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Central Venous Pressure

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https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#1
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28729141/effects-of-transjugular-intrahepatic-portosystemic-shunt-tips-on-blood-volume-distribution-in-patients-with-cirrhosis
#2
Troels M Busk, Flemming Bendtsen, Jens H Henriksen, Stefan Fuglsang, Jens O Clemmesen, Fin S Larsen, Søren Møller
BACKGROUND: Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. AIMS: To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. METHODS: Thirteen cirrhotic patients had their regional blood volume distribution determined with gamma-camera technique before and after TIPS...
June 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28727900/head-midline-position-for-preventing-the-occurrence-or-extension-of-germinal-matrix-intraventricular-hemorrhage-in-preterm-infants
#3
REVIEW
Olga Romantsik, Maria Grazia Calevo, Matteo Bruschettini
BACKGROUND: Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular venous drainage on the ipsilateral side while increasing intracranial pressure and cerebral blood volume. Thus, it has been suggested that cerebral venous pressure is reduced and hydrostatic brain drainage improved if the patient is in supine midline position with the bed tilted 30°...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#4
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28725290/the-discovery-of-the-flammer-syndrome-a-historical-and-personal-perspective
#5
REVIEW
Josef Flammer, Katarzyna Konieczka
This review describes the clinical and basic research that led to the description of Flammer syndrome. It is narrated from a personal perspective. This research was initiated by the observation of an increased long-term fluctuation of visual fields in a subgroup of glaucoma patients. As these patients had strikingly cold hands, peripheral blood flow was tested with a capillary microscopy, and vasospastic syndrome (VS) was diagnosed. Further studies on these patients revealed frequently weakened autoregulation of ocular blood flow and increased flow resistivity in retroocular vessels...
June 2017: EPMA Journal
https://www.readbyqxmd.com/read/28711320/liver-stiffness-measurement-by-transient-elastography-predicts-late-posthepatectomy-outcomes-in-patients-undergoing-resection-for-hepatocellular-carcinoma
#6
Muthukumarassamy Rajakannu, Daniel Cherqui, Oriana Ciacio, Nicolas Golse, Gabriella Pittau, Marc Antoine Allard, Teresa Maria Antonini, Audrey Coilly, Antonio Sa Cunha, Denis Castaing, Didier Samuel, Catherine Guettier, René Adam, Eric Vibert
BACKGROUND: Postoperative hepatic decompensation is a serious complication of liver resection in patients undergoing hepatectomy for hepatocellular carcinoma. Liver fibrosis and clinical significant portal hypertension are well-known risk factors for hepatic decompensation. Liver stiffness measurement is a noninvasive method of evaluating hepatic venous pressure gradient and functional hepatic reserve by estimating hepatic fibrosis. Effectiveness of liver stiffness measurement in predicting persistent postoperative hepatic decompensation has not been investigated...
July 12, 2017: Surgery
https://www.readbyqxmd.com/read/28701597/randomized-comparative-study-of-intravenous-infusion-of-three-different-fixed-doses-of-milrinone-in-pediatric-patients-with-pulmonary-hypertension-undergoing-open-heart-surgery
#7
Neeraj Kumar Barnwal, Sanjeeta Rajendra Umbarkar, Manjula Sudeep Sarkar, Raylene J Dias
BACKGROUND: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone. METHODOLOGY: Patients were randomized into three groups...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28694355/peripheral-venous-pressure-measurements-in-patients-with-acute-decompensated-heart-failure-pvp-hf
#8
Brett W Sperry, Joseph Campbell, Marat Yanavitski, Samir Kapadia, W H Wilson Tang, Mazen Hanna
BACKGROUND: Accurate assessment of volume status is essential in diagnosis and guidance of decongestive therapy in patients with acute heart failure. We sought to compare peripheral venous pressure (PVP) with central venous pressure (CVP), as well as other invasive hemodynamic measurements, in patients hospitalized with an acute heart failure syndrome. METHODS AND RESULTS: PVP-HF (Peripheral Venous Pressure Measurements in Patients With Acute Decompensated Heart Failure) was a single-center prospective study, which enrolled patients admitted with acute heart failure, regardless of ejection fraction or disease pathogenesis...
July 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28690287/stroke-volume-variation-svv-and-pulse-pressure-variation-ppv-as-indicators-of-fluid-responsiveness-in-sevoflurane-anesthetized-mechanically-ventilated-euvolemic-dogs
#9
Yusuke Endo, Jun Tamura, Tomohito Ishizuka, Takaharu Itami, Kiwamu Hanazono, Kenjiro Miyoshi, Tadashi Sano, Kazuto Yamashita, William W Muir
Changes in stroke volume variation (SVV) and pulse pressure variation (PPV) in response to fluid infusion were experimentally evaluated during vecuronium infusion and sevoflurane anesthesia in 5 adult, mechanically ventilated, euvolemic, beagle dogs. Sequential increases in central venous pressure (CVP; 3-7[baseline], 8-12, 13-17, 18-22 and 23-27 mmHg) were produced by infusing lactated Ringer's solution and 6% hydroxyethyl starch solution. Heart rate (beats/min), right atrial pressure (RAP, mmHg), pulmonary arterial pressure (PAP, mmHg), pulmonary capillary wedge pressure (PCWP, mmHg), transpulmonary thermodilution cardiac output (TPTDCO, L/min), stroke volume (SV, ml/beat), arterial blood pressure (ABP, mmHg), extravascular lung water (EVLW, ml), pulmonary vascular permeability index (PVPI, calculated), SVV (%), PPV (%) and systemic vascular resistance (SVR, dynes/sec/cm(5)) were determined at each predetermined CVP range...
July 10, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28682992/connection-of-a-renal-replacement-therapy-or-plasmapheresis-device-to-the-ecmo-circuit
#10
Florent Laverdure, Laurent Masson, Guillaume Tachon, Julien Guihaire, François Stephan
In patients under extracorporeal membrane oxygenation (ECMO) support requiring renal replacement therapy or plasmapheresis, connecting such extracorporeal therapy device to the ECMO circuit provides many advantages compared with central venous catheterization. However, high pressures of the ECMO circuit limit the usefulness of this technique. We propose a new approach to connect extracorporeal therapy lines to the ECMO circuit. Inlet line is connected to the oxygenator, and outlet line is connected either to the femoral artery antegrade perfusion cannula in case of venoarterial ECMO or to the lateral vent of the return cannula in case of venovenous ECMO...
July 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28674631/liver-stiffness-assessed-by-fibrosis-4-index-predicts-mortality-in-patients-with-heart-failure
#11
Yu Sato, Akiomi Yoshihisa, Yuki Kanno, Shunsuke Watanabe, Tetsuro Yokokawa, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Shu-Ichi Saitoh, Yasuchika Takeishi
OBJECTIVE: Liver dysfunction due to heart failure (HF) is known as congestive hepatopathy. It has recently been reported that liver stiffness assessed by transient elastography reflects increased central venous pressure. The Fibrosis-4 (FIB4) index (age (years) × aspartate aminotransferase (IU/L)/platelet count (10(9)/L) × square root of alanine aminotransferase (IU/L)) is expected to be useful for evaluating liver stiffness in patients with non-alcoholic fatty liver disease. We aimed to investigate the impact of the FIB4 index on HF prognosis, with consideration for liver fibrosis markers and underlying cardiac function...
2017: Open Heart
https://www.readbyqxmd.com/read/28673814/comparison-between-pressure-regulated-volume-controlled-and-volume-controlled-ventilation-on-oxygenation-parameters-airway-pressures-and-immune-modulation-during-thoracic-surgery
#12
Khaled Mahmoud, Amany Ammar, Zeinab Kasemy
OBJECTIVES: To compare 2 different ventilatory strategies: pressure-regulated volume-controlled (PRVC) versus volume-controlled ventilation during thoracotomy. DESIGN: Prospective randomized study. SETTING: University hospital. PARTICIPANTS: The study comprised 70 adult patients undergoing thoracic surgery. INTERVENTIONS: Evaluation of oxygenation parameters, airway pressures, and immune modulation...
March 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28673382/rational-use-of-dopamine-in-hypotensive-newborns-improving-our-understanding-of-the-effect-on-cerebral-autoregulation
#13
Vibeke Ramsgaard Eriksen
Hypotension in critically ill newborn infants is associated with higher mortality and higher risk of cerebral injuries. Yet treating hypotension has never been shown to improve outcomes. In fact, some studies have found that hypotensive newborn infants who were treated with dopamine fared worse than a comparable group of newborn infants who were not. Therefore, a concern has been raised that dopamine might cause the observed adverse outcomes. Cerebral autoregulation is a protective mechanism that maintains a fairly constant cerebral blood flow despite fluctuations in blood pressure...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28669704/low-pressure-robot-assisted-radical-prostatectomy-with-the-airseal-system-at-olv-hospital-results-from-a-prospective-study
#14
Sabrina La Falce, Giacomo Novara, Giorgio Gandaglia, Paolo Umari, Geert De Naeyer, Frederiek D'Hondt, Jean Beresian, Rik Carette, Martin Penicka, Yujiing Mo, Geert Vandenbroucke, Alexandre Mottrie
BACKGROUND: Limited studies examined effects of pneumoperiotneum during robot-assisted radical prostatectomy (RARP) and with AirSeal. The aim of this study was to assess the effect on hemodynamics of a lower pressure pneumoperitoneum (8 mmHg) with AirSeal, during RARP in steep Trendelenburg 45° (ST). MATERIALS AND METHODS: This is an institutional review board-approved, prospective, interventional, single-center study including patients treated with RARP at OLV Hospital by one extremely experienced surgeon (July 2015-February 2016)...
June 2, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28666246/the-correlation-between-cvp-derived-parameters-and-the-prognosis-of-critically-ill-patients
#15
Xiaoting Wang, Huan Chen, Dawei Liu, Qing Zhang, Longxiang Su
OBJECTIVE: To investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically ill patients. METHODS: We conducted a retrospective observational cohort study of 488 ICU patients with central venous pressure and its derived parameters in a half-year period in one single ICU centre to compare the length of ICU stay, critical illness scores (SOFA and APACHE II), serum creatinine and lactate levels. RESULTS: The initial, peak and mean CVP levels of critically ill patients and length of ICU stay, peak lactate levels and SOFA scores were significantly correlated...
March 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28665469/central-venous-pressure-monitoring-via-peripherally-or-centrally-inserted-central-catheters-a-systematic-review-and-meta-analysis
#16
Filippo Sanfilippo, Alberto Noto, Gennaro Martucci, Marco Farbo, Gaetano Burgio, Daniele G Biasucci
INTRODUCTION: The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant...
June 23, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28647800/safety-and-effectiveness-of-tolvaptan-for-fluid-management-after-pediatric-cardiovascular-surgery
#17
Yuzo Katayama, Tsukasa Ozawa, Noritsugu Shiono, Hiroshi Masuhara, Takeshiro Fujii, Yoshinori Watanabe
BACKGROUND: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery. METHODS AND RESULTS: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28643321/global-end-diastolic-volume-could-be-more-appropiate-to-reduce-intraoperative-bleeding-than-central-venous-pressure-during-major-liver-transection
#18
Francisco Javier Redondo, Dawid Padilla, Ruben Villazala, Pedro Villaeiro, Victor Baladron, Natalia Bejerano
BACKGROUND: Central venous pressure often fails to identify the true value of cardiac preload. Our purpose is to investigate whether Global End-Diastolic Volume (GEDV) values can control hemodynamic parameters for the measurement of fluid volume, cardiac preload and blood loss during liver transection. METHODS: This was a prospective clinical study that included patients undergoing liver resection. All patients were monitored by means of PiCCO technology and 222 hemodynamic measurements were performed in 74 patients...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28641607/the-use-of-nesiritide-in-patients-with-critical-cardiac-disease
#19
Ronald A Bronicki, Michele Domico, Paul A Checchia, Curtis E Kennedy, Ayse Akcan-Arikan
OBJECTIVE: We evaluated the use of nesiritide in children with critical CHD, pulmonary congestion, and inadequate urine output despite undergoing conventional diuretic therapy. DESIGN: We conducted a retrospective analysis of 11 patients with critical CHD, comprising 18 infusions, each of which occurred during separate hospitalisations. Haemodynamic parameters were assessed, and the stage of acute kidney injury was determined before and throughout the duration of therapy using a standardised definition of acute kidney injury - The Kidney Disease: Improving Global Outcomes criteria...
June 23, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28634780/echocardiographic-inferior-vena-cava-measurement-as-an-alternative-to-central-venous-pressure-measurement-in-neonates
#20
Muzamil Mustafa Mugloo, Seema Malik, Rubeena Akhtar
OBJECTIVES: To evaluate the correlation between echocardiographic inferior vena cava (IVC) measurements and central venous pressure (CVP) in neonates. Also, to evaluate the correlation between IVC measurements and gestational age (GA) and body weight (BW). METHODS: This cross sectional analytical study was conducted from June 2014 through June 2016 in a level III NICU. All neonates requiring intensive hemodynamic monitoring and having umbilical venous catheter (UVC) in place for clinical indications were enrolled in the study...
June 21, 2017: Indian Journal of Pediatrics
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