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Central Venous Pressure

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https://www.readbyqxmd.com/read/28441238/diaphragm-activation-in-ventilated-patients-using-a-novel-transvenous-phrenic-nerve-pacing-catheter
#1
Steven Reynolds, Adrian Ebner, Tracy Meffen, Viral Thakkar, Matt Gani, Kaity Taylor, Linda Clark, Gautam Sadarangani, Ramasamy Meyyappan, Rodrigo Sandoval, Elizabeth Rohrs, Joaquín A Hoffer
OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437324/noncirrhotic-portal-fibrosis-in-pediatric-population
#2
Vikrant Sood, Bikrant B Lal, Rajeev Khanna, Dinesh Rawat, Chhagan Bihari, Seema Alam
OBJECTIVES: Noncirrhotic portal fibrosis (NCPF) has been classically described as a disease of young to middle age with limited literature regarding its occurrence, onset, or clinical presentation in children. We hereby present a series of 19 patients diagnosed and managed as NCPF in pediatric age group. METHODS: A retrospective review of all the patients presenting to the pediatric hepatology department (age <18 years) and diagnosed as NCPF was done and data were evaluated...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28435003/the-hemodynamic-effects-of-aortic-insufficiency-in-patients-supported-with-continuous-flow-left-ventricular-assist-devices
#3
Gabriel Sayer, Nitasha Sarswat, Gene H Kim, Sirtaz Adatya, Diego Medvedofsky, Daniel Rodgers, Eric Kruse, Takeyoshi Ota, Valluvan Jeevanandam, Roberto Lang, Nir Uriel
BACKGROUND: The impact of aortic insufficiency (AI) on the morbidity and mortality of left ventricular assist device (LVAD) patients remains controversial. This study's aim is to assess the hemodynamics of LVAD patients with at least mild AI, at baseline and in response to device speed changes. METHODS: Asymptomatic LVAD patients were prospectively enrolled and underwent a hemodynamic and echocardiographic ramp study. Hemodynamics at rest and in response to device speed changes were compared between patients with at least mild AI at their baseline speed and patients without AI...
April 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28429120/the-influence-of-pump-rotation-speed-on-hemodynamics-and-myocardial-oxygen-metabolism-in-left-ventricular-assist-device-support-with-aortic-valve-regurgitation
#4
Kei Iizuka, Tomohiro Nishinaka, Yoshiaki Takewa, Kenji Yamazaki, Eisuke Tatsumi
Aortic valve regurgitation (AR) is a serious complication under left ventricular assist device (LVAD) support. AR causes LVAD-left ventricular (LV) recirculation, which makes it difficult to continue LVAD support. However, the hemodynamics and myocardial oxygen metabolism of LVAD support with AR have not been clarified, especially, how pump rotation speed influences them. An animal model of LVAD with AR was newly developed, and how pump rotation speed influences hemodynamics and myocardial oxygen metabolism was examined in acute animal experiments...
April 20, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28421732/comparison-of-absolute-fluid-restriction-versus-relative-volume-redistribution-strategy-in-low-central-venous-pressure-anesthesia-in-liver-resection-surgery-a-randomized-controlled-trial
#5
Jan Zatloukal, Richard Pradl, Jakub Kletečka, Tomáš Skalický, Václav Liška, Jan Benes
BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17)...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28420471/-mixed-venous-arterial-carbon-dioxide-difference-combined-with-passive-leg-raising-in-guiding-volume-management-for-patients-post-off-pump-coronary-artery-bypass-grafting
#6
Likun Huo, Peijun Li, Chang Xie, Chenglei Yan, Jie Li
OBJECTIVE: To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG). METHODS: Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28414672/a-strong-and-fortuitous-case-of-dyspnea
#7
R Hammer, M Sciaudone
CASE: A 48 year-old man with no past medical history was sent to our emergency department (ED); from a primary care clinic for hypertensive urgency of 200/130. The man reported an intermittent non-productive cough of approximately one year's duration and worsening dyspnea on exertion and orthopnea over the last month with lower extremity swelling. Of note, he emigrated from Honduras twenty years ago. Blood pressure normalized with administration of Lasix in the ED. Physical exam revealed rales in lung bases bilaterally, jugular venous distension, lower extremity pitting edema with serpiginous patches of erythema and excoriation, and a cardiac gallop...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28407637/pneumatic-compression-but-not-exercise-can-avoid-intradialytic-hypotension-a-randomized-trial
#8
Valeria R C Álvares, Camila D Ramos, Benedito J Pereira, Ana Lucia Pinto, Rosa M A Moysés, Bruno Gualano, Rosilene M Elias
BACKGROUND: Conventional hemodialysis (HD) is associated with dialysis-induced hypotension (DIH) and ineffective phosphate removal. As the main source of extracellular fluid removed during HD are the legs, we sought to reduce DIH and increase phosphate removal by using cycling and pneumatic compression, which would potentially provide higher venous return, preserving central blood flow and also offering more phosphate to the dialyzer. METHODS: We evaluated 21 patients in a randomized crossover fashion in which each patient underwent 3 different HD: control; cycling exercise during the first 60 min; and pneumatic compression during the first 60 min...
April 14, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28401790/comparison-of-iodixanol-and-iopromide-in-patients-with-renal-insufficiency-and-congestive-heart-failure-undergoing-coronary-angiography-by-hemodynamic-monitoring
#9
Geng Qian, Yong-Qiang Yang, Wei Dong, Feng Cao, Yun-Dai Chen
We investigated the impact of contrast media (CM) with different osmolality on cardiac preload in patients with chronic kidney disease (CKD) and congestive heart failure (CHF). Patients with CKD and CHF were equally randomized to receive either iso-osmolar contrast media (IOCM) iodixanol or low-osmolar contrast media iopromide. We measured cardiac preload indexes by invasive hemodynamic monitoring before and after CM injection. Major adverse cardiac events postprocedures were recorded. Increase in extravascular lung water index was only seen in the iopromide group ( P < ...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28396638/physiological-mechanisms-mediating-the-coupling-between-heart-period-and-arterial-pressure-in-response-to-postural-changes-in-humans
#10
Alessandro Silvani, Giovanna Calandra-Buonaura, Blair D Johnson, Noud van Helmond, Giorgio Barletta, Anna G Cecere, Michael J Joyner, Pietro Cortelli
The upright posture strengthens the coupling between heart period (HP) and systolic arterial pressure (SAP) consistently with a greater contribution of the arterial baroreflex to cardiac control, while paradoxically decreasing cardiac baroreflex sensitivity (cBRS). To investigate the physiological mechanisms that mediate the coupling between HP and SAP in response to different postures, we analyzed the cross-correlation functions between low-frequency HP and SAP fluctuations and estimated cBRS with the sequence technique in healthy male subjects during passive head-up tilt test (HUTT, n = 58), during supine wakefulness, supine slow-wave sleep (SWS), and in the seated and active standing positions (n = 8), and during progressive loss of 1 L blood (n = 8) to decrease central venous pressure in the supine position...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28393776/serial-semi-invasive-hemodynamic-assessment-following-pericardiectomy-for-chronic-constrictive-pericarditis
#11
Ujjwal Kumar Chowdhury, Poonam Malhotra Kapoor, Adil Rizvi, Vishwas Malik, Sandeep Seth, Rajiv Narang, Mani Kalaivani, Sarvesh Pal Singh, Sathiya Selvam
OBJECTIVES: This study was designed to prospectively investigate the effects of pericardiectomy via median sternotomy on intra- and postoperative hemodynamics by a new semi-invasive device (Flotrac/VigileoTM monitor) using arterial pressure waveform analysis. PATIENTS AND METHODS: Thirty consecutive patients aged 15 to 55 years (mean+SD, 31.73 + 13.53 years), who had undergone total pericardiectomy via median sternotomy underwent serial hemodynamic evaluation. FlotracTM Sensor - derived stroke volume, stroke volume variation, systemic vascular resistance index (SVRI), cardiac index and right atrial pressure were measured just before and after pericardiectomy, at 12 hours, 24 hours, 48 hours, 72 hours and at discharge postoperatively...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28387886/distinctive-effect-of-6-hydroxyethyl-starch-130-0-4-voluven-infusion-on-pediatric-patients-with-congenital-heart-disease
#12
J-Z Zhang, J-S Liu, S-H Zhang, S-Y Huang, J-J Zhang, J Zhou, J-H Zhou
OBJECTIVE: It has not been clear that Voluven (6% hydroxyethyl starch 130/0.4) may be administered in pediatric patients safely. The purpose of this study was to determine if Voluven could be used for blood volume expansion and hypovolemia prevention in pediatric patients with congenital heart disease. PATIENTS AND METHODS: 50 pediatric patients with congenital heart disease were recruited in the study. Circulatory and respiratory parameters were determined to monitor the responses to intravenous infusion of Voluven in the patients...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28376950/impact-of-the-location-of-the-fenestration-on-fontan-circulation-haemodynamics-a-three-dimensional-computational-model-study
#13
Koichi Sughimoto, Yuta Asakura, Christian P Brizard, Fuyou Liang, Takashi Fujiwara, Kagami Miyaji, Hao Liu
OBJECTIVES: There is no consensus or theoretical explanation regarding the optimal location for the fenestration during the Fontan operation. We investigated the impact of the location of the fenestration on Fontan haemodynamics using a three-dimensional Fontan model in various physiological conditions. METHODS: A three-dimensional Fontan model was constructed on the basis of CT images, and a 4-mm-diameter fenestration was located between the extracardiac Fontan conduit and the right atrium at three positions: superior, middle, and inferior part of the conduit...
April 5, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28376626/waldmann-s-disease-a-rare-cause-of-protein-losing-enteropathy-in-an-adult-patient
#14
Cláudio Rodrigues Martins, Alice Gagnaire, Florian Rostain, Come Lepage
Primary intestinal lymphangiectasia or Waldmann's disease is an uncommon cause of protein losing enteropathy with an unknown etiology and is usually diagnosed during childhood. It is characterized by dilation and leakage of intestinal lymph vessels leading to hypoalbuminemia, hypogammaglobulinemia and lymphopenia. Differential diagnosis should include erosive and non-erosive gastrointestinal disorders, conditions involving mesenteric lymphatic obstruction and cardiovascular disorders that increase central venous pressure...
April 5, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28371908/acute-right-ventricular-resynchronization-improves-haemodynamics-in-children-after-surgical-repair-of-tetralogy-of-fallot
#15
Pavel Vojtovic, Filip Kucera, Peter Kubuš, Roman Gebauer, Tomáš Matejka, Tomáš Tláskal, Miroslav Ložek, Jan Kovanda, Jan Janoušek
Aims: Right bundle branch block is associated with right ventricular (RV) electromechanical dyssynchrony, which may contribute to acute haemodynamic impairment after repair of tetralogy of Fallot (ToF). We sought to evaluate the effects of RV resynchronization on haemodynamics and tissue oxygenation during the first 24 h after surgery. Methods and results: Arterial pressures, cardiac output, and tissue oxygenation were measured in 28 consecutive patients (median age 10...
March 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28371221/prediction-of-right-ventricular-failure-after-ventricular-assist-device-implant-systematic-review-and-meta-analysis-of-observational-studies
#16
REVIEW
Diego Bellavia, Attilio Iacovoni, Cesare Scardulla, Lorenzo Moja, Michele Pilato, Sudhir S Kushwaha, Michele Senni, Francesco Clemenza, Valentina Agnese, Calogero Falletta, Giuseppe Romano, Joseph Maalouf, Michael Dandel
Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is associated with increased morbidity and mortality, but the identification of LVAD candidates at risk for RVF remains challenging. We undertook a systematic review and meta-analysis of observational studies of risk factors associated with RVF after LVAD implant. Thirty-six studies published between 1 January 1995 and 30 April 2015, comprising 995 RVF patients out of a pooled final population of 4428 patients, were identified...
March 31, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28367009/trauma-patients-warrant-upper-and-lower-extremity-venous-duplex-ultrasound-surveillance
#17
Alonso Andrade, Alan H Tyroch, Susan F McLean, Jody Smith, Alex Ramos
BACKGROUND: Due to the high incidence of thromboembolic events (deep venous thrombosis [DVT] and pulmonary embolus [PE]) after injury, many trauma centers perform lower extremity surveillance duplex ultrasounds. We hypothesize that trauma patients are at a higher risk of upper extremity DVTs (UEDVTs) than lower extremity DVTs (LEDVTs), and therefore, all extremities should be evaluated. MATERIALS AND METHODS: A retrospective chart and trauma registry review of Intensive Care Unit trauma patients with upper and LEDVTs detected on surveillance duplex ultrasound from January 2010 to December 2014 was carried out...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28366285/a-review-of-hemodynamic-monitoring-techniques-methods-and-devices-for-the-emergency-physician
#18
Abdullah E Laher, Matthew J Watermeyer, Sean K Buchanan, Nicole Dippenaar, Nelly Clotilde Tchouambou Simo, Feroza Motara, Muhammed Moolla
The emergency department (ED) is frequently the doorway to the intensive care unit (ICU) for a significant number of critically ill patients presenting to the hospital. Hemodynamic monitoring (HDM) which is a key component in the effective management of the critically ill patient presenting to the ED, is primarily concerned with assessing the performance of the cardiovascular system and determining the correct therapeutic intervention to optimise end-organ oxygen delivery. The spectrum of hemodynamic monitoring ranges from simple clinical assessment and routine bedside monitoring to point of care ultrasonography and various invasive monitoring devices...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28365215/mean-arterial-pressure-to-central-venous-pressure-ratio-a-novel-marker-for-right-ventricular-failure-after-left-ventricular-assist-device-placement
#19
Burhan Mohamedali, Rami Doukky, Kelly Karavalos, Elizabeth Avery, Geetha Bhat
BACKGROUND: Early right ventricular failure (RVF) is common after left ventricular assist device (LVAD) implantation and often leads to increased morbidity and mortality. It is difficult to predict early RVF on the basis of clinical and hemodynamic parameters. We investigated the utility of mean arterial pressure (MAP) to central venous pressure (CVP) ratio in predicting early RVF. METHOD: We analyzed a retrospective cohort of 212 consecutive patients who underwent hemodynamic assessment prior to destination therapy LVAD implantation...
March 29, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28363617/exploring-the-best-predictors-of-fluid-responsiveness-in-patients-with-septic-shock
#20
Nianfang Lu, Xiuming Xi, Li Jiang, Degang Yang, Kai Yin
OBJECTIVE: To evaluate respiratory variations in carotid and brachial peak velocity and other hemodynamic parameters to predict responsiveness to fluid challenge. METHODS: A prospective observational study was performed on mechanically ventilated patients with septic shock. Outcomes included the measurements of central venous pressure, intrathoracic blood volume index, stroke volume variation (SVV), pleth variability index(PVI), and ultrasound assessments of respiratory variations in inferior vena cava diameter (ΔIVC), carotid Doppler peak velocity (ΔCDPV), and brachial artery peak velocity (ΔVpeak brach)...
March 22, 2017: American Journal of Emergency Medicine
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