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Critical echocardiography

W P de Boode, M Kluckow, P J McNamara, S Gupta
Neonatologist-performed echocardiography (NPE) is an indispensable tool in the haemodynamic management of critically ill newborn infants. NPE is used to facilitate timely diagnosis of a patent ductus arteriosus (PDA) in preterm infants and to assess its haemodynamic significance. Before treatment is considered, it is obligatory to confirm structural cardiac normality. Importantly, NPE offers the ability to guide therapeutic interventions, allowing an individualised haemodynamic management approach to the PDA...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
Ayan R Patel, Lissa Sugeng, Ben A Lin, Mikel D Smith, Vincent L Sorrell
No abstract text is available yet for this article.
March 13, 2018: Journal of the American Society of Echocardiography
James A Crowhurst, Gregory M Scalia, Mark Whitby, Dale Murdoch, Brendan J Robinson, Arianwen Turner, Liesie Johnston, Swaroop Margale, Sarvesh Natani, Andrew Clarke, Darryl J Burstow, Owen C Raffel, Darren L Walters
BACKGROUND: Transesophageal echocardiography operators (TEEOP) provide critical imaging support for percutaneous structural cardiac intervention procedures. They stand close to the patient and the associated scattered radiation. OBJECTIVES: This study sought to investigate TEEOP radiation dose during percutaneous structural cardiac intervention. METHODS: Key personnel (TEEOP, anesthetist, primary operator [OP1], and secondary operator) wore instantly downloadable personal dosimeters during procedures requiring TEE support...
March 20, 2018: Journal of the American College of Cardiology
Mehrshad Vafaie, Matthias Hochadel, Thomas Münzel, Birgit Hailer, Burghard Schumacher, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Michael Haude, Sebastian Barth, Claus Schmitt, Harald Darius, Lars S Maier, Hugo A Katus, Jochen Senges, Evangelos Giannitsis
BACKGROUND: Since 2008, the German Cardiac Society certified 256 Chest Pain Units (CPUs). Little is known about adherence to recommended performance measures in patients with suspected acute coronary syndrome (ACS) presenting to CPUs. We investigated guideline-adherence regarding critical time intervals and selected performance measures in German Chest Pain Units. METHODS: From 2008 to 2014, 23,804 consecutive patients with suspected ACS were prospectively enrolled in the Chest Pain Unit registry of the German Cardiac Society...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Jasper M Smit, Reinder Raadsen, Michiel J Blans, Manfred Petjak, Peter M Van de Ven, Pieter R Tuinman
BACKGROUND: Insertion of a central venous catheter (CVC) is common practice in critical care medicine. Complications arising from CVC placement are mostly due to a pneumothorax or malposition. Correct position is currently confirmed by chest x-ray, while ultrasonography might be a more suitable option. We performed a meta-analysis of the available studies with the primary aim of synthesizing information regarding detection of CVC-related complications and misplacement using ultrasound (US)...
March 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
Silvia G V Alvarez, Angela McBrien
The ductus arteriosus (DA) is a crucial part of the fetal circulation, both in the normal fetus and in critical congenital heart disease (CHD). It allows shunting between the pulmonary and systemic circulations. In physiological prenatal conditions, the DA lets the majority of right ventricular output bypass the fluid-filled, high-resistance lungs. The DA can cause hemodynamic compromise in the fetus and neonate when constricted or absent (in isolation or in patients with CHD) and may lead to pre- or postnatal sequelae within other systems when forming part of a vascular ring...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
Fang Qiu, Changjiang Dong, Yanxin Liu, Xiaoqi Shao, Di Huang, Yanna Han, Bing Wang, Yanli Liu, Rong Huo, Petro Paulo, Zhiren Zhang, Dan Zhao, Wen-Feng Chu
BACKGROUND AND PURPOSE: Protein modification by small ubiquitin-like modifier (SUMO) plays a critical role in the pathogenesis of heart diseases. The present study was designed to determine whether ginkgolic acid (GA) as a SUMO-1 inhibitor exerts an inhibitory effect on cardiac fibrosis induced by myocardial infarction (MI). EXPERIMENTAL APPROACH: GA was delivered by osmotic pumps in MI mice. Masson staining, electron microscopy (EM) and echocardiography were used to assess cardiac fibrosis, ultrastructure and function...
March 7, 2018: Toxicology and Applied Pharmacology
Yuka Matsunaga, Masataka Ishimura, Hazumu Nagata, Kiyoshi Uike, Tadamune Kinjo, Masayuki Ochiai, Kenichiro Yamamura, Hidetoshi Takada, Yoshihisa Tanoue, Masaki Hayakawa, Masanori Matsumoto, Toshiro Hara, Shouichi Ohga
BACKGROUND: Thrombotic microangiopathies (TMA) are microvascular occlusive disorders characterized by systemic or intrarenal platelet aggregation, thrombocytopenia, and red cell fragmentation. Post-operative TMA mostly occurs in adult patients with cardiovascular surgery, with the distinct pathophysiology from classical thrombotic thrombocytopenic purpura (TTP) although the exact pathophysiology remains unclear. CASE PRESENTATION: A one-month-old infant developed TMA after the initial surgery of double outlet right ventricle...
February 7, 2018: Pediatrics and Neonatology
Udaya Ralapanawa, Thilak Jayalath, Dhanusha Senadhira
BACKGROUND: Acute pancreatitis is an inflammatory condition with varying severity and a range of local and systemic complications. Here we report a patient with acute necrotizing pancreatitis complicated with a true non ST elevation myocardial infarction. CASE PRESENTATION: A 58 year old lady was admitted to our unit with acute onset epigastric pain and vomiting for 4 h duration. Following admission she complained of retrosternal tightening type of a chest pain...
March 9, 2018: BMC Research Notes
Mattia Arrigo
No abstract text is available yet for this article.
March 7, 2018: European Heart Journal
Bharat Kumar, Jennifer Strouse, Melissa Swee, Petar Lenert, Manish Suneja
INTRODUCTION: Hydralazine is an antihypertensive medication that has been associated with drug-induced lupus erythematosus (DIL) as well as ANCA-associated vasculitis (AAV). Although rare, early diagnosis is critical since drug cessation is the mainstay of therapy. This retrospective study aims to characterize the clinical, laboratory, and histopathologic features of this disease. METHODS: Once approval was obtained from the Institutional Review Board at the University of Iowa, all patients carrying a diagnosis of vasculitis (ICD9 code: 447...
January 12, 2018: Seminars in Arthritis and Rheumatism
Renuka E Peterson, Grace Freire, Cynthia J Marino, Saadeh B Jureidini
Right ventricular-dependent coronary circulation (RVDCC) is associated with pulmonary atresia with intact ventricular septum and is defined by two or more epicardial coronary arteries with atresia or severe stenosis resulting in the dependency of coronary supply by retrograde flow. The hypothesis of this study is that coronary Doppler flow patterns on echocardiography can be used to distinguish patients with RVDCC. Between 2007 and 2016, we reviewed 16 patients with pulmonary atresia or critical pulmonary stenosis...
March 8, 2018: Pediatric Cardiology
Mario Boehm, Nadine Arnold, Adam Braithwaite, Josephine Pickworth, Changwu Lu, Tatyana Novoyatleva, David G Kiely, Friedrich Grimminger, Hossein A Ghofrani, Norbert Weissmann, Werner Seeger, Allan Lawrie, Ralph T Schermuly, Baktybek Kojonazarov
BACKGROUND: Aldosterone is a mineralocorticoid hormone critically involved in arterial blood pressure regulation. Although pharmacological aldosterone antagonism reduces mortality and morbidity among patients with severe left-sided heart failure, the contribution of aldosterone to the pathobiology of pulmonary arterial hypertension (PAH) and right ventricular (RV) heart failure is not fully understood. METHODS: The effects of Eplerenone (0.1% Inspra® mixed in chow) on pulmonary vascular and RV remodeling were evaluated in mice with pulmonary hypertension (PH) caused by Sugen5416 injection with concomitant chronic hypoxia (SuHx) and in a second animal model with established RV dysfunction independent from lung remodeling through surgical pulmonary artery banding...
March 2, 2018: BMC Pulmonary Medicine
John Bates McCutcheon, Pascha Schaffer, Matthew Lyon, Richard Gordon
Bedside ultrasound is often used as a part of the evaluation of patients who are critically ill. The McConnell sign is an important echocardiographic finding in some critically ill patients with pulmonary embolism and an acute right ventricular infarct. We present 3 critically ill patients with confirmed acute chest syndrome who showed the McConnell sign on echocardiography. In patients with sickle cell disease presenting with chest pain and shortness of breath, the presence of the McConnell sign does not narrow the differential diagnosis between pulmonary embolism, an acute right ventricular infarct, and acute chest syndrome...
March 2, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Maria N Plana, Javier Zamora, Gautham Suresh, Luis Fernandez-Pineda, Shakila Thangaratinam, Andrew K Ewer
BACKGROUND: Health outcomes are improved when newborn babies with critical congenital heart defects (CCHDs) are detected before acute cardiovascular collapse. The main screening tests used to identify these babies include prenatal ultrasonography and postnatal clinical examination; however, even though both of these methods are available, a significant proportion of babies are still missed. Routine pulse oximetry has been reported as an additional screening test that can potentially improve detection of CCHD...
March 1, 2018: Cochrane Database of Systematic Reviews
C Nafati, M Gardette, M Leone, L Reydellet, V Blasco, A Lannelongue, F Sayagh, S Wiramus, F Antonini, J Albanèse, L Zieleskiewicz
BACKGROUND: In critical patients, left ventricular ejection fraction and fractional shortening are used to reflect left ventricular systolic function. An emerging technique, two-dimensional-strain echocardiography, allows assessment of the left ventricle systolic longitudinal deformation (global longitudinal strain) and the speed at which this deformation occurs (systolic strain rate). This technique is of increasing use in critical patients in intensive care units and in the peri-operative period where preload constantly varies...
February 21, 2018: Annals of Intensive Care
Philippe Vignon
No abstract text is available yet for this article.
February 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
Cosmin Balan, Adrian View-Kim Wong
Catecholamines are entrenched in the management of shock states. A paradigm shift has pervaded the critical care arena in recent years acknowledging their propensity to cause harm and fuel a 'death-spiral'. We present the case of a 21-year-old male following a witnessed out-of-hospital cardiac arrest who received high-quality cardiopulmonary resuscitation and standard advanced life support for refractory ventricular fibrillation until return of spontaneous circulation after 70 min. Early post-admission echocardiography revealed severe diffuse sub-basal left ventricular hypertrophy with dynamic mid-cavity obstruction and akinetic apical pouching...
February 2018: Journal of the Intensive Care Society
Thomas W Carver
OBJECTIVE: Surgical critical care (SCC) fellows are expected to receive training in critical care ultrasound (CCUS) but training is sporadic and there is no standardized curriculum to guide educators. Previous studies show wide variation in CCUS training during fellowship across specialties but SCC has been underrepresented. This study was performed to assess SCC program directors' views regarding CCUS during fellowship training. DESIGN: Adult SCC program directors were surveyed regarding the role of CCUS in fellowship training...
February 12, 2018: Journal of Surgical Education
Wei Sheng Tan, Thomas P Mullins, Melanie Flint, Sarah L Walton, Helle Bielefeldt-Ohmann, David A Carter, Meera R Gandhi, Hayley R McDonald, Joan Li, Karen M Moritz, Melissa E Reichelt, Linda A Gallo
There is an increased incidence of heart failure in individuals with diabetes mellitus (DM). The co-existence of kidney disease in DM exacerbates the cardiovascular prognosis. Researchers have attempted to combine the critical features of heart failure, using transverse aortic constriction, with DM in mice but variable findings have been reported. Furthermore, kidney outcomes have not been assessed in this setting thus its utility as a model of heart failure in DM and kidney disease is unknown. We generated a mouse model of obesity, hyperglycemia and mild kidney pathology by feeding male C57BL/6J mice a high fat diet (HFD)...
February 14, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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