac-remodeling-in-a-heart-selective-mirna-deficient-mouse
#11
Shuilian Luo, Yuhang Chen, Rui He, Yujun Shi, Li Su
OBJECTIVE: The decreased expression of muscle-specific microRNA-1 (miR-1) has been found in many cardiovascular diseases and is considered to contribute to heart failure (HF). Here we investigated the role of miR-1 in myocardium protection by infusion of miR-1 in a cardiac global miRNA-deficient mouse. METHODS: We generated a cardiac-selective miRNA-deficient mouse by crossing Dicer(flox/flox) mice with mice expressing tamoxifen-inducible Cre recombinase under the control of a mouse αMHC promoter...
November 5, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29113815/evaluation-of-left-ventricular-diastolic-function-by-the-intensivist
#12
REVIEW
Yonatan Y Greenstein, Paul H Mayo
The assessment of left ventricular diastolic function is an important element of advanced critical care echocardiography. Standard methods of evaluating diastolic function that are routinely performed on an elective basis in the cardiology echocardiography laboratory may be difficult to apply in the critical care unit. In this article, we review methods of measuring diastolic function with echocardiography that are of relevance to the intensivist and present two options for measurement: the standard cardiology method and a simplified approach...
November 4, 2017: Chest
https://www.readbyqxmd.com/read/29107407/transesophageal-echocardiography-guidelines-for-point-of-care-applications-in-cardiac-arrest%C3%A2-resuscitation
#13
James Fair, Michael Mallin, Haney Mallemat, Joshua Zimmerman, Robert Arntfield, Ross Kessler, Jonathan Bailitz, Michael Blaivas
Cardiac arrest is one of the most challenging patient presentations managed by emergency care providers, and echocardiography can be instrumental in the diagnosis, prognosis, and treatment guidance in these critically ill patients. Transesophageal echocardiography has many advantages over transthoracic echocardiography in a cardiac arrest resuscitation. As transesophageal echocardiography is implemented more widely at the point of care during cardiac arrest resuscitations, guidelines are needed to assist emergency providers in acquiring the equipment and skills necessary to successfully incorporate it into the management of cardiac arrest victims...
October 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29080935/echocardiography-in-functional-midgut-neuroendocrine-tumors-when-and-how-often
#14
REVIEW
Javier G Castillo, Tara Naib, Jerome S Zacks, David H Adams
The management of patients with midgut neuroendocrine tumors (MNET) is rapidly evolving. Current preoperative detection rates of primary tumor sites are higher than ever and progression-free survival in patients with already advanced disease is expanding due to the implementation of novel efficacious treatment strategies. This survival benefit may potentially translate into a need for a multidisciplinary approach to an even more heterogenous variety of clinical conditions, among these, carcinoid syndrome (CS) and carcinoid heart disease (CHD)...
October 28, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/29067561/acc-aats-aha-ase-asnc-hrs-scai-scct-scmr-sts-2017-appropriate-use-criteria-for-multimodality-imaging-in-valvular-heart-disease-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery-american
#15
John U Doherty, Smadar Kort, Roxana Mehran, Paul Schoenhagen, Prem Soman
This document is 1 of 2 companion appropriate use criteria (AUC) documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. This document addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas the second, companion document addresses this topic with regard to structural heart disease...
October 24, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29066081/acc-aats-aha-ase-asnc-hrs-scai-scct-scmr-sts-2017-appropriate-use-criteria-for-multimodality-imaging-in-valvular%C3%A2-heart-disease-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery-american
#16
John U Doherty, Smadar Kort, Roxana Mehran, Paul Schoenhagen, Prem Soman, Greg J Dehmer, John U Doherty, Paul Schoenhagen, Zahid Amin, Thomas M Bashore, Andrew Boyle, Dennis A Calnon, Blase Carabello, Manuel D Cerqueira, John Conte, Milind Desai, Daniel Edmundowicz, Victor A Ferrari, Brian Ghoshhajra, Praveen Mehrotra, Saman Nazarian, T Brett Reece, Balaji Tamarappoo, Wendy S Tzou, John B Wong, John U Doherty, Gregory J Dehmer, Steven R Bailey, Nicole M Bhave, Alan S Brown, Stacie L Daugherty, Larry S Dean, Milind Y Desai, Claire S Duvernoy, Linda D Gillam, Robert C Hendel, Christopher M Kramer, Bruce D Lindsay, Warren J Manning, Praveen Mehrotra, Manesh R Patel, Ritu Sachdeva, L Samuel Wann, David E Winchester, Michael J Wolk, Joseph M Allen
This document is 1 of 2 companion appropriate use criteria (AUC) documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. This document addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas the second, companion document addresses this topic with regard to structural heart disease...
October 20, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29064271/effects-of-extracorporeal-cardiopulmonary-resuscitation-on-neurological-and-cardiac-outcome-after-ischaemic-refractory-cardiac-arrest
#17
Francesca Cesana, Leonello Avalli, Laura Garatti, Anna Coppo, Stefano Righetti, Ivan Calchera, Elisabetta Scanziani, Paolo Cozzolino, Cristina Malafronte, Andrea Mauro, Federica Soffici, Endrit Sulmina, Veronica Bozzon, Elena Maggioni, Giuseppe Foti, Felice Achilli
BACKGROUND: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation...
October 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29049339/reliability-of-transcardiopulmonary-thermodilution-cardiac-output-measurement-in-experimental-aortic-valve-insufficiency
#18
Martin Petzoldt, Constantin J Trepte, Jan Ridder, Stefan Maisch, Philipp Klapsing, Jan F Kersten, Hans Peter Richter, Jens C Kubitz, Daniel A Reuter, Matthias S Goepfert
BACKGROUND: Monitoring cardiac output (CO) is important to optimize hemodynamic function in critically ill patients. The prevalence of aortic valve insufficiency (AI) is rising in the aging population. However, reliability of CO monitoring techniques in AI is unknown. The aim of this study was to investigate the impact of AI on accuracy, precision, and trending ability of transcardiopulmonary thermodilution-derived COTCPTD in comparison with pulmonary artery catheter thermodilution COPAC...
2017: PloS One
https://www.readbyqxmd.com/read/29047005/identification-of-valve-related-artifact-during-cardiac-mapping
#19
Krishna Kancharla, Thomas M Munger, Rick A Nishimura, Abhishek Deshmukh, Douglas L Packer, Samuel J Asirvatham, Suraj Kapa
PURPOSE: During cardiac mapping, it is critical to discriminate signals related to cardiac conduction versus those due to mechanical interaction with other cardiac structures such as valves. We sought to define characteristics that could facilitate discrimination of valve artifact from cardiac conduction signals. METHODS: Patients with structurally normal heart undergoing mapping for ventricular arrhythmias arising from the vicinity of the aortic valve between January 2013 and May 2015 were included...
October 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29030027/comparison-of-right-ventricular-measurements-by-perioperative-transesophageal-echocardiography-as-a-predictor-of-hemodynamic-instability-following-cardiac-surgery
#20
Pei-Chi Ting, An-Hsun Chou, Chia-Chih Liao, Victor Chien-Chia Wu, Feng-Chun Tsai, Jaw-Ji Chu, Min-Wen Yang, Shi-Chuan Chang
BACKGROUND: The relationship between perioperative right ventricular (RV) performance and hemodynamic instability after cardiac surgery seemed less portrayed. Therefore, we sought to elucidate this relationship and compare the accuracy of different RV systolic indices in predicting outcome of cardiac surgery. METHODS: This study enrolled consecutive patients referred for cardiac surgeries. Exclusion criteria were non-sinus rhythm or contraindications to transesophageal echocardiography (TEE)...
October 10, 2017: Journal of the Chinese Medical Association: JCMA
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