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Central Venous Pressure

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https://www.readbyqxmd.com/read/29240626/first-report-of-biventricular-percutaneous-impella-ventricular-assist-device-use-in-pediatric-patients
#1
Javier J Lasa, Daniel A Castellanos, Susan W Denfield, William J Dreyer, Sebastian C Tume, Henri Justino, Athar M Qureshi
There is a growing interest in the use of percutaneously delivered ventricular assist devices (PVAD) in the pediatric patient population. A 16 year old female and 18 year old male both status post heart transplantation presented with evidence of graft rejection and acute severe global systolic and diastolic heart failure necessitating hemodynamic catheterization and inotropic support. Both underwent percutaneous Impella CP LVAD (Abiomed, Danvers, MA) placement with close monitoring of right ventricular function...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29225809/venous-air-embolism-related-to-the-use-of-central-catheters-revisited-with-emphasis-on-dialysis-catheters
#2
REVIEW
Steve Siu-Man Wong, Hau C Kwaan, Todd S Ing
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29225154/development-of-a-predictive-model-for-blood-transfusions-and-bleeding-during-liver-transplantation-an-observational-cohort-study
#3
Luc Massicotte, François Martin Carrier, André Y Denault, Pierre Karakiewicz, Zoltan Hevesi, Mickael McCormack, Lynda Thibeault, Anna Nozza, Zhe Tian, Michel Dagenais, André Roy
OBJECTIVE: Orthotopic liver transplantation (OLT) frequently is associated with major blood loss and considerable transfusion requirements. The goal of this study was to define the risk factors for multiple transfusions and major bleeding during OLT and to help identify higher risk patients that could benefit from targeted interventions. DESIGN: OLTs were studied for this observational cohort study. SETTING: Community hospital. PARTICIPANTS: A total of 800 consecutive OLTs were studied...
October 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221272/goal-directed-fluid-restriction-using-stroke-volume-variation-and-cardiac-index-during-one-lung-ventilation-a-randomized-controlled-trial
#4
Hui Xu, Shu-Hua Shu, Di Wang, Xiao-Qing Chai, Yan-Hu Xie, Wei-De Zhou
Background: Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). Methods: A Total of 168 patients scheduled for elective thoracoscopic lobectomy under OLV were randomized into the GDFR protocol (group G) or conventional fluid therapy groups (group C)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29209437/retinal-venous-pressure-measurements-in-patients-with-flammer-syndrome-and-metabolic-syndrome
#5
Dominique Mustur, Zakieh Vahedian, Jerome Bovet, Maneli Mozaffarieh
Background: The purpose of this research is to analyze retinal venous pressure (RVP) of both eyes of patients who visited a Swiss ophthalmic practice and compare values among the following groups of patients with primary open-angle glaucoma (POAG), Flammer syndrome (FS), and metabolic syndrome (MetS). Methods: RVP was measured in both eyes of all patients who visited a Swiss ophthalmic practice during March 2016 till November 2016, and the results were analyzed retrospectively...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/29203173/evaluation-of-the-dynamic-predictors-of-fluid-responsiveness-in-dogs-receiving-goal-directed-fluid-therapy
#6
Maja J Drozdzynska, Yu-Mei Chang, Giacomo Stanzani, Ludovic Pelligand
OBJECTIVES: Goal-directed fluid therapy (GDFT) based on pulse pressure variation (PPV) was used in anaesthetized dogs undergoing abdominal surgeries. The aims were 1) to evaluate the success rate of the PPV ≥13% in detecting fluid responsiveness [delta stroke volume (ΔSV) ≥10%]; 2) to assess the correlation between PPV, systolic pressure variation (SPV), Plethysmograph Variability Index (PVI) and central venous pressure (CVP) and 3) to establish the threshold value for the PVI that would predict a PPV value of ≥13% and indirectly discriminate responders from nonresponders to fluid therapy...
June 17, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#7
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201477/a-case-of-advanced-glaucoma-with-increased-episcleral-venous-pressure-in-a-17-year-old-with-eisenmenger-syndrome
#8
Leanne Grech, Adrian Mifsud, Maryanne Caruana, Francis Carbonaro
Eisenmenger syndrome refers to reversal of shunt and central cyanosis due to pulmonary hypertension induced by congenital heart disease with a large systemic-to-pulmonary shunt. We report a case of a 17-year-old man with Eisenmenger syndrome who presented with gradual deterioration in visual acuity and was diagnosed with advanced secondary open angle glaucoma. There have been reports of patients suffering from thrombosis due to hyperviscosity associated with this syndrome; however, to our knowledge, the association of secondary open angle glaucoma with Eisenmenger syndrome has not yet been documented...
2017: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/29198765/increased-pituitary-volumes-in-children-after-fontan-operation-congestion-in-the-other-portal-circulation
#9
Jun Muneuchi, Yusaku Nagatomo, Seigo Okada, Chiaki Iida, Hiromitsu Shirozu, Yuichiro Sugitani, Mamie Watanabe
We performed brain magnetic resonance imaging in 40 patients after the Fontan procedure and 40 control subjects. Pituitary volumes in patients after Fontan were significantly larger than those in the control subjects (472 [425-527] vs 257 [182-311]; P < .0001), and were significantly related to central venous pressure.
November 29, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29183321/effects-of-controlled-hypoxemia-or-hypovolemia-on-global-and-intestinal-oxygenation-and-perfusion-in-isoflurane-anesthetized-horses-receiving-an-alpha-2-agonist-infusion
#10
Klaus Hopster, Liza Wittenberg-Voges, Florian Geburek, Charlotte Hopster-Iversen, Sabine B R Kästner
BACKGROUND: Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia...
November 28, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29183138/-experimental-model-for-cardiogenic-shock-with-pericardial-tamponade
#11
Gábor Bari, Szilárd Szűcs, Dániel Érces, Melinda Ugocsai, Noémi Bozsó, Dóra Balog, Mihály Boros, Gabriella Varga
INTRODUCTION: Pericardial tamponade (PT) is a life-threatening condition, with low cardiac output. The hemodynamic consequences of PT can severely affect the circulation of all tissues, including the microcirculation of the kidneys and the intestinal mucosa. Our aim was to develop a hemodynamically stable and controllable large animal model of PT to study the consequences of cardiogenic shock. METHODS: Two groups of anesthetized vietnamese minipigs (n = 6, both groups) were used...
December 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/29180647/prediction-of-postoperative-outcomes-using-intraoperative-hemodynamic-monitoring-data
#12
Varesh Prasad, Maria Guerrisi, Mario Dauri, Filadelfo Coniglione, Giuseppe Tisone, Elisa De Carolis, Annagrazia Cillis, Antonio Canichella, Nicola Toschi, Thomas Heldt
Major surgeries can result in high rates of adverse postoperative events. Reliable prediction of which patient might be at risk for such events may help guide peri- and postoperative care. We show how archiving and mining of intraoperative hemodynamic data in orthotopic liver transplantation (OLT) can aid in the prediction of postoperative 180-day mortality and acute renal failure (ARF), improving upon predictions that rely on preoperative information only. From 101 patient records, we extracted 15 preoperative features from clinical records and 41 features from intraoperative hemodynamic signals...
November 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29178987/time-to-threshold-as-a-new-indicator-of-circulatory-state-and-prognosis-in-patients-with-pulmonary-embolism
#13
Andreas Gunter Bach, Bettina-Maria Taute, Alexey Surov
BACKGROUND: Bolus tracking is commonly applied in computed tomography pulmonary angiography. The time that it takes for contrast to reach a predefined threshold in the pulmonary artery is called time to threshold (TTT). TTT could be associated with the circulatory state, and ultimately with prognosis in patients with PE. AIM: The purpose of the present study was to examine the correlation of TTT with embolus burden, radiological and clinical parameters of circulatory state, and ultimately with 30-day mortality...
November 16, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29171669/volume-responsiveness-assessed-by-passive-leg-raising-and-a-fluid-challenge-a-critical-review-focused-on-mean-systemic-filling-pressure
#14
K Cooke, R Sharvill, S Sondergaard, A Aneman
This review applied cardiovascular principles relevant to the physiology of venous return in interpreting studies on the utility of a passive leg-raising manoeuvre to identify patients who do (responders) or do not respond to a subsequent intravenous volume challenge with an increase in cardiac output. Values for cardiac output, mean arterial and central venous pressure, and the calculated cardiovascular variables mean systemic filling pressure analogue, heart efficiency, cardiac power indexed by volume state and volume efficiency, before and after passive leg raising as well as before and after fluid volume challenge, were extracted from published studies...
November 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29169604/validation-of-peripherally-inserted-central-catheter-derived-fick-cardiac-outputs-in-patients-with-heart-failure
#15
Kristen M Tecson, Anupama Vasudevan, Amarinder Bindra, Susan M Joseph, Joost Felius, Shelley A Hall, Parag Kale
The pulmonary artery catheter (PAC) remains the gold standard to calculate Fick cardiac outputs (FCOs) in patients with heart failure admitted to the intensive care unit (ICU). The peripherally inserted central catheter (PICC) provides long-term intravenous access and is used outside the ICU; however, there is scant literature validating venous oxygen saturations (VOSs) from PICC lines. Heart failure patients in the ICU with an existing PAC requiring a PICC line to transition were enrolled. Three blood samples were taken per person (1 at PICC, 1 at central venous pressure [CVP], and 1 at distal PAC)...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29163185/orthostatic-intolerance-in-older-persons-etiology-and-countermeasures
#16
REVIEW
Nandu Goswami, Andrew P Blaber, Helmut Hinghofer-Szalkay, Jean-Pierre Montani
Orthostatic challenge produced by upright posture may lead to syncope if the cardiovascular system is unable to maintain adequate brain perfusion. This review outlines orthostatic intolerance related to the aging process, long-term bedrest confinement, drugs, and disease. Aging-associated illness or injury due to falls often leads to hospitalization. Older patients spend up to 83% of hospital admission lying in bed and thus the consequences of bedrest confinement such as physiological deconditioning, functional decline, and orthostatic intolerance represent a central challenge in the care of the vulnerable older population...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29157318/effect-of-clinical-variables-on-the-volume-of-blood-collected-for-blood-cultures-in-an-adult-patient-population
#17
R Logan Jones, Harlan R Sayles, Paul D Fey, Mark E Rupp
OBJECTIVE To identify clinical variables that influence blood culture volume recovery DESIGN Retrospective chart review and linear model analysis SETTING A 621-bed Academic Medical Center with a Clinical Laboratory that processes 20,000+ blood cultures annually and dedicated phlebotomy staff for venipuncture PATIENTS Consecutive patients requiring blood culture METHODS Over a 6-day period, blood volume was determined in 568 culture bottles from 128 unique adult patients, and clinical data from the time of phlebotomy were extracted from hospital electronic medical records...
November 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29151335/comparison-of-tidal-volume-and-deep-breath-preoxygenation-techniquesundergoing-coronary-artery-bypass-graft-surgery-effects-of-hemodynamicresponse-and-arterial-oxygenation
#18
Zafer Taş, Tülay Hoşten, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Ahmet Arıkan, Zeynep Mine Solak
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#19
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#20
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
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